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The Annals of Thoracic Surgery, Vol 25, 407-412, Copyright © 1978 by The Society of Thoracic Surgeons

ARTICLES

Intraoperative changes in coronary resistance during aortic valve replacement

P Karkola, E Saarela, S Tuononen, R Pokela, L Nuutinen, MI Kairaluoma and TK Larmi

Coronary vascular resistance was investigated in 10 patients undergoing aortic valve replacement using continuous constant-pressure coronary perfusion at 32 degrees C. After coronary flow was initiated, resistance was low but increased steadily until it reached a certain resting level. The plateau was attained faster after a short period of anoxia than after a longer period. The initial postischemic resistance was dependent on the duration preceding anoxia, being of the same magnitude after short and moderate periods of anoxia but significantly higher after a long period. This resistance difference between the groups lasted for the whole perfusion. The total coronary resistance and flow reached a plateau in 30 minutes, while resistance increased threefold but flow decreased to half of the initial postanoxia flow. Our results indicate the importance of initiating coronary perfusion soon after aortic cross-clamping to avoid increase in the initial vascular resistance and subsequent inadequate myocardial flow.


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 Eur. J. Cardiothorac. Surg.Home page
X. Y. Jin, D. G. Gibson, and J. R. Pepper
The effects of cardioplegia on coronary pressure-flow velocity relationships during aortic valve replacement
Eur. J. Cardiothorac. Surg., September 1, 1999; 16(3): 324 - 330.
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Copyright © 1978 by The Society of Thoracic Surgeons.