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. 1998;25(3):185–193.

Valve replacement under retrograde warm-blood cardioplegia. Results in 287 patients.

G A Tolis 1, N Sfyras 1, G Astras 1, G Georgiou 1
PMCID: PMC325547  PMID: 9782558

Abstract

We studied 287 consecutive patients who underwent valve replacement procedures under retrograde warm-blood cardioplegia between 1 March 1992 and 30 June 1997 (64 months). Some of the procedures were performed in combination with other operations (70), but most (217) were isolated. Thirty patients had undergone previous "open" procedures and another 25 patients had undergone prior "closed" procedures. The 30-day postoperative mortality rate was 3.8% (11 deaths). In 7 patients, the cause of death was not cardiogenic. We did not observe any instance of right ventricular failure, perforation of the coronary sinus, phrenic nerve palsy, or wound infection. These results indicate that retrograde warm-blood cardioplegia provides excellent myocardial protection of both ventricles during valve replacement.

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Selected References

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  1. Bel A., Aznag H., Faris B., Menasché P. Warm blood cardioplegia in high risk patients. Eur J Cardiothorac Surg. 1997 Jun;11(6):1118–1124. doi: 10.1016/s1010-7940(97)01220-7. [DOI] [PubMed] [Google Scholar]
  2. Buckberg G. D., Brazier J. R., Nelson R. L., Goldstein S. M., McConnell D. H., Cooper N. Studies of the effects of hypothermia on regional myocardial blood flow and metabolism during cardiopulmonary bypass. I. The adequately perfused beating, fibrillating, and arrested heart. J Thorac Cardiovasc Surg. 1977 Jan;73(1):87–94. [PubMed] [Google Scholar]
  3. Christakis G. T., Koch J. P., Deemar K. A., Fremes S. E., Sinclair L., Chen E., Salerno T. A., Goldman B. S., Lichtenstein S. V. A randomized study of the systemic effects of warm heart surgery. Ann Thorac Surg. 1992 Sep;54(3):449–459. doi: 10.1016/0003-4975(92)90434-6. [DOI] [PubMed] [Google Scholar]
  4. Gates R. N., Laks H., Drinkwater D. C., Pearl J. M., Zaragoza A. M., Lewis W., Sorensen T. J., Kaczer E. M., Chang P. A. Gross and microvascular distribution of retrograde cardioplegia in explanted human hearts. Ann Thorac Surg. 1993 Sep;56(3):410–417. doi: 10.1016/0003-4975(93)90872-f. [DOI] [PubMed] [Google Scholar]
  5. Gundry S. R., Razzouk A. J., Vigesaa R. E., Wang N., Bailey L. L. Optimal delivery of cardioplegic solution for "redo" operations. J Thorac Cardiovasc Surg. 1992 May;103(5):896–901. [PubMed] [Google Scholar]
  6. Gundry S. R., Wang N., Bannon D., Vigesaa R. E., Eke C., Pain S., Bailey L. L. Retrograde continuous warm blood cardioplegia: maintenance of myocardial homeostasis in humans. Ann Thorac Surg. 1993 Feb;55(2):358–363. doi: 10.1016/0003-4975(93)90997-v. [DOI] [PubMed] [Google Scholar]
  7. Gundry S. R., Wang N., Sciolaro C. M., Van Arsdell G. S., Razzouk A. J., Hill A. C., Bailey L. L. Uniformity of perfusion in all regions of the human heart by warm continuous retrograde cardioplegia. Ann Thorac Surg. 1996 Jan;61(1):33–35. doi: 10.1016/0003-4975(95)00880-2. [DOI] [PubMed] [Google Scholar]
  8. Hoffenberg E. F., Ye J., Sun J., Ghomeshi H. R., Salerno T. A., Deslauriers R. Antegrade and retrograde continuous warm blood cardioplegia: a 31P magnetic resonance study. Ann Thorac Surg. 1995 Nov;60(5):1203–1209. doi: 10.1016/0003-4975(95)00547-X. [DOI] [PubMed] [Google Scholar]
