Elective cardioplegia by local cardiac hypothermia.

ELECTIVE cardiac arrest is an important adjunct to open-heart surgery. It provides a motionless, dry operative field with minimal blood loss and less chance for gaseous embolism to the coronary arteries. Cardioplegia reduces metabolic requirements of the heart and prolongs myocardial tolerance to cessation of coronary blood flow.1 Deep cardiac hypothermia produces an effective arrest.2 Simultaneously, it reduces metabolic requirements and protects against tissue anoxia.3 , 4 By differentially cooling the heart and maintaining the body at mild hypothermic temperature levels with extracorporeal circulation, it avoids the disadvantages of deep, total-body hypothermia. Rapid arrest and reversibility are possible without protracted total-body cooling . . .