Cardiac operation without hypothermia for the patient with cold agglutinin

Recently, a new technique for myocardial protection that does not rely on hypothermia has been reported. In this method, the heart is continuously perfused with normothermic hyperkalemic blood cardioplegia during the cross-clamp period. Cardiac arrest is achieved and maintained using high levels of potassium. Hypothermia is not part of this technique; thus, the danger of hypothermia can be avoided in the patient with cold agglutinin disease without compromising myocardial protection. This communication reports our experience using retrograde continuous normothermic blood cardioplegia in one patient with potent cold agglutinins and severe coronary artery occlusive disease. This patient experienced an uneventful operative and postoperative course and remains asymptomatic, now more than two years after operation.