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Ann Thorac Surg 1982;34:318-323
© 1982 The Society of Thoracic Surgeons
From St. Luke's Hospital and Medical Center, Phoenix, and the Department of Chemical and Bioengineering, Arizona State University, Tempe, AZ
Accepted for publication July 29, 1981.
* Address reprint requests to Dr. Fisk, St. Luke's Hospital Medical Center, 525 N 18th St, Suite 403, Phoenix, AZ 85006
To evaluate the possibility of inadequate right ventricular protection during operation, the temperatures of the anterior myocardium of the right ventricle and the middle of the interventricular septum were compared at ten-minute intervals throughout the period of continuous coronary ischemia in 130 consecutive patients. Systemic temperature was lowered to 23°C, using cardiopulmonary bypass. Cardiac arrest was induced by aortic cross-clamping and infusion of cold cardioplegic solution. Cold solution was reinfused as necessary to maintain septal temperatures at less than 20°C.
Despite the use of superior and inferior vena caval cannulation for control of venous return, it was more difficult to maintain the right ventricle at the desired degree of myocardial hypothermia than the left ventricle. The difference between left and right ventricular temperatures was as great as 19°C. In 80% of the observations (n = 1,010), the right ventricle was warmer than the left ventricle. The most frequently occurring temperature differences (left ventricle minus right ventricle) were in the 2° to 3°C range. These data indicate that it is more difficult to maintain hypothermia in the right ventricle. Concern for the left ventricle alone may be misleading. An alarming degree of rewarming may occur in the right ventricle and thereby contribute to right ventricular dysfunction and unilateral right ventricular failure.
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