Iaterogenic injuries during retrograde delivery of cardioplegia.
During last eight years, retrograde delivery of cardioplegia was used on a regular basis, utilizing a DLP INC (Grand Rapids, MI) or a Research Medical INC (Salt Lake City UT) delivery systems, in almost an equal number of patients. This method resulted in a high pressure rupture, or perforation of the coronary sinus, its radicals or the right ventricle (RV) in 0.06% (5/7886) of patients. Intraoperative diagnosis of these injuries were confirmed on abnormal haemodynamic tracings and trans oesophageal echocardiography (TOE), and appearance of cardiac contusion or leakage of cardioplegia. A low incidence of these iaterogenic injuries may be attributed to: (1) a regular use of this method and (2) use of TOE guided manipulations in select high risk and reoperative patients. Repair of these injuries, as described, resulted in salvage of 4/5 (80%) patients.
Kaul
T K
TK
Department of Cardiac Surgery, Baptist Medical Center, 817 Princeton Avenue SW, Birmingham, AL 35211, USA.
Fields
B L
BL
Jones
C R
CR
D000368:Aged; D000369:Aged, 80 and over; D002314:Cardioplegic Solutions / Q000008:administration & dosage*; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000293:injuries; D016503:Drug Delivery Systems; D017809:Fatal Outcome; D005260:Female; D006324:Heart Arrest, Induced / Q000009:adverse effects* / Q000379:methods*; D006335:Heart Injuries / Q000209:etiology*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male
D002314:Cardioplegic Solutions