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Ann Thorac Surg 1997;64:1518
© 1997 The Society of Thoracic Surgeons

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Correspondence

Warm Cardioplegia in Cardiac Transplantation

Department of Cardiothoracic Surgery, Sri Ramachandra Medical College University Hospital, Porur, Madras 600116, India.

To the Editor:

We read with interest the article "Clinical Trial of Retrograde Warm Blood Reperfusion Versus Standard Cold Topical Irrigation of Transplanted Hearts" by Carrier and associates [1]. Carrier and associates conclude that retrograde warm blood reperfusion appears to improve the initial recovery of transplanted hearts and that the technique is easy to use and may be a useful approach for graft protection during surgical implantation.

We use a simpler technique to protect the donor heart. After the donor heart is harvested in the usual manner, during implantation, instead of cold topical irrigation, we give antegrade warm blood cardioplegia every 10 minutes via the aortic root after placing a straight clamp on the donor aorta distally. Because we use the alternate technique of systemic and pulmonary venous connections [2], the right atrium is not opened and hence coronary sinus cannulation could be cumbersome. Moreover, by administering antegrade cardioplegia through normal coronary arteries we achieve adequate protection of the entire myocardium. Concern regarding right ventricular protection via the retrograde route does not exist. We commend Carrier and associates on their technique of warm blood reperfusion of the donor heart and recommend that antegrade delivery could be a simpler and more effective technique.

References

1. Carrier M, Leung TK, Solymoss C, Cartier R, Leclerc Y, Pelletier LC. Clinical trial of retrograde warm blood reperfusion versus standard cold topical irrigation of transplanted hearts. Ann Thorac Surg 1996;61:1310–5.[Abstract/Free Full Text]
2. Aravot DJ, Wells FC, Large SR, Wallwork J. Alternative method for cardiac transplantation: surgical considerations and technical aspects. Ann Thorac Surg 1996;61:1549–51.[Abstract/Free Full Text]

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This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Richard Saldanha Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Balakrishnan, K. R. Articles by Parvathy, U. Search for Related Content PubMed PubMed Citation Articles by Balakrishnan, K. R. Articles by Parvathy, U.