Cardioplegia

Cardioplegia

Cardioplegia is a medical technique that involves the intentional and temporary cessation of cardiac activity, primarily to facilitate cardiac surgery. This procedure is essential for providing a still and bloodless field, allowing surgeons to perform intricate operations on the heart.

Types of Cardioplegia

Cardioplegia can be classified into several types based on the method of delivery and the composition of the solution used:

• Crystalloid Cardioplegia: This type uses a solution devoid of blood, typically containing electrolytes, buffers, and substrates to protect the heart muscle.
• Blood Cardioplegia: This method involves the use of the patient's own blood mixed with a cardioplegic solution, providing better oxygen delivery and metabolic support.
• Antegrade Cardioplegia: The solution is delivered through the coronary arteries in the direction of normal blood flow.
• Retrograde Cardioplegia: The solution is delivered through the coronary sinus, flowing in the opposite direction of normal blood flow.

Mechanism of Action

Cardioplegia works by inducing a state of cardiac arrest through the use of a cold or chemically modified solution. The primary components of cardioplegic solutions often include:

• Potassium: High concentrations of potassium cause depolarization of the cardiac cells, leading to cessation of electrical activity.
• Magnesium: Helps stabilize cell membranes and prevent calcium overload.
• Buffers: Maintain pH balance within the myocardial cells.
• Substrates: Provide metabolic support during the period of arrest.

Clinical Applications

Cardioplegia is commonly used in various types of cardiac surgery, including:

• Coronary artery bypass grafting (CABG)
• Valve replacement surgery
• Congenital heart defect repairs

Advantages

The use of cardioplegia offers several advantages:

• Provides a motionless field for precise surgical intervention.
• Reduces metabolic demands of the heart muscle.
• Protects the myocardium from ischemic damage during the period of arrest.

Complications

While cardioplegia is generally safe, potential complications can include:

• Inadequate myocardial protection leading to ischemia.
• Electrolyte imbalances.
• Reperfusion injury upon restoration of blood flow.

Related Pages

• Cardiac surgery
• Coronary artery bypass surgery
• Heart valve surgery
• Myocardial ischemia
• Congenital heart defect

Cardiovascular disease A-Z

Most common cardiac diseases

• Cardiac arrhythmia‎
• Cardiogenetic disorders‎
• Cardiomegaly‎
• Cardiomyopathy‎
• Cardiopulmonary resuscitation‎
• Chronic rheumatic heart diseases‎
• Congenital heart defects‎
• Heart neoplasia‎
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• Pericardial disorders
• Syndromes affecting the heart‎
• Valvular heart disease‎

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A

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• Acute decompensated heart failure
• Arteriosclerotic heart disease
• Athletic heart syndrome
• Atrial flutter
• Atrioventricular fistula
• Cardiovascular disease in Australia
• Autoimmune heart disease

B

• Brown atrophy of the heart

C

• Ebb Cade
• Cardiac allograft vasculopathy
• Cardiac amyloidosis
• Cardiac asthma
• Cardiac tamponade
• Cardiogenic shock
• Cardiogeriatrics
• Cardiorenal syndrome
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• Duke Treadmill Score
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• Eisenmenger's syndrome
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• Eosinophilic myocarditis

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• Heart attack
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• Heart to Heart (1949 film)
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I

• Idiopathic giant-cell myocarditis
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K

• Keshan disease

L

• Loeffler endocarditis

M

• Mydicar
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N

• Nonbacterial thrombotic endocarditis

O

• OLR1
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• Papillary fibroelastoma
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• Right axis deviation
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• Saturated fat and cardiovascular disease
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T

• Traumatic cardiac arrest

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• Ventricular aneurysm
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W

• Waon therapy