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Ann Thorac Surg 1987;43:92-97
© 1987 The Society of Thoracic Surgeons

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Articles

Antegrade and Retrograde Infusion of Cardioplegia: Assessment by Thermovision

From the Department of Surgery, Section of Cardiac Surgery, Washington Veterans Administration Hospital, and the Department of Surgery, Section of Cardiothoracic Surgery, Georgetown University, Washington, DC

Accepted for publication March 3, 1986.

^* Address reprint requests to Dr. Shapira, Department of Surgery, Section of Cardiac Surgery, Washington VA Hospital, 50 Irving St NW, Washington, DC 20422

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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