[Antegrade and retrograde blood cardioplegia]

The article analyses the techniques of antegrade/retrograde blood cardioplegia which ensures even distribution of the solution in the heart so as to reduce the ischemic injury to the myocardium during compression of the aorta. The author describes methods of inducing cardioplegia by means of "warmed" blood for "reanimation" of the heart during cardioplegia and for the prevention of "reperfusion injuries" occurring immediately after the clamp is removed from the aorta. A method of rapid transatrial cannulation of the coronary sinus is described which provides for safe, rapid, and simple retrograde cardioplegia and helps to avoid isolation of the right heart. The theoretical basis of this operative technique is discussed as well as the specific methods for achieving the above mentioned purposes of using blood cardioplegia for resuscitation, avoidance, and prevention of ischemic and perfusion damages. Preliminary clinical experience in the use of antegrade/retrograde cardioplegia is generalized in this article. The results allowed us to introduce these methods of blood cardioplegia as an effective measure of myocardial protection during operations on adult patients and in some operations on children.