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Myocardial distribution of cardioplegic solution after retrograde delivery in patients undergoing cardiac surgical procedures.

Publication ,  Journal Article
Aronson, S; Lee, BK; Zaroff, JG; Wiencek, JG; Walker, R; Feinstein, S; Karp, RB
Published in: J Thorac Cardiovasc Surg
February 1993

The myocardial distribution of both antegrade and retrograde cardioplegia for cardiac surgical intervention, after induction of cardioplegia via the aortic root, was directly assessed and compared in 19 patients by means of contrast echocardiography. Two-dimensional transesophageal echocardiographic images of the short axis of the left ventricle at the level of the papillary muscles were obtained after sonicated Renografin-76 microbubbles were injected into an aortic root and/or transatrial coronary sinus catheter during delivery of cardioplegic solution. Segmental distribution of cardioplegic solution was immediately noted in the myocardium at the time of contrast injections. In 11 of 18 patients (61%) cardioplegic solution was dispersed to all left ventricular myocardial segments after antegrade delivery. In 17 of 19 patients (90%) retrogradely delivered cardioplegic solution (after antegrade induction of cardioplegia in 18 of the 19 patients) was dispersed to all the left ventricular myocardial segments, including the septum. In 2 of the patients, initial lack of retrograde distribution of cardioplegic solution was remedied when the coronary sinus catheter was repositioned and contrast cardioplegic solution was reinjected. Imaging of the right ventricle was possible in only 4 of the 19 patients and revealed that after retrograde delivery, cardioplegic solution had been at least partially distributed to the right ventricle as well. We performed off-line videodensitometric analysis in 9 patients after retrograde delivery of cardioplegic solution. Mean peak pixel-intensity ratio of flow from the endocardium to the epicardium in the left ventricular free wall was 1.46 +/- 0.27, and mean peak pixel-intensity ratio of flow from the left to the right intraventricular septal endocardium was 1.39 +/- 0.33 (p < or = 0.05).

Duke Scholars

Published In

J Thorac Cardiovasc Surg

ISSN

0022-5223

Publication Date

February 1993

Volume

105

Issue

2

Start / End Page

214 / 221

Location

United States

Related Subject Headings

  • Tissue Distribution
  • Respiratory System
  • Myocardium
  • Middle Aged
  • Male
  • Image Enhancement
  • Humans
  • Heart Ventricles
  • Heart Arrest, Induced
  • Female
 

Citation

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Aronson, S., Lee, B. K., Zaroff, J. G., Wiencek, J. G., Walker, R., Feinstein, S., & Karp, R. B. (1993). Myocardial distribution of cardioplegic solution after retrograde delivery in patients undergoing cardiac surgical procedures. J Thorac Cardiovasc Surg, 105(2), 214–221.
Aronson, S., B. K. Lee, J. G. Zaroff, J. G. Wiencek, R. Walker, S. Feinstein, and R. B. Karp. “Myocardial distribution of cardioplegic solution after retrograde delivery in patients undergoing cardiac surgical procedures.J Thorac Cardiovasc Surg 105, no. 2 (February 1993): 214–21.
Aronson S, Lee BK, Zaroff JG, Wiencek JG, Walker R, Feinstein S, et al. Myocardial distribution of cardioplegic solution after retrograde delivery in patients undergoing cardiac surgical procedures. J Thorac Cardiovasc Surg. 1993 Feb;105(2):214–21.
Aronson, S., et al. “Myocardial distribution of cardioplegic solution after retrograde delivery in patients undergoing cardiac surgical procedures.J Thorac Cardiovasc Surg, vol. 105, no. 2, Feb. 1993, pp. 214–21.
Aronson S, Lee BK, Zaroff JG, Wiencek JG, Walker R, Feinstein S, Karp RB. Myocardial distribution of cardioplegic solution after retrograde delivery in patients undergoing cardiac surgical procedures. J Thorac Cardiovasc Surg. 1993 Feb;105(2):214–221.
Journal cover image

Published In

J Thorac Cardiovasc Surg

ISSN

0022-5223

Publication Date

February 1993

Volume

105

Issue

2

Start / End Page

214 / 221

Location

United States

Related Subject Headings

  • Tissue Distribution
  • Respiratory System
  • Myocardium
  • Middle Aged
  • Male
  • Image Enhancement
  • Humans
  • Heart Ventricles
  • Heart Arrest, Induced
  • Female