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Thermographic evaluation of myocardial temperature during infusion of cold cardioplegia
Insights
Patients with coronary artery disease experience delayed myocardial cooling. Unobstructed coronary arteries allow for significantly faster cooling rates during cardioplegic solution infusion.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Coronary artery disease (CAD) can impede myocardial cooling during cardiac surgery.
- The extent of left anterior descending (LAD) artery stenosis may influence cooling efficiency.
Purpose of the Study:
- To investigate the impact of LAD stenosis severity on myocardial cooling rates.
- To compare myocardial cooling in patients with varying degrees of CAD to those without.
Main Methods:
- 40 patients with significant LAD stenosis (70%, 90%, or occlusion) were grouped.
- Myocardial temperature was measured using a thermocamera during cold cardioplegic solution infusion.
- Comparison group (D) included 10 patients without CAD undergoing mitral valve replacement.
Main Results:
- Patients with 70% LAD stenosis cooled to 15°C in 4.5 min; 12°C in 10 min.
- Patients with 90% LAD stenosis showed similar cooling rates.
- Patients with LAD occlusion had slower cooling (18°C at 5 min, 14°C at 10 min).
- Control group (no CAD) reached 12°C in 3 min and 10°C in 7 min.
Conclusions:
- Myocardial cooling is significantly slower in patients with coronary artery disease.
- The degree of LAD stenosis influences the rate of myocardial cooling.
- Unobstructed coronary arteries facilitate more rapid and efficient myocardial cooling.
Abstract:
Delay in myocardial cooling during an infusion of cold cardioplegic solution may occur in patients with coronary artery disease. Forty patients with significant stenosis of the left anterior descending coronary artery (LAD) were divided into 3 groups according to the extent of the LAD stenosis. Group A consisted of 12 patients with 70% stenosis. Group B included 23 patients with 90% stenosis, and in group C there were 5 patients with LAD occlusion. Myocardial temperature was measured with a thermocamera during infusion of 2000 ml 8 to 10 degrees C cold Bretschneider's cardioplegic solution and compared to 10 other patients without coronary artery disease undergoing mitral valve replacement (group D). In group A the myocardium cooled to 15 degrees C after 4 1/2 minutes and to 12 degrees C after 10 minutes. In group B the myocardial temperature was 15 degrees C after 5 minutes and 12 degrees C after 10 minutes. In group C the temperature reached 18 degrees C after 5 minutes and 14 degrees C after 10 minutes. In group D the myocardial temperature was 12 degrees C after 3 minutes and 10 degrees C after 7 minutes. This study shows far better myocardial cooling rates in patients with unobstructed coronary arteries.