Related Experiment Video

Updated: Jul 29, 2026

The Perinatal Asphyxiated Lamb Model: A Model for Newborn Resuscitation
09:03

The Perinatal Asphyxiated Lamb Model: A Model for Newborn Resuscitation

Published on: August 15, 2018

Iaterogenic injuries during retrograde delivery of cardioplegia

T K Kaul1, B L Fields, C R Jones

  • 1Department of Cardiac Surgery, Baptist Medical Center, 817 Princeton Avenue SW, Birmingham, AL 35211, USA.

Cardiovascular Surgery (London, England)
|August 26, 2000
PubMed

Insights

Retrograde cardioplegia delivery via DLP or Research Medical systems is safe, with rare coronary sinus or right ventricle injuries (0.06%). Transesophageal echocardiography (TOE) aids diagnosis and management, salvaging 80% of injured patients.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Anesthesia
  • Medical Device Technology

Background:

  • Retrograde cardioplegia delivery is a common technique for myocardial protection during cardiac surgery.
  • Utilizing delivery systems from DLP INC and Research Medical INC has been standard practice over the last eight years.
  • Understanding potential complications and diagnostic methods is crucial for patient safety.

Observation:

  • A low incidence of iatrogenic injuries, specifically rupture or perforation of the coronary sinus or right ventricle, was observed.
  • These injuries occurred in 0.06% (5/7886) of patients undergoing retrograde cardioplegia delivery.
  • Intraoperative diagnosis was facilitated by abnormal hemodynamic tracings and transesophageal echocardiography (TOE).

Findings:

  • The low incidence of injuries may be attributed to the regular use of the technique and the application of TOE-guided manipulations in high-risk patients.
  • Cardiac contusion or cardioplegia leakage were noted indicators of these injuries.
  • Successful repair of these iatrogenic injuries resulted in an 80% salvage rate (4/5 patients).

Implications:

  • Regular use and advanced imaging like TOE can minimize risks associated with retrograde cardioplegia delivery.
  • Prompt intraoperative diagnosis and surgical repair are effective in managing these rare but serious complications.
  • This study highlights the safety profile and effective management strategies for retrograde cardioplegia delivery systems.

More Related Videos

A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation09:12

A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation

Published on: April 27, 2019

A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft08:30

A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft

Published on: February 14, 2022

Related Concept Videos

Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Cytotoxic Edema: Pathophysiology01:21

Cytotoxic Edema: Pathophysiology

Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous supply...
Secondary Spinal Cord Injury llI: Pathophysiology01:25

Secondary Spinal Cord Injury llI: Pathophysiology

Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...