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Thorac Cardiovasc Surg 2020; 68(03): 232-234
DOI: 10.1055/s-0039-1679925
Special Report
Georg Thieme Verlag KG Stuttgart · New York

Intermittent Antegrade Warm Blood Cardioplegia: What Is Next?

Antonio Maria Calafiore
1   Department of Cardiac Surgery, Pope John Paul II Foundation, Campobasso Italy
,
Piero Pelini
1   Department of Cardiac Surgery, Pope John Paul II Foundation, Campobasso Italy
,
Massimilliano Foschi
2   Department of Cardiac Surgery, SS Annunziata Hospital, Chieti, Italy
,
Michele Di Mauro
2   Department of Cardiac Surgery, SS Annunziata Hospital, Chieti, Italy
› Author Affiliations Funding None.
Further Information

Publication History

21 December 2018

22 January 2019

Publication Date:
05 March 2019 (online)

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Abstract

The introduction of warm heart surgery was a radical change in the concept of myocardial protection. In 1992, we applied a protocol for intermittent antegrade warm blood cardioplegia (CPL), which acquired some popularity for its simplicity and effectiveness. The possibility to deliver the warm blood CPL intermittently using the antegrade route attracted the attention of the scientific world, as the surgical procedure was less complicated. In this report, our aim is to focus on the changes that the protocol underwent over time and the reasons why these changes were made.

Keywords

cardiopulmonary bypass - inflammation - myocardial protection - cardioplegia

Disclosures

None to disclose.


Supplementary Material

 

  • References

  • 1 Salerno TA, Houck JP, Barrozo CA. , et al. Retrograde continuous warm blood cardioplegia: a new concept in myocardial protection. Ann Thorac Surg 1991; 51 (02) 245-247
    CrossrefPubMedGoogle Scholar
  • 2 Lichtenstein SV, Ashe KA, el Dalati H, Cusimano RJ, Panos A, Slutsky AS. Warm heart surgery. J Thorac Cardiovasc Surg 1991; 101 (02) 269-274
    CrossrefPubMedGoogle Scholar
  • 3 Calafiore AM, Teodori G, Mezzetti A. , et al. Intermittent antegrade warm blood cardioplegia. Ann Thorac Surg 1995; 59 (02) 398-402
    CrossrefPubMedGoogle Scholar
  • 4 Mezzetti A, Calafiore AM, Lapenna D. , et al. Intermittent antegrade warm cardioplegia reduces oxidative stress and improves metabolism of the ischemic-reperfused human myocardium. J Thorac Cardiovasc Surg 1995; 109 (04) 787-795
    CrossrefPubMedGoogle Scholar
  • 5 Tian G, Xiang B, Butler KW. , et al. A 31P-nuclear magnetic resonance study of intermittent warm blood cardioplegia. J Thorac Cardiovasc Surg 1995; 109 (06) 1155-1163
    CrossrefPubMedGoogle Scholar
  • 6 Franke UF, Korsch S, Wittwer T. , et al. Intermittent antegrade warm myocardial protection compared to intermittent cold blood cardioplegia in elective coronary surgery--do we have to change?. Eur J Cardiothorac Surg 2003; 23 (03) 341-346
    CrossrefPubMedGoogle Scholar
  • 7 Mallidi HR, Sever J, Tamariz M. , et al. The short-term and long-term effects of warm or tepid cardioplegia. J Thorac Cardiovasc Surg 2003; 125 (03) 711-720
    CrossrefPubMedGoogle Scholar
  • 8 Hirose M, Hirose Y, Gamou M, Harigae M, Fujiwara C. The efficiency of intermittent antegrade warm blood cardioplegia [in Japanese]. Masui 1999; 48 (01) 48-52
    PubMedGoogle Scholar
  • 9 Caputo M, Bryan AJ, Calafiore AM, Suleiman MS, Angelini GD. Intermittent antegrade hyperkalaemic warm blood cardioplegia supplemented with magnesium prevents myocardial substrate derangement in patients undergoing coronary artery bypass surgery. Eur J Cardiothorac Surg 1998; 14 (06) 596-601
    CrossrefPubMedGoogle Scholar
  • 10 Flameng WJ, Herijgers P, Dewilde S, Lesaffre E. Continuous retrograde blood cardioplegia is associated with lower hospital mortality after heart valve surgery. J Thorac Cardiovasc Surg 2003; 125 (01) 121-125
    CrossrefPubMedGoogle Scholar
  • 11 Ardehali A, Laks H, Drinkwater Jr DC, Gates RN, Kaczer E. Ventricular effluent of retrograde cardioplegia in human hearts has traversed capillary beds. Ann Thorac Surg 1995; 60 (01) 78-82 , discussion 82–83
    CrossrefPubMedGoogle Scholar
  • 12 Ruengsakulrach P, Buxton BF. Anatomic and hemodynamic considerations influencing the efficiency of retrograde cardioplegia. Ann Thorac Surg 2001; 71 (04) 1389-1395
    CrossrefPubMedGoogle Scholar
  • 13 Kouerinis IA, Manopoulos CG, Zografos GC. , et al. Retrograde cardioplegia in CABG: is it really useful? The microcirculation and a capillary unit model. Med Sci Monit 2006; 12 (11) RA265-RA268
    PubMedGoogle Scholar
  • 14 Ghazy T, Allham O, Ouda A, Kappert U, Matschke K. Is repeated administration of blood-cardioplegia really necessary?. Interact Cardiovasc Thorac Surg 2009; 8 (05) 517-521
    CrossrefPubMedGoogle Scholar
  • 15 Hoyer A, Lehmann S, Mende M. , et al. Custodiol versus cold Calafiore for elective cardiac arrest in isolated aortic valve replacement: a propensity-matched analysis of 7263 patients. Eur J Cardiothorac Surg 2017; 52 (02) 303-309
    CrossrefPubMedGoogle Scholar
  • 16 Kuhn EW, Liakopoulos O, Slottosch I. , et al. Buckberg versus Calafiore cardioplegia in patients with acute coronary syndromes. Thorac Cardiovasc Surg 2018; 66 (06) 457-463
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Zeriouh M, Heider A, Rahmanian PB. , et al. Six-years survival and predictors of mortality after CABG using cold vs. warm blood cardioplegia in elective and emergent settings. J Cardiothorac Surg 2015; 10: 180
    CrossrefPubMedGoogle Scholar
  • 18 Sobieraj M, Kilanowska M, Ładziński P. , et al. Type of cardioplegic solution as a factor influencing the clinical outcome of open-heart congenital procedures. Kardiochir Torakochirurgia Pol 2018; 15 (02) 86-94
    PubMedGoogle Scholar