How to determine the correct placement of the retrograde cardioplegia catheter.
Besides the surgeon's experience, there is no objective method to detect whether the retrograde cannula is inserted correctly before injecting the cardioplegia and measuring the coronary sinus pressure after the aorta cross-clamp. Repositioning of the retrograde cannula once extracorporeally is not always an easy maneuver and may include the risk of venous air suction. Manual detection of the cannula's position may jeopardize the stability of an ischemic heart (Ann Thorac Surg 50(6) (1990) 882; J Cardiothorac Vasc Anesth 5(6) (1991) 646; Ann Thorac Surg 52(4) (1991) 879). Determining the retrograde cannula position avoiding unnecessary prolongation of the ischemia would allow a better protection of the heart. To our knowledge such a method has not yet been published.
Unità Operativa di Cardiochirurgia, Istituto Clinico Humanitas, Via Manzoni, Rozzano, Italy. eric.manasse@humanitas.it
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