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Ann Thorac Surg 1979;28:317-322
© 1979 The Society of Thoracic Surgeons

Articles

The Importance of Monitoring Intramyocardial Temperature during Hypothermic Myocardial Protection

Ray C.J. Chiu, M.D. Ph.D.*, Peter E. Blundell, M.D., Henry J. Scott, M.D., Steven Cain, M.D.

Division of Cardiovascular and Thoracic Surgery, McGill University, and the Montreal General Hospital Montreal, Que, Canada.

* Address reprint requests to Dr. Chiu, The Montreal General Hospital, Rm 961, 1650 Cedar Ave, Montreal, PQ, Canada H3G 1A4.

In 50 patients undergoing cardiac operation, hypothermic cardioplegic solution was infused into the root of the aorta immediately after aortic cross-clamping. Cardiac standstill was achieved within 1 to 3 minutes. However, monitoring of intramyocardial temperature with a needle thermistor revealed that such core cooling is unpredictable (the intramyocardial temperature achieved ranged from 7° to 33°C), unstable (this temperature can rise at more than 0.5°C per minute), and uneven (a difference of up to 17°C was observed between the intramyocardial temperature of the anterior and posterior left ventricular sites). The area supplied by the stenotic coronary artery was least protected. Monitoring of intramyocardial temperature enables one to know when supplementary cooling is indicated. We conclude that widespread differences in this temperature during cardiac operation make monitoring advisable for optimal myocardial protection.




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