Myocardial preservation in children

Use of cardioplegia of various types including cold crystalloid, blood cardioplegia, is the standard method of myocardial protection in children undergoing cardiac surgery. Cardioplegia is very effective in adult cardiac surgery for myocardial protection; however there are very few studies in children on the benefits of cardioplegic myocardial protection, compared to other methods of myocardial protection in the pediatric population. Results of the few available studies of crystalloid cardioplegia in children are contradictory. The most important difference between the adult and pediatric hearts is the greater tolerance of ischemia by the pediatric heart. This tolerance for ischemia by the pediatric heart is further enhanced by the use of hypothermia. Interest is now focused on the use of hypothermic protection of the pediatric myocardium because of the controversial contribution of crystalloid cardioplegia in the pediatric hearts. (Ind J Extra Corpor Technol 2011;21:0–0)