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A flexible but simple cardioplegic delivery system has been designed that offers the advantages of alternating antegrade and retrograde delivery or blood and crystalloid (Plegisol¿ solution) cardioplegia to optimize myocardial preservation. Initial antegrade delivery of crystalloid cardioplegic solution achieves rapid cardiac arrest while subsequent retrograde delivery with blood cardioplegia improves myocardial protection due to uniform distribution of the solution. Occasionally, temporary transferral from blood to crystalloid is indicated to clarify the surgical field.

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