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Ann Thorac Surg 1983;35:621-625
© 1983 The Society of Thoracic Surgeons

Articles

The Effect of Nitroglycerin Cardioplegia on Myocardial Cooling in Patients Undergoing Myocardial Revascularization

Roderick Landymore, M.D., F.R.C.S.(C)*, Steven Colvin, M.D., Wayne Isom, M.D., Alfred Culliford, M.D.

From the Department of Surgery, Division of Thoracic and Cardiovascular Surgery, the New York University Medical Center, New York, NY

Accepted for publication July 6, 1982.

* Address reprint requests to Dr. Landymore, Room 119, Pavilion, Victoria General Hospital, Halifax, NS, Canada B3H 2Y9

The effect of intracoronary administration of nitroglycerin on the distribution of cardioplegia and myocardial cooling was assessed in 45 patients undergoing elective myocardial revascularization. The patients were divided into three groups. Myocardial temperature was measured over the right and left coronary artery distributions in Group 1 after the infusion of 1 liter of potassium blood cardioplegic solution (20 mEq of potassium per liter). Similar temperature measurements were made in Group 2 after the addition of 300 µg of nitroglycerin to the cardioplegic solution and in Group 3 after the addition of 1,000 µg of nitroglycerin. Nitroglycerin did not affect myocardial cooling, and large temperature gradients persisted after delivery of cardioplegia in patients with occlusive coronary artery disease. Unexpectedly, however, the rate of cardioplegia delivery increased by 134%, within the same range of infusion pressures, in patients receiving nitroglycerin. Although nitroglycerin cardioplegia does not affect the regional disparity in the distribution of cardioplegia in patients with severe coronary artery disease, intracoronary administration of nitroglycerin reduces the time required for administration of cardioplegia and thereby decreases the total ischemia time.




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