Pediatric myocardial protection: a cardioplegic strategy is the "solution".

摘要: Abstract This article describes the experimental infrastructure and subsequent successful clinical application of a comprehensive cardioplegic strategy that limits intraoperative injury improves postoperative outcomes in pediatric patients. The infant heart is at high risk damage from poor protection as result preoperative hypertrophy, cyanosis, ischemia. These factors may also make immature (pediatric) more sensitive to arrest compared with mature (adult) heart. cyanosis pressure volume overload are discussed, followed by strategies warm induction reperfusion substrate enhancements, multidose cardioplegia, "modified" integrated approach allow ischemia only when visualization needed surgeries. importance using blood cardioplegia solution, reduced calcium, increased magnesium, low perfusion shown. A practical framework based on these experimentally proven principles then presented surgeon apply clinically. results depicted series 567 patients, including 93 patients hypoplastic left syndrome. Applications concepts should improve safety reduce morbidity mortality.