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Ann Thorac Surg 1991;51:278-283
© 1991 The Society of Thoracic Surgeons

Articles

Optimizing myocardial hypothermia: I. Temperature probe design and clinical inferences

Thomas B. Kinney, MDa,b, Pat O. Daily, MD*,a,b, Thomas A. Pfeffer, MDa,b

a University of California, San Diego, USA
b Medical Center and Sharp Memorial Hospital, San Diego, California USA

Accepted for publication October 26, 1990.

* Address reprint requests to Dr Daily, 8010 Frost St, Suite 501, San Diego, CA 92123.

Myocardial hypothermia is an essential component of myocardial preservation for most cardiac operations. Because of multiple causes of rewarming, it is necessary to monitor temperatures at specific sites (right and left ventricular epicardium and endocardium or cavity). Thus, plastic temperature probes have been designed and fabricated to facilitate temperature monitoring at these sites. Using a bare thermocouple as a standard, in vitro comparison of metallic probes and plastic probes revealed differences of 4.0 ° ± 0.9 °C and 0.7 ° ± 0.6 °C, respectively (p < 0.005). Consequently, metallic probes do not have sufficient accuracy to detect transmural temperature gradients because of "stem effect." Using the plastic probes to evaluate temperature changes in porcine hearts after cardioplegia-induced hypothermia revealed a temperature rise of 1 °C/min at all sites if control of systemic and venous return and local myocardial cooling are not provided. The use of temperature monitoring at multiple sites permits identification and prevention of various causes of myocardial rewarming and is facilitated by the use of plastic probes described herein which contain dual thermocouples.




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