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The Annals of Thoracic Surgery, Vol 34, 647-658, Copyright © 1982 by The Society of Thoracic Surgeons
P Menasche, S Kural, M Fauchet, A Lavergne, P Commin, M Bercot, B Touchot, G Georgiopoulos and A Piwnica
During aortic valve surgery, cardioplegic solution is delivered through
direct cannulation of both coronary ostia. Since this approach may cause an
intimal injury leading to acute dissection or late ostial stenosis, we have
evaluated retrograde coronary sinus perfusion (RCSP) as a means of
delivering cardioplegia in 12 patients undergoing aortic valve replacement.
The retroperfusion of the cardioplegic solution was performed with a
balloon-tipped catheter inserted into the coronary sinus through the right
atrium. The perfusion pressure averaged 40 mm Hg. Twelve patients
undergoing antegrade coronary perfusion served as controls. Both groups
were matched for preoperative and intraoperative data. The postoperative
evaluation focused on hemodynamic status, as evidenced by serial
measurements of right-sided pressures and cardiac output at 1, 6, 12, 18,
and 24 hours after operation. The stroke volume index and the left
ventricular and right ventricular systolic stroke work indexes were then
calculated. There was no statistically significant difference between the
two groups. We conclude that RCSP is a simple, safe, and effective means of
cardioplegic protection during aortic valve surgery.
ARTICLES
Retrograde coronary sinus perfusion: a safe alternative for ensuring cardioplegic delivery in aortic valve surgery
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