Heterogeneous distribution of cardioplegic solution in pigs

Septal dyskinesia in the left ventricle is detected frequently in many patients after open-heart surgery. The present study was designed to determine whether the antegrade delivery of cardioplegic solution to the regional wall categorized in echocardiography is homogeneous, and whether the distribution to the septal wall differs from that to the lateral wall in the absence of coronary artery disease. To assess these hypotheses quantitatively, radioactive microspheres were mixed into the cardioplegic solution and infused by an antegrade method in eight normal pigs. The cardioplegic distribution to the septal wall was significantly less than to the lateral wall close to the base of the left ventricle (P<0.05). Therefore, antegrade perfusion of cardioplegic solution was non-uniformly distributed to the regional and transmural wall of normal pig hearts. Absence of functional correlation was a limitation of this study. However, these findings suggest that inadequate protection of the ventricular septum by antegrade cardioplegia might be an explanation for the abnormalities of septal wall motion after open-heart surgery.