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The Annals of Thoracic Surgery, Vol 43, 92-97, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

Antegrade and retrograde infusion of cardioplegia: assessment by thermovision

N Shapira, GM Lemole, PM Spagna, FJ Bonner, J Fernandez and D Morse

The efficacy of two routes of cardioplegia infusion was examined by assessing the hypothermia induced in patients with critically obstructed or occluded major coronary arteries. The antegrade (through the aorta) and the retrograde (through the coronary sinus) methods of cardioplegia infusion were compared using myocardial thermograms. Patients (N = 8) were matched according to angiographic similarities of their coronary artery disease. Adequate myocardial cooling distal to a critical obstruction could frequently not be obtained with antegrade infusion of cardioplegic solution. With retrograde infusion, the desired uniform cooling of the myocardium, as determined by thermographic analysis of the surface temperatures of the heart, was obtained. We conclude that retrograde infusion of cardioplegic solution induces more effective and homogeneous hypothermia in patients with critically obstructive multivessel coronary disease, and may provide improved myocardial protection.


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