[The versatility of anterograde/retrograde cardioplegia in heart surgery].
Eighty patients underwent open-heart surgery from March 1990 to March 1993. We used combined aortic root (antegrade)/coronary sinus (retrograde) perfusion for cardioplegia delivery as a means of myocardial protection. The special retroplegia cannula was introduced to the coronary sinus (CS) in 67 patients by the transatrial (blind intubation) after one cannula cava insertion; the CS was cannulated under direct vision by right atriotomy after bicaval cannulation in 13 patients. Varied and prolonged cardiac procedures were done using cooled crystalloid cardioplegia (4 centigrades + potassium) except in one patient with severe ventricular damage in whom warm blood cardioplegia was infused. There was no CS or cardiac vein damage or disruption. There was no A-V blockade. The CS was intubated easily in all cases and cardioplegia solution readily infused. Coronary sinus pressure never exceeded 40 mm Hg. Overall hospital mortality (30 days postoperative) was 3.75% (3 cases). Sepsis was the cause of death in 2 patients and stroke in one. Inotropes were used in few cases as a means of renal protection. We conclude that the combined antegrade/retrograde cardioplegia delivery can be used routinely in most patients undergoing open-heart surgery.
Urrea
M S
MS
Departamento de Cirugía Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Herrera
V
V
Santibáñez
J A
JA
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality; D005112:Extracorporeal Circulation; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology
Versatilidad de la cardioplejía anterógrada/retrógrada en cirugía cardíaca.