Myocardial protection and cardioplegia

Model answer

Core facts. Anticoagulation per the verified STS/SCA/AmSECT targets — heparin 300 IU/kg fixed method, ACT 400-or-480 s surveyed thresholds, protamine at the surveyed 1:1 commonest ratio given slow — with TOE views named for weaning and regional assessment.

Topic structure. Cover hyperkalaemic diastolic arrest (taught mechanism), blood vs crystalloid and warm vs cold strategy choices, antegrade/retrograde delivery with the AR and RV caveats, single-shot del Nido/HTK evidence, TOE role, and the canonical crisis: Inadequate myocardial protection with difficulty weaning and regional wall-motion abnormality.

Close. Disposition, ICU plan, and common traps.