Anaes Vivas · Cardiac anaesthesia
Myocardial protection and cardioplegia — viva
Structured oral examination station for myocardial-protection-cardioplegia.
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Study tools
Target exams
ANZCAFRCAEDAICABAFCAI
Prompt
Cardiac theatre stem focusing on myocardial protection and cardioplegia with a monitoring printout and TOE still available.
Opening
One-line answer: Cardioplegia protects myocardium by inducing hyperkalaemic diastolic arrest (taught mechanism), cooling and intermittent re-dosing; know blood vs crystalloid, warm vs cold, antegrade (aortic root) vs retrograde (coronary sinus), and single-shot del Nido/HTK strategies.[4][6]
References6ShowHide
- [1]Mazer CD, Whitlock RP, Fergusson DA, et al. Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery (TRICS III). New England Journal of Medicine, 2017.PMID 29130845
- [2]Hahn RT, Abraham T, Adams MS, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. Journal of the American Society of Echocardiography, 2013.PMID 23998692
- [3]Levy JH, et al. What's fishy about protamine? Clinical use, adverse reactions, and potential alternatives. Journal of Thrombosis and Haemostasis, 2023.PMID 37062523
- [4]An KR, Rahman IA, Tam DY, et al. A Systematic Review and Meta-Analysis of del Nido Versus Conventional Cardioplegia in Adult Cardiac Surgery. Innovations (Phila), 2019.PMID 31347414
- [6]Derryberry S, Tribble C In Through the Out Door: Tips and Tricks for Giving Retrograde Cardioplegia. Heart Surgery Forum, 2018.PMID 30084786
- [8]Shore-Lesserson L, Baker RA, Ferraris V, et al. STS/SCA/AmSECT Clinical Practice Guidelines: Anticoagulation during Cardiopulmonary Bypass. Journal of Extra-Corporeal Technology, 2018.PMID 29559750