[HSF] high flowWarm blood cardioplegia versus Salarenos technique

[Tea Acuff]

so cardioplegia has the reverse effect of athletic scholarships?
tea


----- Original Message ----
From: "tdmartin2000 at aol.com" <tdmartin2000 at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Saturday, April 21, 2007 7:13:17 AM
Subject: Re: [HSF] high flowWarm blood cardioplegia versus Salarenos technique


I guess I'll chime in on this discussion. Yes - cardioplegia is your friend. I don't even really worry about clamp times anymore. One of my partners recently had a real disaster of a case with a 4hr clamp time. Pt came off with minimal inotropes and was extubated the next morning. I am a dinosaur and still use crystalloid. Having said all of  that I would have to agree however that ischemia is bad in the literal sense. In the lab, perfused hearts will always look better on the microscopic level than ischemic hearts and in reallity perfused hearts should function better, even if it is only noticeable with subclinical measures. The advantage of the still, flaccid, bloodless heart is in my mind the ease of the operation and the ability to get the best technical result possible. Not to say that surgeons can't learn to get good results with a beating bloody heart, but in many situations, I think the best and easiest technical results are achieved in a still clean operative
 field. 
Cardioplegia levels the playing field in many situations.

Tom Martin
U of Florida
Gainesville 

-----Original Message-----
From: Hgrmd at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Fri, 20 Apr 2007 6:22 PM
Subject: Re: [HSF] high flowWarm blood cardioplegia versus Salarenos technique


Michael,
  Your intraoperative myocardial protection plan sounds very similar  to 
mine.  Today, I operated on a 77 yo lady with a 6.2cm root, 3+ AI, mod  TR, 
severe 
2vd, and chronic AF.  I did a biologic Bentall, 1 artery and 2  vein grafts, 
Cryomaze, and a tricuspid repair.  The clamp time was 3 hrs, 2  minutes.  She 
came off easily, AV paced, with an EF of 60% on 5mcgs of  dobutamine and some 
NTG.  The point is there's more than one way to  effectively and safely skin a 
cat.
Hal



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