Continuous warm blood cardioplegia pitfalls and solutions.

BACKGROUND: Continuous warm blood cardioplegia offers superior preservation in both routine and complicated cardiac cases. Management of continuous perfusion is an important task during each case. METHODS: The authors have developed several specific techniques to ensure stable catheter insertion and placement for continuous coronary sinus or antegrade ostial perfusion. RESULTS: Over 3,800 patients have been operated on with continuous warm blood cardioplegia using catheter techniques as described in this article. The overall 30-day mortality was 3.9%. CONCLUSIONS: Safe application of continuous warm blood cardioplegia has many advantages over prior cold techniques, but surgeons must know certain technical modifications to be able to universally apply continuous techniques safely.