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Cardioplegia Delivery Methods Flashcards

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  1. The St. Thomas' Hospital cardioplegia solution is classified as:

    Answer: Extracellular-type crystalloid cardioplegia

    St. Thomas' solution is an extracellular-type crystalloid cardioplegia with sodium and calcium concentrations approximating extracellular fluid.

  2. Histidine-tryptophan-ketoglutarate (HTK/Custodiol) cardioplegia is primarily indicated for:

    Answer: Single-dose myocardial protection with extended ischemic tolerance

    HTK solution provides extended single-dose myocardial protection, commonly used for heart transplantation and complex procedures requiring longer ischemic times.

  3. During antegrade cardioplegia delivery via aortic root, what pressure range is typically targeted to ensure adequate coronary perfusion without causing distension?

    Answer: 50–80 mmHg

    Antegrade aortic root cardioplegia is typically delivered at 50–80 mmHg to achieve adequate coronary distribution without pressure-related myocardial damage.

  4. Which potassium concentration range is most commonly used to induce initial cardiac arrest in hyperkalemic cardioplegia?

    Answer: 20–40 mEq/L

    Initial cardioplegia doses typically contain 20–40 mEq/L potassium to rapidly depolarize the myocardium and achieve cardiac arrest.

  5. Which myocardial temperature target is associated with optimal protection during cold crystalloid cardioplegia?

    Answer: 15°C

    Cold crystalloid cardioplegia aims to cool the myocardium to approximately 15°C, markedly reducing metabolic oxygen demand during ischemia.

  6. What is the significance of adding magnesium to cardioplegia solution?

    Answer: Magnesium acts as a calcium antagonist and reduces reperfusion injury

    Magnesium competes with calcium at cellular channels, reducing calcium overload during ischemia and reperfusion, thus limiting myocardial injury.

  7. Why is topical myocardial cooling used in conjunction with cardioplegia delivery?

    Answer: To provide additional surface cooling and offset rewarming from surrounding structures

    Topical cooling with iced saline counteracts rewarming from mediastinal structures and blood, maintaining myocardial hypothermia between cardioplegia doses.