Assessment of the position of retrograde cardioplegia catheter: comparison of hemodynamic versus manual evaluation in a prospective randomized trial.
OBJECTIVE
To evaluate a hemodynamic method for the assessment of the position of the retrograde cardioplegia catheter (RCC) versus conventional Manual Assessment.


METHODS
We randomized 200 patients undergoing aortic valve surgery to Manual (n = 101) or Hemodynamic Assessment (n = 99). In the Hemodynamic group a 25% pressure increase at the tip of the RCC when a fistula with the ascending aorta was created via a luer-lock was considered indicative of correct RCC placement. Transesophageal echocardiography was used as a comparison evaluation method.


RESULTS
The Hemodynamic and Manual Assessment considered the RCC positioning successful in 89.9% versus 85.1% of cases. Echocardiography confirmed these results in Hemodynamic group but revealed 23 cases of misrecognized incorrect placement in the Manual group (p < 0.0001). Manual maneuvers resulted in 18 cases of secondary displacement and 19 cases of hemodynamic instability (p < 0.0001).


CONCLUSIONS
The Hemodynamic Method is quantitative, reproducible, highly reliable, and safer than palpation in the posterior atrioventricular groove.
Gaudino
Mario
M
Division of Cardiac Surgery, Catholic University, Rome, Italy.
Anselmi
Amedeo
A
Glieca
Franco
F
Luciani
Nicola
N
Perisano
Mario
M
Piscitelli
Mariantonietta
M
Possati
Gianfederico
G
D000368:Aged; D000465:Algorithms; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006328:Cardiac Catheterization; D017548:Echocardiography, Transesophageal; D005260:Female; D006305:Health Status Indicators; D006324:Heart Arrest, Induced / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D015203:Reproducibility of Results