A NEW TECHNIQUE FOR DELIVERING ANTEGRADE RETROGRADE BLOOD CARDIOPLEGIA WITHOUT RIGHT HEART ISOLATION

被引：19

作者：

BUCKBERG, GD

DRINKWATER, DC

LAKS, H

机构：

[1] Department of Surgery, Division of Cardiovascular Surgery, UCLA School of Medicine, Los Angeles, CA

[2] Department of Surgery, UCLA Medical Center, Los Angeles, CA

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1990年 / 4卷 / 03期

关键词：

Antegradelretrograde; Blood cardioplegia; New technique;

D O I：

10.1016/1010-7940(90)90188-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We report our updated experience with combined antegrade/retrogradecardioplegia using a self-inflating/deflating balloon cannula that allowsrapid transatrial retrograde coronary sinus cannulation (10-15 s) withoutright heart isolation. This permits routine single venous cannulation andoptimizes myocardial protection when combined with antegrade cardioplegia.Two hundred fifty-five consecutive patients underwent antegrade/retrogradecardioplegia. Initial antegrade blood cardioplegia caused immediate arrest(less than 1 min), and the cardioplegic dose was divided equally betweenantegrade and retrograde delivery. Included are 173 isolated CABG patients(39 with either extending infarction, cardiogenic shock, or ejectionfraction less than 20%), and 37 coronary reoperations, 67 with aorticand/or mitral valve procedures, 3 with arrhythmia surgery, and 7 children(VSD, Rastelli, Konno, etc). Septal temperature in patients with LADocclusion fell to 11.6 degrees C +/- 0.5 after retrograde vs only 16.1degrees C +/- 3 after antegrade cardioplegia (p less than 0.05). Overallhospital mortality was 2.8% and no complications followed transatrialretrograde coronary sinus cannulation. Antegrade/retrograde cardioplegiaallowed retrograde flushing of debris in redo coronary operations, producedimmediate arrest with low cardioplegic volumes, improved cardioplegicdistribution during IMA grafting, allowed aortic and mitral valveprocedures to proceed uninterrupted, and ensured distribution in unforeseenaortic insufficiency. Antegrade/retrograde cardioplegia is now usedroutinely in all adult and in many pediatric operations because of itsspeed, safety, and simplicity. [Eur J Cardio-thorac Surg (1990) 4: 163-168]. © Springer-Verlag.

引用

页码：163 / 168

页数：6

共 12 条

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