What is custodial solution?
Histidine-tryptophan-ketoglutarate, or Custodiol HTK solution, is a high-flow, low-potassium preservation solution used for organ transplantation. The solution was initially developed by Hans-Jürgen Bretschneider. The composition of HTK is similar to that of extracellular fluid.
What are types of cardioplegia?
One of the most important myocardial protection techniques is cardioplegia – indirect or direct administration of cardioplegic solution to the coronary arteries. Both crystalloid cardioplegia and blood cardioplegia are widely used in pediatric cardiac surgery [1–3].
How does Custodiol cardioplegia work?
Custodiol® solution, also called histidine-tryptophan-ketoglutarate (HTK) or Bretschneider’s solution, is a particular kind of long-acting intracellular crystalloid cardioplegia (CCP) that differs from other extracellular cardioplegic solutions because of its low sodium and potassium content that induce the diastolic …
Who invented cardioplegia?
The term cardioplegia (cardio, heart and plegia, paralysis) was first introduced by Lam in 1957 (Lam et al., 1957), yet the method of arrest has its roots in the early experiments of British physiologist Sidney Ringer using the frog heart (Figure 2).
What is cold blood cardioplegia?
The technique of myocardial protection by means of a cardioplegic solution consisting of cold blood (10 degrees C) with potassium (30 mEq. per liter) is described. A disposable cooling coil is used and a separate pump head for coronary perfusion is avoided.
How does HTK solution cause diastolic cardiac arrest?
The solution has an intracellular sodium concentration (15 mmol/L) and slightly elevated extracellular potassium concentration (10 mmol/L) (see Table 44-1). This electrolyte constellation causes a decrease in cardiac electric activity and finally results in diastolic cardiac arrest.
Which is better Custodiol HTK or cold cardioplegic solution?
The purpose of the study is to demonstrate that Custodiol-HTK is not inferior to cold cardioplegic solution in patients undergoing cardiovascular surgery requiring cardioplegic arrest.
Who is the inventor of the HTK solution?
The HTK solution (Custodiol) was initially developed as a cardioplegic solution by the German physiologist Hans Jürgen Bretschneider at the University of Göttingen in the early 1970s.88,89 In 1980 HTK solution was introduced as a preservation solution into clinical heart transplantation.
When was HTK first used in liver preservation?
Although HTK solution was initially designed as a cardiac preservation solution, it was successfully tested in clinical liver preservation in Europe in the 1990s.