Commentary: Easier is not always better than better

Abstract

The quest for the ideal cardioplegia solution dates back to the use of potassium for cardiac arrest by Melrose in 1957. 1 Further improvements were facilitated by the work of Gay and Ebert in 1973, Hearse in 1976, Buckberg in 1978, and Fremes in 1984, thus, enabling safe, open cardiac surgery. 2-5 A cornucopia of choices now exist that provide a quiet, bloodless field for cardiac surgery (Table 1). There is significant variation in practice among surgeons worldwide, with the majority of surgeons in Europe, North America, Australia/New Zealand, and South America using chemical cardioplegia. 6 Variation exists in the degree of dilution of blood with crystalloid cardioplegia and even the use of blood cardioplegia versus crystalloid. It was estimated in 2018 that 10.7% of US surgeons used del Nido