Related Experiment Video
Updated: Aug 9, 2025
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
Cardioplegia in Open Heart Surgery: Age Matters
Jovana Bradić1,2, Marijana Andjić1,2, Jovana Novaković1,2
1Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia.
Insights
Blood cardioplegia offers greater benefits for pediatric heart protection compared to crystalloid solutions. However, optimal strategies for pediatric myocardium preservation remain individualized, lacking standardized protocols.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Cardiothoracic Anesthesia
Background:
- Cardioplegia is crucial for preventing ischemia-reperfusion (I-R) injury during cardiac surgery.
- Crystalloid and blood cardioplegic solutions have distinct advantages and disadvantages.
- Pediatric myocardium has unique structural and metabolic properties requiring tailored cardioplegic approaches.
Purpose of the Study:
- To review available cardioplegic solutions for pediatric patients.
- To emphasize differences in myocardial injury associated with various cardioplegic solutions.
- To highlight dosing strategies and regimens for pediatric cardioplegia.
Main Methods:
- Literature search of the PubMed database.
- Keywords used: cardioplegia, I-R, pediatric population.
- Analysis of studies on cardioplegic strategies and cardiac muscle damage markers.
Main Results:
- Evidence suggests superior benefits of blood cardioplegia over crystalloid solutions for pediatric myocardium preservation.
- Significant differences in heart injury observed with various cardioplegic solutions.
Conclusions:
- Blood cardioplegia appears more beneficial than crystalloid for pediatric heart protection.
- Standardized protocols are not yet established; surgeon choice is paramount.
- Myocardial damage severity is influenced by surgical factors and patient condition.
Introduction:
Cardioplegia is a pharmacological approach essential for the protection of the heart from ischemia-reperfusion (I-R) injury. Over the years, numerous cardioplegic solutions have been developed, with each cardioplegic approach having its advantages and disadvantages. Cardioplegic solutions can be divided into crystalloid and blood cardioplegic solutions, and an experienced surgeon chooses the type of solution based on the individual needs of patients in order to provide optimal heart protection. Importantly, the pediatric immature myocardium is structurally, physiologically, and metabolically different from the adult heart, and consequently its needs to achieve cardioplegic arrest strongly differ. Therefore, the present review aimed to provide a summary of the cardioplegic solutions available to pediatric patients with a special focus on emphasizing differences in heart injury after various cardioplegic solutions, the dosing strategies, and regimens.
Material And Methods:
The PubMed database was searched using the terms cardioplegia, I-R, and pediatric population, and studies that investigated the influence of cardioplegic strategies on markers of cardiac muscle damage were further analyzed in this review.
Conclusions:
A large body of evidence suggested more prominent benefits achieved with blood compared to those with crystalloid cardioplegia in pediatric myocardium preservation. However, standardized and uniform protocols have not been established so far, and an experienced surgeon chooses the type of cardioplegia solution based on the individual needs of patients, while the severity of myocardial damage strongly depends on the type and duration of the surgical procedure, overall patient condition, and presence of comorbidities, etc.
