[HSF] Inotropes, ventricular fibrillation and myocardial protection

[Tohru Asai]

Ani
Thanks for quating my practice. I think that Tomas' comment "fibrillating
dying heart" is incomplete expression. Most of my cases becomes
spontaneously beating on sinus or junctional after aorta unclamped if not
induced by a fibrillator. Since I may be nervous or too meticulous to de-air
heart chambers with lung inflated vigorously, I do induce fibrillation for a
short period. But as you mentioned, what is wrong about it? After turned off
a fibrillator, some hearts even do not need defbrillation! And usually come
off CPB with minimal or no inotrope as Hal's cases. I do not remember so far
I had not used IABP only for long clamp or malprotection even in sickest
"dying hearts" for years. BTW I was studying cardioplegia in animal lab at
NYU around 1990, now I make my own "home cocktail" of blood cardioplegia. I
frankly feel that I do not need amio, lidocain, and/or terminal shots in my
routine "cocktail party"!

-- 
Tohru Asai

> many intentionally as in Tohru's practice