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Calafiore cardioplegia is a myocardial protection strategy used during cardiac surgery, most notably in coronary artery bypass grafting (CABG). Developed by surgeon Antonio Calafiore, this technique utilizes intermittent, antegrade (or sometimes retrograde) delivery of a warm (normothermic or tepid) blood-based solution enriched with potassium and magnesium. Unlike traditional cold crystalloid cardioplegia, the Calafiore method leverages the oxygen-carrying capacity of the patient's own blood and avoids the physiological stressors associated with profound hypothermia and hemodilution. The solution induces rapid diastolic cardiac arrest by elevating extracellular potassium concentrations, which depolarizes the cardiomyocyte membrane and inactivates voltage-gated sodium channels. The inclusion of magnesium acts as a natural calcium antagonist, preventing intracellular calcium overload and reducing reperfusion injury. This approach is favored for its simplicity and the maintenance of myocardial metabolic activity during the ischemic period.
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