Methods and results: Consecutive cases of intra-cardiac tumour resection at St Vincent’s Hospital from 1990 to 2012 were reviewed. Thirty-one cases were identified. Twenty- nine were neoplastic, and two later identified as thrombus. Of the neoplasms, 18 were myxomas, two fibroelastomas, two clear cell renal carcinomas, two leiomyosarcomas, and one lipoma, sarcoma, poorly differentiated adenocarcimona, and hemangioma. Of the myxomas, 53% of patients were female and 46% were male. The mean age at presentation was 58 (32–76) years. All tumours were solitary. Presentation was with dyspnoea (33%), palpitations/arrhythmias (20%), and recur- rent pulmonary oedema (6%). Forty-six percent had a history of embolic stroke. All patients underwent echocardiography. Of the myxo- mas, resection was performed via right atriotomy (53%), left atriotomy (26%), and transeptal approach (20%). Sixty percent required an autologous pericardial patch repair/closure for remaining intra-atrial septal defect. Two had concomitant CAGS, one an aortic root repair, and one closure of ASD. The size of tumour ranged from 1.5 cm  1.5 cm to 8.5 cm  4.4 cm. At the time of follow up, three patients were deceased. Discussion: We found that our series closely reflected that which is represented in the literature in terms of prevalence, presentation, mode of diagnosis and resection. We found that of the myxomas, solid tumours are more common, more likely to be associated with heart failure, and best resected in a whole part. We found that papillary tumours are more likely to be associated with neurological symptoms and emboli, are more friable, and therefore more likely resected by piecemeal removal. We had excellent resection rates with no mortality associ- ated with the surgery or with benign tumour pathology. http://dx.doi.org/10.1016/j.hlc.2013.10.039 Friday 23 August – MO 1.8/1340–1345 Custodiol is a Safe Alternative to Blood Cardioplegia in Major Aortic Surgery Nisal K. Perera 1* , Sean D. Galvin 1 , Bruno Marino 2 , Frank Liskaser 2 , Peter McCall 2 , Rinaldo Bellomo 3 , Siven Seevenayagam 1 , George Matalanis 1 1 Departments of Cardiac Surgery, Australia 2 Perfusion, Australia 3 Intensive Care, Austin Hospital, Heidleberg, Victoria, Australia * Corresponding author. Introduction: Single dose cardioplegia has many potential advantages in complex aortic procedures. Since 2008 we have selectively used Bretschneider histidine–tryptophan–keto- glutarate (HTK) crystalloid solution (Custodiol Dr. Franz Ko ¨ hlerChemie GmbH) and it is now our preferred method of myocardial protection in complex aortic surgery. Methods: Patients undergoing major open aortic surgery at a single centre, during a 13-year period (June 2001–March 2013) were identified from a prospectively collected data- base. Pre, intra- and postoperative characteristics were examined. Patients receiving standard blood cardioplegia (BC) were compared to those receiving Custodiol cardiople- gia (CC). Results: Three hundred and twenty one patients had major open aortic procedures performed. Status was urgent in 44 (14%); emergency in 76 (24%) and salvage in eight (3%) patients. Eighty-eight (27%) patients had acute type A aortic dissections. BC was used in 221 (68%) and CC in 100 (32%) patients. Pre-operative characteristics were similar in the two groups. Post-operative outcomes (Table 1) were similar but there was reduced RBC transfusion (BC: 2.77 Æ 1.72 vs CC: 1.77 Æ 1.87 units; p < 0.001); reduced return to theatre for bleeding (BC: 27% vs CC: 12%; p = 0.004) and a trend to a reduced in-hospital mortality (BC: 13% vs CC: 6%; p = 0.08) with the use of Custodiol cardioplegia. Discussion: The Custodiol group is a contemporary sur- gical cohort (2008–2013) and improved outcomes may be due to changes in practise over time. Single dose Custodiol car- dioplegia is a convenient and simple method of myocardial Table 1 Variable BC (n = 221) CC (n = 100) p-value Surgery Aortic 48 (22%) 25 (25%) Aortic + CABG 6 (3%) 3 (3%) Aortic + valve 125 (56%) 62 (62%) Aortic + valve + CABG 42 (19%) 10 (10%) AV procedure None 54 (24%) 28 (28%) Repair 2(1%) 6 (6%) Resuspension 12(5%) 8 (8%) Replacement 74 (34%) 9 (9%) David 43 (20%) 26 (26%) Bentall 36 (16%) 21 (21%) Ross 0 (0%) 2 (2%) Cross clamp (min) 170.5 (123.5–223.5) a 174.5 (133–206) a 0.899 Bypass (min) 245 (198–309) a 254 (200.5–325.5) a 0.957 IABP 12 (5%) 3 (3%) 0.407 Ventricular assist device 8 (4%) 4 (4%) 0.868 Length of stay (days) 9 (7–15) a 8.5 (7–16) a 0.555 ICU Stay (h) 44 (22–111) a 42 (21–93) a 0.636 Ventilation time (h) 15 (10–41.5) a 11 (8–23) a 0.956 Tracheostomy 24 (11%) 9 (9%) 0.460 Return to theatre 60 (27%) 12 (12%) 0.004 Periop Ml 11 (5%) 1 (1%) 0.113 New arrythmia 81 (37%) 30 (30%) 0.240 Permanent CVA 21 (10%) 4 (4%) 0.103 Transient CVA 2 (1%) 3 (3%) 0.174 CWH 32 (14%) 10 (10%) 0.301 Inotropes > 4 h 111 (50%) 62 (62%) 0.104 Limb ischaemia 7 (3%) 2 (2%) 0.631 GT complication 17 (8%) 6 (6%) 0604 R6C units 2.77 Æ 1.72 b 1.77 Æ 11.87 b <0.001 Non RBC units 0 (0–15) a 7 (1–15) a 0.988 Hospital mortality elective 28 (13%) 6 (6%) 0.080 6/128 (4.6%) 1/55(1.5%) Redo aortic surgery 9 (4%) 4 (4%) a Median (interquartile range). b Mean Æ standard deviation. Abstracts e45