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[Antegrade or retrograde blood cardioplegic method: comparison of postsurgical right ventricular function and
S Kuraoka1, H Orita, T Watanabe
1Second Department of Surgery, Yamagata University School of Medicine, Japan.
Summary
Retrograde cardioplegia temporarily impacted right ventricular function post-surgery but showed no persistent issues. This method is a viable alternative to antegrade cardioplegia for open heart surgery.
Area of Science:
- Cardiovascular Surgery
- Cardiac Anesthesia
Background:
- Antegrade and retrograde cardioplegia are methods for delivering solutions during open heart surgery.
- Comparing their effects on postsurgical cardiac function and conduction disturbances is crucial.
Purpose of the Study:
- To compare postsurgical right ventricular function and conduction disturbances between antegrade (AC) and retrograde (RC) cold blood cardioplegia during open heart surgery.
Main Methods:
- Thirty-four patients were divided into AC and RC groups.
- Postoperative monitoring included oxygenation capacity (A-aDO2, RI), ventricular function (LVSWI, RVSWI), dopamine dosage, and conduction disturbances.
Main Results:
- Both methods showed similar recovery of respiratory and left ventricular function.
- Retrograde cardioplegia (RC) group exhibited temporary early postsurgical right ventricular dysfunction, resolving within 3 hours.
- 28% of RC patients experienced transient conduction disturbances, with no persistent issues.
Conclusions:
- Retrograde coronary sinus perfusion is a potentially valuable alternative to antegrade cardioplegia delivery.
- While transient right ventricular dysfunction and conduction disturbances occurred with RC, they were temporary and resolved.
- Further research may validate retrograde cardioplegia as a safe and effective option.