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Ann Thorac Surg 1982;34:647-658
© 1982 The Society of Thoracic Surgeons
From the Services de Chirurgie Cardio-vasculaire, Biophysique et Médecine Nucléaire et Anatomie Pathologique, Hôpital Lariboisière, Paris, France
* Address reprint requests to Dr. Menasché, Service de Chirurgie Cardio-vasculaire, Hôpital Lariboisière, 2, rue Ambroise Paré, 75475 Paris Cedex 10, France
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.
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