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 Fisk, R. L. Articles by Guilbeau, E. J. Search for Related Content PubMed PubMed Citation Articles by Fisk, R. L. Articles by Guilbeau, E. J.

The Annals of Thoracic Surgery, Vol 34, 318-323, Copyright © 1982 by The Society of Thoracic Surgeons

ARTICLES

Asymmetrical myocardial hypothermia during hypothermic cardioplegia

RL Fisk, D Ghaswalla and EJ Guilbeau

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 degrees 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 degrees 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 degrees 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 degrees to 3 degrees 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.

This article has been cited by other articles:

				R. A. Schroeder, G. L. Wood, J. S. Plotkin, and P. C. Kuo Intraoperative Use of Inhaled PGI2 for Acute Pulmonary Hypertension and Right Ventricular Failure Anesth. Analg., August 1, 2000; 91(2): 291 - 295. [Abstract] [Full Text] [PDF]

				R. R. Chaturvedi, D. F. Shore, C. Lincoln, S. Mumby, M. Kemp, J. Brierly, A. Petros, J. M.G. Gutteridge, J. Hooper, and A. N. Redington Acute Right Ventricular Restrictive Physiology After Repair of Tetralogy of Fallot : Association With Myocardial Injury and Oxidative Stress Circulation, October 5, 1999; 100(14): 1540 - 1547. [Abstract] [Full Text] [PDF]

				C. I. Brookes, P. A. White, A. J. Bishop, P. J. Oldershaw, A. N. Redington, and N. E. Moat Validation of a new intraoperative technique to evaluateload-independent indices of right ventricular performance in patients undergoingcardiac operations J. Thorac. Cardiovasc. Surg., September 1, 1998; 116(3): 468 - 472. [Abstract] [Full Text]

				S. Cullen, D. Shore, and A. Redington Characterization of Right Ventricular Diastolic Performance After Complete Repair of Tetralogy of Fallot : Restrictive Physiology Predicts Slow Postoperative Recovery Circulation, March 15, 1995; 91(6): 1782 - 1789. [Abstract] [Full Text]