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Ann Thorac Surg 1994;57:403-406
© 1994 The Society of Thoracic Surgeons

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Articles

Perfusion deficits with retrograde warm blood cardioplegia

Division of Cardiothoracic Surgery, New England Deaconess Hospital/Harvard Medical School, Boston, Massachusetts, USA

Accepted for publication April 6, 1993.

^_* Address reprint requests to Dr Krukenkamp, Division of Cardiothoracic Surgery, New England Deaconess Hospital, 110 Francis St, Suite 2-C, Boston, MA 02215.

	Abstract

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Prior studies of cold retrograde cardioplegia have demonstrated the existence of regional deficits in perfusate delivery. To address the hypothesis that these deficits persist with the use of warm perfusate, cardioplegic arrest was induced in 7 swine hearts with retrograde warm blood cardioplegia. Regional perfusion was assessed with the simultaneous infusion of colored 10-µm microspheres. The percentage microsphere recovery (regional microsphere count/total number of microspheres counted x 100) was greatest in the anterior (43% ± 4%) and lateral (35% ± 6%) left ventricle. The microsphere recoveries in the posterior left ventricle (7% ± 1%) and anterior septum (14% ± 4%) were intermediate, and were statistically lower than those in the anterior left ventricle (p < 0.01). The lateral right ventricle (0.6% ± 0.2%) and the posterior septum (1.4% ± 0.9%) exhibited minimal perfusion versus that in the anterior left ventricle (p < 0.01). Less than 1% of the infused microspheres were recovered in the aortic root; 67% were recovered in the right ventricle and are presumed to have bypassed the microcirculation as nonnutritive flow. These data demonstrate that cold retrograde perfusion patterns persist during retrograde warm blood cardioplegia. Limited perfusion of the right ventricle and the posterior septum as well as a large nonnutritive flow were also noted. These perfusion deficits in metabolically active arrested hearts may limit myopreservation at low cardioplegia flow rates.

	Footnotes

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Presented in part at the Seventy-eighth Clinical Congress at the American College of Surgeons, New Orleans, LA, Oct 12–15, 1992.

Supported by National Institutes of Health grant HL29077.

¹ Doctor Krukenkamp is the recipient of National Institutes of Health First Award HL48751.

	References

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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map 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 Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Caldarone, C. A. Articles by Levitsky, S. Search for Related Content PubMed PubMed Citation Articles by Caldarone, C. A. Articles by Levitsky, S.