I never used the custodiol in pediatric cardiac surgery and my experience of using this type of cardioplegic is limited during the explants of the heart and heart-lung.I think the custodiol has two negative effects: the excessive dilution and action of depressed ventricular function

 Dr Nappi , I agree with you  thank you very much

In our institute DEL NIDO cardioplegia  a unique 4 parts crystalloid and 1 part blood formulation were  used,  mostly single dose in most of complex neonatal and pediatric surgeries and we have good results.

In our centre always use custodiol for pediatric cardiac surgery and we have excellents results. I think the problem of excessive dilution is resolve with modified ultrafiltration on the end of surgery.