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Topical cooling of the heart. A valuable adjunct to cold cardioplegia

C L Olin1, I E Huljebrant

  • 1Department of Cardiothoracic Surgery, University Hospital, Linköping, Sweden.

Scandinavian Journal of Thoracic and Cardiovascular Surgery. Supplementum
|January 1, 1993
PubMed

Insights

Topical heart cooling enhances myocardial hypothermia during open-heart surgery, especially with cold cardioplegia and prolonged aortic cross-clamping. Using an insulating pad protects the heart and phrenic nerve when employing ice slush for cooling.

Area of Science:

  • Cardiovascular Surgery
  • Hypothermia Therapy

Background:

  • Topical cardiac cooling is an effective adjunct to cold cardioplegia.
  • It is particularly beneficial in patients undergoing prolonged aortic cross-clamping.
  • It prevents myocardial rewarming from collateral circulation and adjacent organs.

Purpose of the Study:

  • To demonstrate the efficiency of topical cardiac cooling during open-heart surgery.
  • To illustrate the use of a cardiac insulating pad with ice slush topical cooling.
  • To measure myocardial and surrounding tissue temperatures during aortic cross-clamping.

Main Methods:

  • Open-heart surgery utilizing cold crystalloid cardioplegia.
  • Topical cardiac cooling with ice slush.
  • Placement of a cardiac insulating pad to protect the heart and left phrenic nerve.
  • Continuous temperature monitoring of the myocardium and surrounding areas.

Main Results:

  • Topical cooling significantly enhanced myocardial hypothermia.
  • The insulating pad effectively protected the heart and phrenic nerve from cold injury.
  • Rewarming by coronary collaterals and adjacent organs was minimized.

Conclusions:

  • Topical cardiac cooling is a valuable technique to improve myocardial protection during open-heart surgery.
  • The use of an insulating pad is crucial when employing ice slush for topical cooling.
  • This method enhances hypothermia and prevents detrimental rewarming, especially in complex cases.

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