A technique for infusion of cardioplegic solution in coronary artery bypass with aortic regurgitation.
BACKGROUND
Complications such as heart failure due to insufficient cardioplegia may develop in on-pump coronary artery bypass (CAB) with mild-to-moderate aortic regurgitation (AR). A technique for administration of cardioplegic solution was carried out to avoid such complications.


RESULTS
Cardiopulmonary bypass was established. After aortic cross-clamping, cardioplegic solution was administered from aortic root. Because complete cardiac arrest was not rapidly achieved, the aortic root was incised. Three cusps of the aortic valve were sutured. The aorta was closed; cardioplegic solution was administered from the aortic root. Then, cardiac arrest was rapidly achieved. After distal anastomosis of quadruple bypass was completed, the suture of the cusps was removed. There was no exacerbation of AR due to this method compared to the preoperative state.


CONCLUSIONS
When off-pump coronary artery bypass is impossible and retrograde cardioplegia cannot be performed for a certain reason, this method may be set to one of the choices.
Imamaki
Mizuho
M
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan. imamaki-cuh@umin.ac.jp
Shimakura
Tadayuki
T
D000368:Aged; D000714:Anastomosis, Surgical; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000628:therapy*; D002314:Cardioplegic Solutions / Q000008:administration & dosage*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000628:therapy; D004452:Echocardiography; D005112:Extracorporeal Circulation; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D008297:Male; D008323:Mammary Arteries / Q000473:pathology / Q000601:surgery; D011126:Polypropylenes / Q000008:administration & dosage*; D012501:Saphenous Vein / Q000473:pathology / Q000637:transplantation
D002314:Cardioplegic Solutions; D011126:Polypropylenes