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Ann Thorac Surg 1988;46:401-405
© 1988 The Society of Thoracic Surgeons

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Articles

A New Technique of Internal Cardiac Cooling Improves Atrial Protection

Baker Medical Research Institute and the C. J. Officer Brown Cardiac Surgery Unit, Alfred Hospital, Melbourne, Australia

Accepted for publication April 18, 1988.

^* Address reprint requests to Dr. Rosenfeldt, Baker Medical Research Institute, PO Box 348, Commercial Rd, Prahran, Victoria, Australia 3181

We developed a technique for selectively cooling the right heart during cardioplegic arrest by intracavitary right atrial (RA) perfusion with cold blood. In dogs during hypothermic cardioplegic arrest, we compared the effects on myocardial temperature of RA perfusion and two snared caval cannulas with three methods of venous cannulation without perfusion: a two-stage atriocaval cannula, two caval cannulas and two snared caval cannulas. The mean atrioventricular (AV) node temperature with RA perfusion (16.5° ± 0.4°C) was significantly lower than with the atriocaval cannula (25.1° ± 0.2°C), two caval cannulas (25.2° ± 0.3°C) or two snared caval cannulas (21.6° ± 0.2°C) (p > 0.01, RA perfusion versus other groups). The results for RA wall temperature showed a similar pattern. RA perfusion produced similar results in 6 patients undergoing coronary artery bypass grafting. We conclude that hypothermic protection of the right atrium and AV node is inadequate with conventional techniques of cannulation and cooling, and may be improved by the use of internal RA cooling.

This article has been cited by other articles:

				M. A.J.M. Huybregts, R. de Vroege, and W. van Oeveren A New System for Right Atrial Cooling Ann. Thorac. Surg., April 1, 2008; 85(4): 1421 - 1424. [Abstract] [Full Text] [PDF]

				X.-Z. Chen, M. Newman, and F. L. Rosenfeldt Internal Cardiac Cooling Improves Atrial Preservation: Electrophysiological and Biochemical Assessment Ann. Thorac. Surg., October 1, 1988; 46(4): 406 - 411. [Abstract] [PDF]