Kardioplegi

Kardioplegi refers to a medical technique used during cardiac surgery to temporarily stop the heart and protect it from ischemia, or oxygen deprivation, while the surgeon performs necessary procedures. The term originates from the Greek words *kardia* (heart) and *plegein* (to strike), reflecting the method’s purpose of inducing a controlled arrest of cardiac function.

The procedure is typically achieved through the administration of a cold, potassium-rich solution, often via the coronary arteries. This solution induces ventricular fibrillation, halting the heart’s contractions while maintaining its electrical activity at a minimal level. The heart remains metabolically inactive, reducing oxygen demand and preventing damage from prolonged ischemia.

Kardioplegi is essential in surgeries such as coronary artery bypass grafting (CABG), valve replacements, and repairs of congenital heart defects. By suspending blood flow to the heart, surgeons gain a motionless, bloodless field, improving precision and safety. The technique also allows for controlled rewarming and reperfusion of the heart after the procedure, minimizing post-operative complications like arrhythmias or myocardial infarction.

There are two primary types of kardioplegi: antegrade (delivered through the aorta) and retrograde (infused through the coronary sinus). Each method has advantages depending on the surgical context, patient anatomy, and clinical needs. Modern variations include intermittent or continuous infusion protocols, as well as the use of oxygenated solutions to further enhance myocardial protection.

While generally safe, kardioplegi carries risks such as arrhythmias, myocardial stunning, or systemic inflammatory responses. Careful monitoring of electrolyte balance, temperature, and perfusion is critical to minimizing adverse effects. Advances in cardioplegic solutions, including additives like antioxidants or metabolic substrates, continue to improve outcomes in cardiac surgery.