  9. Ihnken K., Morita K., Buckberg G. D., Aharon A., Laks H., Panos A. L., Drinkwater D. C., Chugh R., Del Rizzo D., Salerno T. A. The safety of simultaneous arterial and coronary sinus perfusion: experimental background and initial clinical results. J Card Surg. 1994 Jan;9(1):15–25. doi: 10.1111/j.1540-8191.1994.tb00819.x. [DOI] [PubMed] [Google Scholar]
  10. LILLEHEI C. W., DEWALL R. A., GOTT V. L., VARCO R. L. The direct vision correction of calcific aortic stenosis by means of a pump-oxygenator and retrograde coronary sinus perfusion. Dis Chest. 1956 Aug;30(2):123–132. doi: 10.1378/chest.30.2.123. [DOI] [PubMed] [Google Scholar]
  11. Lichtenstein S. V., Abel J. G., Salerno T. A. Warm heart surgery and results of operation for recent myocardial infarction. Ann Thorac Surg. 1991 Sep;52(3):455–460. doi: 10.1016/0003-4975(91)90905-6. [DOI] [PubMed] [Google Scholar]
  12. Lichtenstein S. V., Abel J. G., Slutsky A. S. Warm retrograde cardioplegia. Protection of the right ventricle in mitral valve operations. J Thorac Cardiovasc Surg. 1992 Aug;104(2):374–380. [PubMed] [Google Scholar]
  13. Lichtenstein S. V., Ashe K. A., el Dalati H., Cusimano R. J., Panos A., Slutsky A. S. Warm heart surgery. J Thorac Cardiovasc Surg. 1991 Feb;101(2):269–274. [PubMed] [Google Scholar]
  14. Lichtenstein S. V., el Dalati H., Panos A., Slutsky A. S. Long cross-clamp time with warm heart surgery. Lancet. 1989 Jun 24;1(8652):1443–1443. doi: 10.1016/s0140-6736(89)90140-2. [DOI] [PubMed] [Google Scholar]
  15. Lolley D. M., Hewitt R. L. Myocardial distribution of asanguineous solutions retroperfused under low pressure through the coronary sinus. J Cardiovasc Surg (Torino) 1980 May-Jun;21(3):287–294. [PubMed] [Google Scholar]
  16. MELROSE D. G., DREYER B., BENTALL H. H., BAKER J. B. Elective cardiac arrest. Lancet. 1955 Jul 2;269(6879):21–22. doi: 10.1016/s0140-6736(55)93381-x. [DOI] [PubMed] [Google Scholar]
  17. Menasché P., Touchot B., Pradier F., Bloch G., Piwnica A. Simplified method for delivering normothermic blood cardioplegia. Ann Thorac Surg. 1993 Jan;55(1):177–178. doi: 10.1016/0003-4975(93)90504-b. [DOI] [PubMed] [Google Scholar]
  18. Menasché P., Tronc F., Nguyen A., Veyssié L., Demirag M., Larivière J., Le Dref O., Piwnica A. H., Bloch G. Retrograde warm blood cardioplegia preserves hypertrophied myocardium: a clinical study. Ann Thorac Surg. 1994 Jun;57(6):1429–1435. doi: 10.1016/0003-4975(94)90096-5. [DOI] [PubMed] [Google Scholar]
  19. Page R. D., Sharpe D. A., Bellamy C. M., Rashid A., Fabri B. M. Normothermic arrest with continuous hyperkalaemic blood: initial experience. Eur J Cardiothorac Surg. 1992;6(9):461–468. doi: 10.1016/1010-7940(92)90241-o. [DOI] [PubMed] [Google Scholar]
  20. Partington M. T., Acar C., Buckberg G. D., Julia P., Kofsky E. R., Bugyi H. I. Studies of retrograde cardioplegia. I. Capillary blood flow distribution to myocardium supplied by open and occluded arteries. J Thorac Cardiovasc Surg. 1989 Apr;97(4):605–612. [PubMed] [Google Scholar]
  21. Salerno T. A., Houck J. P., Barrozo C. A., Panos A., Christakis G. T., Abel J. G., Lichtenstein S. V. Retrograde continuous warm blood cardioplegia: a new concept in myocardial protection. Ann Thorac Surg. 1991 Feb;51(2):245–247. doi: 10.1016/0003-4975(91)90795-r. [DOI] [PubMed] [Google Scholar]
  22. Solorzano J., Taitelbaum G., Chiu R. C. Retrograde coronary sinus perfusion for myocardial protection during cardiopulmonary bypass. Ann Thorac Surg. 1978 Mar;25(3):201–208. doi: 10.1016/s0003-4975(10)63522-9. [DOI] [PubMed] [Google Scholar]
  23. Tolis G. A., Astras G., Sfyras N., Georgiou G. Experience with warm blood cardioplegia in 480 patients. Cardiovasc Surg. 1995 Apr;3(2):175–180. doi: 10.1016/0967-2109(95)90890-h. [DOI] [PubMed] [Google Scholar]

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