Key result
Retrograde cardioplegia via coronary sinus perfusion offers safety and ease of use during open-heart surgery, though concerns remain regarding right ventricular preservation and catheter dislodgment.
Retrograde cardioplegia via coronary sinus perfusion is a useful technique for myocardial protection during open-heart surgery, though concerns about right ventricular preservation and catheter complications remain.
May guide myocardial protection choices in open-heart surgery; leaves open optimal right ventricular preservation strategies.
In recent years there has been increasing use of coronary sinus perfusion to deliver cardioplegic solutions during open-heart surgery. This has been aided by advances in coronary sinus catheter design and by easier methods of cannula insertion. Coronary sinus perfusion has been used with both intermittent crystalloid and blood cardioplegia and has recently evolved to include retrograde continuous normothermic blood cardioplegia. Coronary sinus perfusion has several advantages including safety, ease of use (with a single cannula placed out of the operative field), usefulness in patients with significant aortic regurgitation, redo coronary artery bypass graft surgery, and acute myocardial infarction. However, there are continuing concerns about the distribution of retrograde perfusion, preservation of right ventricular function, dislodgment of the coronary sinus catheter (and resulting ischemia during surgery), and damage to the coronary sinus.
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Panos et al. (1997) conducted a review in Open-heart surgery. Retrograde cardioplegia (coronary sinus perfusion) was evaluated. Retrograde cardioplegia via coronary sinus perfusion offers safety and ease of use during open-heart surgery, though concerns remain regarding right ventricular preservation and catheter dislodgment.
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