Induced Cardiac Arrest

Björk, Viking Olov; Fors, Bertil

doi:10.1016/s0022-5223(20)31702-5

Cited by 41 publications

(4 citation statements)

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“…It has given advantages in the efficiency of operations in the field of cardiac surgery. Using a new CCC solution at temperatures below 0 °C, will hold an important place in the evolution of cardioplegia [22,23].…”

Section: Improving Surgical Efficiency Using a New CCC Solutionmentioning

confidence: 99%

Innovative CCC Solution for Open Heart Surgery

Shatlyk,

Orazmyrat,

Begench

2024

Act Sci CasRep

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Section: Improving Surgical Efficiency Using a New CCC Solutionmentioning

confidence: 99%

Innovative CCC Solution for Open Heart Surgery

Shatlyk,

Orazmyrat,

Begench

2024

Act Sci CasRep

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“…Despite Melrose enthusiasm, several experimental and human studies soon showed that hyperkalemic solution could lead to left ventricular dysfunction, refractory ventricular fibrillation, and cardiac cell death, which was linked to potassium-related cytotoxicity [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. With so much controversy, hyperkaliaemic cardioplegia was abandoned for many years [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Cardioplegia between Evolution and Revolution: From Depolarized to Polarized Cardiac Arrest in Adult Cardiac Surgery

Francica

Tonelli

Rossetti

et al. 2021

JCM

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Despite current advances in perioperative care, intraoperative myocardial protection during cardiac surgery has not kept the same pace. High potassium cardioplegic solutions were introduced in the 1950s, and in the early 1960s they were soon recognized as harmful. Since that time, surgeons have minimized many of the adverse effects by lowering the temperature of the heart, lowering K+ concentration, reducing contact K+ time, changing the vehicle from a crystalloid solution to whole-blood, adding many pharmacological protectants and modifying reperfusion conditions. Despite these attempts, high potassium remains a suboptimalway to arrest the heart. We briefly review the historical advances and failures of finding alternatives to high potassium, the drawbacks of a prolonged depolarized membrane, altered Ca2+ intracellular circuits and heterogeneity in atrial-ventricular K+ repolarization during reanimation. Many of these untoward effects may be alleviated by a polarized membrane, and we will discuss the basic science and clinical experience from a number of institutions trialling different alternatives, and our institution with a non-depolarizing adenosine, lidocaine and magnesium (ALM) cardioplegia. The future of polarized arrest is an exciting one and may play an important role in treating the next generation of patients who are older, and sicker with multiple comorbidities and require more complex operations with prolonged cross-clamping times.

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“…However, in a few years, these methods of cardioprotection were discredited. This was due to the unexpected postoperative mortality associated with the administration of potassium citrate [5]. Over the next 10 years, operations on beating heart, operations with intermittent perfusion and operations on ischemic heart with superficial cooling were used.…”

Section: Graphical Abstract: Introductionmentioning

confidence: 99%

Long-Term Protective Effects of Single-Dose infusion of Warm Blood Cardioplegic Solution in a mini-pig model on the background of intraoperative anemia

Ag¹,

Rn²,

Ea³

et al. 2021

Preprint

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Objectives: The tolerable ischemic time for many cardioplegia solutions has not been established yet. The aim of this study was to estimate the effect of a single-dose of cardioplegia solution Normacor (solution No. 1) and to establish the tolerable ischemic time in a normothermic cardiopulmonary bypass mini-pig model on the background of intraoperative anemia. Methods: Five female mini-pigs (34plus-or-minus sign3 kg, 6-month-old) were subjected to 180 min or 210 min of cardiac arrest by single-dose 400 ml Normacor cardioplegia (solution No. 1). A needle biopsy was taken from the left ventricle before the aortic cross-clamping and every 30 minutes after it. The restoration of left ventricle contractility was assessed by the clinical indicators, catecholamine support, morphological and immunohistochemical examination. Results: The morphological signs of cardiomyocytes ischemia were found after 120 minutes of aortic cross-clamping. According to the content of succinate dehydrogenase and hypoxia-inducible factor, the signs of the cardiomyocytes ischemic injury onset were detected at the same time point. During the entire period of aortic cross-clamping atrial activity was observed in all cases. The proposed single-dose ischemic time for re-dosing of cardioplegia is 120 minutes or ventricular activity onset. Conclusions: Safe and effective cardioprotection can be achieved with warm blood cardioplegia Normacor (solution No. 1) within 120 minutes for a single-dose infusion.

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Induced Cardiac Arrest

Cited by 41 publications

References 0 publications

Innovative CCC Solution for Open Heart Surgery

Innovative CCC Solution for Open Heart Surgery

Cardioplegia between Evolution and Revolution: From Depolarized to Polarized Cardiac Arrest in Adult Cardiac Surgery

Long-Term Protective Effects of Single-Dose infusion of Warm Blood Cardioplegic Solution in a mini-pig model on the background of intraoperative anemia

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