What is Custodiol cardioplegia?
Custodiol is an intracellular crystalloid cardioplegic solution used by some centres for myocardial protection in complex cardiac surgery and for organ preservation in transplant surgery.
Who discovered cardioplegia?
term cardioplegia (cardio, heart and plegia, paralysis) was first introduced by Lam in 1957(Lam et al., 1957), yet the method of arrest has its roots in the early experiments of British phys- iologist Sidney Ringer using the frog heart (Figure 2).
How does Custodiol cardioplegia work?
Custodiol® solution, also called histidine-tryptophan-ketoglutarate (HTK) or Bretschneider’s solution, is a particular kind of long-acting intracellular crystalloid cardioplegia (CCP) that differs from other extracellular cardioplegic solutions because of its low sodium and potassium content that induce the diastolic …
How many types of cardioplegia are there?
Cardioplegia administration can be anterograde, retrograde, or both. The anterograde cardioplegia is inserted in the proximal aorta and contains three lumens: one to administer the cardioplegia, another for suctioning, and the third to measure intraluminal pressure.
What is St Thomas cardioplegia?
St. Thomas’ cardioplegic solution No. 2 (ST) has been a popular crystalloid cardioplegia among cardiac surgeons; however, it must be administered repeatedly at short intervals during the surgery. Increases in myocardial acidosis between the doses have been noted, affecting the postoperative outcome adversely [2, 3].
What is custodial solution?
Histidine-tryptophan-ketoglutarate, or Custodiol HTK solution, is a high-flow, low-potassium preservation solution used for organ transplantation. The solution was initially developed by Hans-Jürgen Bretschneider. The composition of HTK is similar to that of extracellular fluid.
Why is cardioplegia used?
Cardioplegia is an essential component of cardiopulmonary bypass and with the primary goal to reduce myocardial oxygen demand by creating electrical quiescence and cooling the heart to reduce the ischemic effects of being on bypass.
What is a cardioplegic solution?
Solution. Cardioplegia Solution A is a sterile, non-pyrogenic solution for cardiac perfusion in a Viaflex bag. It is used to induce cardiac stasis and to protect the myocardium during open-heart surgery.
What is cardioplegia made of?
Each 100 mL of solution contains Calcium Chloride Dihydrate USP 17.6 mg, Magnesium Chloride, Hexahydrate USP 325.3 mg, Potassium Chloride USP 119.3 mg and Sodium Chloride USP 643 mg in Water for Injection, USP.
What is St Thomas solution?
Thomas’ Hospital cardioplegic solution number 2. This cardioplegic solution (NaCl 110.0 mM, NaHCO3 10.0 mM, KCl 16.0 mM, MgCl2 16.0 mM, CaCl2 1.2 mM, pH 7.8) is designed for routine clinical use combining optimal protection with simplicity of formulation and administration/infusion.
What is University of Wisconsin solution?
Belzer UW® Cold Storage Solution is intended for flushing and cold storage of kidney, liver and pancreas organs at the time of their removal from the organ donor in preparation for storage, transportation and eventual transplantation into a donor recipient.
How is Custodiol cardioplegia used in cardiac surgery?
Introduction: Custodiol cardioplegia is attractive for minimally invasive cardiac surgery, as a single dose provides a long period of myocardial protection. Despite widespread use in Europe, there is little data confirming its efficacy compared with conventional (blood or crystalloid) cardioplegia.
Which is better Custodiol or a heart transplant?
No difference was identified in studies that compared Custodiol with other solutions for heart transplant. Conclusions: Despite widespread clinical use, the evidence supporting the superiority of Custodiol over other solutions for myocardial protection or organ preservation is limited. Large randomised trials are required.
How is Custodiol used in the field of transplantation?
Whilst initially introduced for myocardial protection in routine cardiac surgery, Custodiol has expanded into the field of transplantation. It has been used not only in cardiac transplantation, and adopted widely in Europe ( 8 ), but also in the preservation of multiple organs ( 9 ).
What causes cardiac arrest in an intracellular cardioplegia?
It is classified as an intracellular, crystalloid cardioplegia due to its low sodium and calcium content. Sodium depletion of the extracellular space causes a hyperpolarization of the myocyte plasma membrane, inducing cardiac arrest in diastole.