HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Crooke, G. A. Articles by Colvin, S. B. Search for Related Content PubMed PubMed Citation Articles by Crooke, G. A. Articles by Colvin, S. B.

The Journal of Thoracic and Cardiovascular Surgery, Vol 102, 631-637, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Biventricular distribution of cold blood cardioplegic solution administered by different retrograde techniques

GA Crooke, LH Harris, EA Grossi, FG Baumann, AC Galloway and SB Colvin
Department of Surgery, New York University Medical Center, NY 10016.

Although retrograde cardioplegia has been shown to provide adequate overall protection to the myocardium, delivery of cardioplegic solution to the right ventricle and septum is poor. We used an animal model of occlusion of the left anterior descending coronary artery to study the effects of modifying the conditions of retrograde cardioplegia administration on delivery to the right and left ventricles. Adult mongrel dogs (n = 12) were each given five retrograde injections of microsphere-labeled cardioplegic solution at 10-minute intervals. Four injections were made directly into the coronary sinus with ostial balloon occlusion at the following dosages and pressures: (1) 10 ml/kg at 30 mm Hg, (2) 20 ml/kg at 30 mm Hg, (3) 10 ml/kg at 50 mmHg, and (4) 20 ml/kg at 50 mm Hg. A fifth dose (20 ml/kg) was given directly into the right atrium at 50 mm Hg. Delivery of cardioplegic solution to the left and right ventricles was significantly reduced when the right atrial route was compared with the coronary sinus route at the same dosage and pressure (for left ventricle, 6.0% +/- 1.4% versus 22.7% +/- 11.4%/100 gm, p less than 0.001; for right ventricle, 0.7% +/- 0.2% versus 4.1% +/- 0.4%/100 gm, p less than 0.001). Septal delivery was less than that to the anterior and posterior left ventricle (10.4% +/- 1.3% versus 30.3% +/- 3.9% and 27.9% +/- 3.1%/100 gm, p less than 0.0001) for all injections. Delivery to the body of the right ventricle was less than that to the inflow and outflow tracts (1.8% +/- 0.2% versus 4.5% +/- 0.7% and 8.4% +/- 1.5%/100 gm, p less than 0.0001). These results indicate that, in this model, (1) the right atrial route provides less overall cardioplegic solution to both ventricles than direct retrograde coronary sinus cardioplegia and (2) regional abnormalities in distribution with direct retrograde coronary sinus cardioplegia are not affected by changes in the dosage or pressure of injection.

This article has been cited by other articles:

				E. Bezon, J. N. Choplain, A. A. Aziz Khalifa, H. Numa, N. Salley, and J. A. Barra Continuous retrograde blood cardioplegia ensures prolonged aortic cross-clamping time without increasing the operative risk Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 403 - 407. [Abstract] [Full Text] [PDF]

				S. R. Gundry, N. Wang, C. M. Sciolaro, G. S. Van Arsdell, A. J. Razzouk, A. C. Hill, and L. L. Bailey Uniformity of Perfusion in All Regions of the Human Heart by Warm Continuous Retrograde Cardioplegia Ann. Thorac. Surg., January 1, 1996; 61(1): 33 - 35. [Abstract] [Full Text]

				A. Ardehali, H. Laks, D. C. Drinkwater Jr, R. N. Gates, and E. Kaczer Ventricular Effluent of Retrograde Cardioplegia in Human Hearts Has Traversed Capillary Beds Ann. Thorac. Surg., July 1, 1995; 60(1): 78 - 82. [Abstract] [Full Text]

				M. Carrier, J. Gregoire, A. Khalil, P. Thai, J.-G. Latour, and L. C. Pelletier Myocardial distribution of retrograde cardioplegic solution assessed by myocardial thallium 201 uptake J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1115 - 1118. [Abstract] [Full Text]