Protecting heart in heart operations: Evaluating the Terminal 'Hot Shot'

The effect of an enhanced mixture of blood with cell membrane stabilizing agents called as Terminal 'Hot Shot' cardioplegia(THS) is studied. THS consists of 20% Mannitol 20 ml 2% Xylocaine 60mg 15% Magnesium Sulphate 500mg 8.4% Sodium Bicarbonate 20ml Hot water 50ml Patients own warm Blood at 37 degree celsius 400ml 500ml of THS at 37°C, is administered both in the saphenous vein grafts at 100ml/each and the rest is delivered in the aortic root via intraortic infusion, at the termination of coronary artery bypass grafting while the patient is on Cardiopulmonary Bypass machine. The whole process of administration took 5-6 minutes by the lead cardiac surgeon. Adherence to intervention was documented in operative report. Cold blood cardioplegia was administered after placing the patient on Cardiopulmonary Bypass machine to arrest the heart in all patients. After arresting the heart, aorta was cross clamped and grafting started. In approximately 60mins of arrest (stated by the mean Aortic cross clamp time) THS administration was started. THS administration was done in the intervention group after the aortic cross clamp was removed after all the distal anastomosis was performed, prior to doing proximal anastomosis , while the patient was on CPB.