Elective cardiac arrest by means of chemical agents and by hypothermia has been thoroughly assessed by many investigations. Local hypothermia of the myocardium has been found to minimize the deleterious effects with a better preservation of cardiac function.1
Differential cooling of the heart while the body is perfused and cooled to 30-32 C was introduced by Urschell2 in 1959. The elective cardioplegia was achieved by local cardiac hypothermia with cold saline or perfusion of the coronaries with Ringer's lactate of 2 C. Cross3 perfused the coronaries with cold blood in 1957. This procedure caused not only technical difficulties, but marked depression of cardiac work and increased blood viscosity and platelet damage, resulting in hemorrhage.
It is well known that local cooling of the kidney by saline ice slush in bags is very effective, and has been used by urologists for several years. This technique provides an extremely
HEIMBECKER RO, LAJOS TZ. Ice-Chip Cardioplegia. Arch Surg. 1962;84(1):130–140. doi:10.1001/archsurg.1962.01300190134017
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