Does warm blood retrograde cardioplegia preserve right ventricular function?
BACKGROUND
Efficacy of warm blood retrograde cardioplegia in preserving right heart function remains controversial. The current study was conducted to gauge the preservation of right ventricular function after warm blood retrograde cardioplegia.


METHODS
We studied 75 consecutive patients undergoing isolated heart valve procedures with warm blood retrograde cardioplegia as the exclusive mode of preservation. Right ventricular radionuclide ejection fraction and hemodynamic measurements using a pulmonary artery catheter were calculated before and within 3 days after operation.


RESULTS
Postoperative radionuclide right ventricular ejection fraction was well preserved at 0.4686 +/- 0.0122 compared with 0.4327 +/- 0.0255 preoperatively (p = 0.7064). Right ventricular systolic work index improved from 5.82 +/- 0.52 to 8.97 +/- 0.60 g x m/m2 (p < 0.0001) and cardiac index increased from 2.40 +/- 0.09 to 2.92 +/- 0.11 L/m2 (p < 0.0001). When right ventricular systolic work index was correlated with preload, 30 patients moved up and down on the same ventricular function curve and 42 moved to a higher inotropic curve postoperatively. Only 3 patients demonstrated decreased inotropy.


CONCLUSIONS
In the clinical setting warm blood retrograde cardioplegia used as the exclusive mode of myocardial preservation provides adequate protection of the right heart.
Kulshrestha
P
P
Department of Surgery, The Baystate Medical Center, Springfield, Massachusetts 01199, USA.
Rousou
J A
JA
Engelman
R M
RM
Flack
J E
JE
Deaton
D W
DW
Wait
R B
RB
Hampf
H M
HM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006349:Heart Valve Diseases / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D013696:Temperature; D016278:Ventricular Function, Right