The Annals of Thoracic Surgery, Vol 23, 154-155, Copyright © 1977 by The Society of Thoracic Surgeons
Selective intracavitary and coronary profound hypothermic cardioplegia for myocardial preservation: a new technique
A Schachner, G Schimert, TZ Lajos, AB Lee Jr and JH Siegel
A technique is described for selective intracavitary and coronary
hypothermic perfusion during cardiac bypass with cardioplegia to facilitate
cardiac operations. A cold perfusate (Plasmalyte 148 and mannitol, 12.5
gm/L at 8 degrees to 10 degrees C) is administered with the aid of a
low-flow perfusion pump into the left ventricular cavity and coronary
circulation through an apical perfusion-venting (Per-Vent) catheter. This
perfusate cools the myocardium rapidly and homogeneously to a temperature
of 15 degrees to 20 degrees C. Within this temperature range, complete
cardioplegia occurs and the safe ischemia period can be extended to 120
minutes. This method was applied in 50 unselected consecutive adult
patients undergoing aortocoronary saphenous vein bypass grafting or aortic
or mitral valve replacement. All patients survived and had excellent
recovery of ventricular function.