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  • CUSTODIOL® HTK Solution for Myocardial Protection During an Aortic Valve Replacement and CABGx2 A note from the perfusionist: "CUSTODIOL® HTK is a hyper-polarizing cardioplegia and because of the large histidine buffer concentration, there is no room, osmolality wise, for normal Na+ levels. This is why the Na+ drops. It does not cause harm to the patient, and can be easily fixed with DUF (dilutional ultrafiltration with NaHCO3 buffered 0.9% NCL soultion) as mentioned in the video."