The use of potassium arrest in open cardiac surgery

Gerbode, Frank; Melrose, D. G.

doi:10.1016/0002-9610(58)90906-1

Cited by 32 publications

(14 citation statements)

References 2 publications

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“…introduced the concept of chemical cardiac arrest in canines [ 5 ]. Gerbode and Melrose were the first to report use of potassium citrate to induce cardiac arrest in humans [ 6 ]. The project relied on the assumption that a high concentration of potassium ions depolarizes the membrane and arrests the heart in diastole.…”

Section: The Cardioplegia Conceptmentioning

confidence: 99%

Del Nido cardioplegia – what is the current evidence?

Sanetra¹,

Pawlak²,

Cisowski³

2018

kitp

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Section: The Cardioplegia Conceptmentioning

confidence: 99%

Del Nido cardioplegia – what is the current evidence?

Sanetra¹,

Pawlak²,

Cisowski³

2018

kitp

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“…The London team performed the first cardioplegic arrest using a citrated form of potassium in a canine model of cardiopulmonary bypass. The “Melrose technic,” as it became known, used 2.0 ml of 25% solution of tri-potassium citrate added to 18 ml warm oxygenated whole blood in a syringe (9:1 blood: potassium ratio), and injecting directly into the aortic root of hypothermic dogs (25°C) (Melrose et al, 1955; Gerbode and Melrose, 1958). The heart arrested in seconds and remained electrically quiescent for 30 min and returned good function in the healthy dog.…”

Section: Introductionmentioning

confidence: 99%

“…Melrose's group were the first to propose that high potassium-citrate may afford “elective reversible cardiac arrest” in human open-heart surgery (Melrose et al, 1955). Three years later, Gerbode and Melrose increasingly used potassium citrate to induce cardiac arrest in humans (Gerbode and Melrose, 1958). …”

Section: Introductionmentioning

confidence: 99%

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

Dobson¹,

Faggian²,

Onorati³

et al. 2013

Front. Physiol.

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Despite surgical proficiency and innovation driving low mortality rates in cardiac surgery, the disease severity, comorbidity rate, and operative procedural difficulty have increased. Today's cardiac surgery patient is older, has a “sicker” heart and often presents with multiple comorbidities; a scenario that was relatively rare 20 years ago. The global challenge has been to find new ways to make surgery safer for the patient and more predictable for the surgeon. A confounding factor that may influence clinical outcome is high K+ cardioplegia. For over 40 years, potassium depolarization has been linked to transmembrane ionic imbalances, arrhythmias and conduction disturbances, vasoconstriction, coronary spasm, contractile stunning, and low output syndrome. Other than inducing rapid electrochemical arrest, high K+ cardioplegia offers little or no inherent protection to adult or pediatric patients. This review provides a brief history of high K+ cardioplegia, five areas of increasing concern with prolonged membrane K+ depolarization, and the basic science and clinical data underpinning a new normokalemic, “polarizing” cardioplegia comprising adenosine and lidocaine (AL) with magnesium (Mg2+) (ALM™). We argue that improved cardioprotection, better outcomes, faster recoveries and lower healthcare costs are achievable and, despite the early predictions from the stent industry and cardiology, the “cath lab” may not be the place where the new wave of high-risk morbid patients are best served.

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“…Gradually as experience with the technique increased [81], the long-term effects of Melrose solution became known. Surgeons found that there was late vascular and myocardial injury in these patients [82][83][84][85][86][87][88].…”

Section: Cardioplegiamentioning

confidence: 99%

The History of Myocardial Protection

Panos¹

2003

Myocardial Protection

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CHAPTER 1technique of retrograde cardioplegia [23][24][25][26][27][28][29][30][31]. Others studied the electrophysiology [21,32] of the heart, the physiology of coronary blood flow [33][34][35][36][37][38], myocardial energetics [31,[39][40][41], and the relationships between coronary blood flow and cardiac mechanics [42][43][44]. All of this important basic science work was crucial to later clinical applications.

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The use of potassium arrest in open cardiac surgery

Cited by 32 publications

References 2 publications

Del Nido cardioplegia – what is the current evidence?

Del Nido cardioplegia – what is the current evidence?

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

The History of Myocardial Protection

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