modified del nido + histidine-tryptophan-ketoglutarate solution

Modified Del Nido + Custodiol refers to a combination or sequential cardioplegic regimen used for myocardial protection during cardiac surgery. Modified Del Nido is a potassium-based, extracellular-type solution traditionally containing lidocaine, magnesium sulfate, and sodium bicarbonate, often mixed with blood in a 1:4 or 1:8 ratio to induce rapid depolarized cardiac arrest. Custodiol (Histidine-Tryptophan-Ketoglutarate or HTK) is a low-sodium, intracellular-type solution designed for extended protection (up to 3 hours) through potent histidine buffering against acidosis and metabolic support from ketoglutarate and tryptophan. This combination is typically employed in complex, long-duration adult or pediatric cardiac procedures, such as aortic root replacements or multi-valve surgeries, to leverage the rapid induction and microvascular protection of Del Nido with the prolonged, stable buffering capacity of Custodiol.

Brand names

Custodiol HTK

Other names

Modified Del NidoHTK solutionBretschneider solutionDel Nido solutionModified Del Nido + Custodiol