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Andrew C. Fiore
Keith S. Naunheim
George C. Kaiser
Vallee L. Willman
Lawrence R. McBride
Hendrick B. Barner
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Ann Thorac Surg 1989;47:684-688
© 1989 The Society of Thoracic Surgeons

Articles

Coronary sinus versus aortic root perfusion with blood cardioplegia in elective myocardial revascularization

Andrew C. Fiore, MD*, Keith S. Naunheim, MD, George C. Kaiser, MD, Vallee L. Willman, MD, Lawrence R. McBride, MD, D.Glenn Pennington, MD, Hendrick B. Barner, MD

Department of Surgery, St. Louis University Medical Center and St. Mary's Health Center, St. Louis, Missouri, USA

* Address reprint requests to Dr Fiore, Department of Surgery, St. Louis University Medical Center, 3635 Vista Ave at Grand Blvd, PO Box 15250, St. Louis, MO 63110-0250.

The role of retrograde coronary sinus cardioplegia in patients undergoing elective coronary artery bypass grafting has not been fully defined. Forty patients undergoing coronary artery bypass grafting received either aortic root (20 patients) or coronary sinus (20 patients) cold potassium blood cardioplegia. The patients were similar with respect to age, ventricular function, severity of coronary artery disease, cross-clamp time, completeness of revascularization, frequency of internal mammary artery grafting, and mean infusate volume and temperature. The time required to deliver the initial dose of cardioplegic solution and the time to achieve arrest were prolonged in the coronary sinus group (p < 0.001 and p < 0.02, respectively). There were no differences between the two groups postoperatively with regard to enzymatic indices, hemodynamic measurement, or clinical outcome. Right ventricular function was preserved equally in both groups. We conclude that coronary sinus cardioplegia is a safe alternative to aortic root perfusion, but offers no advantage in elective myocardial revascularization.




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