As I have mentioned in a previous blog, I have been getting more comfortable with using Del Nido Cardioplegia.
I have enclosed the components that we utilize.
We use a 4:1, blood: cardioplegia ratio
I believe that it has been described using a 1:4 ratio.
I usually deliver a 2 liter induction dose and then I give an additional 500cc , 45-55 minutes later.
I would recommend not giving an additional dose within 20 minutes of unclamping because I have noticed that the heart is a bit more stunned and takes longer to resume electrical activity.
1 liter of Plasmalyte or Isolyte or Normasol
Mannitol 20% 16 mL
Magnesium 2 g 4 mL
KCL 35 mEq
Sodium Bicarbonate 13 mL
Lidocaine 2% 6.5 mL
I usually end up using approximately 2 liters of this cardioplegia because I also utilize this solution to irrigate the aortic root and LV after debriding the calcium or for testing my mitral valve repair.