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J Thorac Cardiovasc Surg 2003;126:2111
© 2003 The American Association for Thoracic Surgery

Letter to the editor

Study of warm perfusion rather than cardioplegia

Edward B. Savage, MD

Rush–Presbyterian–St Luke's Medical Center, Chicago, IL 60612, USA

To the Editor:

I read the article by Mallidi and colleagues,1 "The Short-term and Long-term Effects of Warm or Tepid Cardioplegia," and raise the following concern. The title is not descriptive of the protocols. Rather than isolated cold or warm cardioplegia, the article really describes cold and warm total-body and cardiac perfusion strategies. The article states, "In the warm or tepid blood cardioplegia group, the systemic temperature was maintained at 33°C to 37°C, and the blood cardioplegia was delivered at a temperature of 37°C. In the tepid cardioplegia group, the systemic temperature was permitted to drift passively during the operation to 32°C to 34°C. The temperature of the cardioplegia was 28° to 30°C. In the cold cardioplegia group, the systemic temperature was actively cooled to 25°C to 32°C, and the blood cardioplegia was actively cooled to a temperature of 5°C to 8°C."

Other combinations may have similar results, for example a warm corporeal perfusion strategy (drifting without active cooling) and cold cardioplegia. The data do not preclude such a result.

This group has done a nice job scientifically studying and promoting warm perfusion and protection strategies. I think that describing their technique as "warm blood cardioplegia" does not describe the strategy adequately, and "warm perfusion strategy" might be more accurate.


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  1. Mallidi HR, Sever J, Tamariz M, Singh S, Hanayama N, Christakis GT, et al. The short-term and long-term effects of warm or tepid cardioplegia. J Thorac Cardiovasc Surg. 2003;125:711–720[Abstract/Free Full Text]

Related Article

Reply to the Editor
Hari R. Mallidi and Stephen E. Fremes
J. Thorac. Cardiovasc. Surg. 2003 126: 2111-2112. [Extract] [Full Text] [PDF]




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