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Retrograde-delivered cardioplegia is not distributed equally to the right ventricular free wall and septum.

Publication ,  Journal Article
Winkelmann, J; Aronson, S; Young, CJ; Fernandez, A; Lee, BK
Published in: J Cardiothorac Vasc Anesth
April 1995

Right ventricular myocardial protection during cardiac surgery continues to be a challenge. Retrograde delivery of cardioplegia has been shown to perfuse left ventricular regions subtended by critical coronary stenosis and not adequately protected by antegrade delivery. However, the distribution of cardioplegia from the coronary sinus to the right ventricle remains in question. A reliable means for assessing such flow distribution intraoperatively is provided by contrast echocardiography. It was hypothesized that conventional use of coronary sinus catheters for retrograde cardioplegia delivery does not reliably perfuse the myocardial region subtended by the right coronary artery. Six patients scheduled to undergo elective coronary artery bypass surgery were evaluated with contrast echocardiography to determine the distribution of retrograde-delivered cardioplegia into the right ventricle. Sonicated Renografin-76 (Squibb Diagnostics, Princeton, NJ) was injected during retrograde delivery of cold crystalloid cardioplegia solution and continuous two-dimensional ultrasound imaging of the heart. On-line videodensitometric analysis was performed with a digital ultrasound system. The area under the curve and peak pixel intensity were determined for the anterior septum, the posterior septum, and the right ventricular free wall for each contrast injection. Recorded VHS videotape images of contrast-enhanced perfusion patterns were also reviewed and scored. On-line acoustic-densitometric analysis showed that right ventricular posterior and anterior septal peak pixel intensities were 4.8 +/- 3.2 and 7.3 +/- 1.5, respectively, compared with only 1.6 +/- 1.2 (p < or = 0.05) in the right ventricular free wall.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

J Cardiothorac Vasc Anesth

DOI

ISSN

1053-0770

Publication Date

April 1995

Volume

9

Issue

2

Start / End Page

135 / 139

Location

United States

Related Subject Headings

  • Videotape Recording
  • Signal Processing, Computer-Assisted
  • Online Systems
  • Male
  • Intraoperative Care
  • Humans
  • Heart Ventricles
  • Heart Septum
  • Heart Arrest, Induced
  • Female
 

Citation

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MLA
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Winkelmann, J., Aronson, S., Young, C. J., Fernandez, A., & Lee, B. K. (1995). Retrograde-delivered cardioplegia is not distributed equally to the right ventricular free wall and septum. J Cardiothorac Vasc Anesth, 9(2), 135–139. https://doi.org/10.1016/S1053-0770(05)80183-1
Winkelmann, J., S. Aronson, C. J. Young, A. Fernandez, and B. K. Lee. “Retrograde-delivered cardioplegia is not distributed equally to the right ventricular free wall and septum.J Cardiothorac Vasc Anesth 9, no. 2 (April 1995): 135–39. https://doi.org/10.1016/S1053-0770(05)80183-1.
Winkelmann J, Aronson S, Young CJ, Fernandez A, Lee BK. Retrograde-delivered cardioplegia is not distributed equally to the right ventricular free wall and septum. J Cardiothorac Vasc Anesth. 1995 Apr;9(2):135–9.
Winkelmann, J., et al. “Retrograde-delivered cardioplegia is not distributed equally to the right ventricular free wall and septum.J Cardiothorac Vasc Anesth, vol. 9, no. 2, Apr. 1995, pp. 135–39. Pubmed, doi:10.1016/S1053-0770(05)80183-1.
Winkelmann J, Aronson S, Young CJ, Fernandez A, Lee BK. Retrograde-delivered cardioplegia is not distributed equally to the right ventricular free wall and septum. J Cardiothorac Vasc Anesth. 1995 Apr;9(2):135–139.
Journal cover image

Published In

J Cardiothorac Vasc Anesth

DOI

ISSN

1053-0770

Publication Date

April 1995

Volume

9

Issue

2

Start / End Page

135 / 139

Location

United States

Related Subject Headings

  • Videotape Recording
  • Signal Processing, Computer-Assisted
  • Online Systems
  • Male
  • Intraoperative Care
  • Humans
  • Heart Ventricles
  • Heart Septum
  • Heart Arrest, Induced
  • Female