Valve replacement under retrograde warm-blood cardioplegia. Results in 287 patients

We studied 287 consecutive patients who underwent valve replacement procedures under retrograde warm-blood cardioplegia between 1 March 1992 and 30 June 1997 (64 months). Some of the procedures were performed in combination with other operations (70), but most (217) were isolated. Thirty patients had undergone previous "open" procedures and another 25 patients had undergone prior "closed" procedures. The 30-day postoperative mortality rate was 3.8% (11 deaths). In 7 patients, the cause of death was not cardiogenic. We did not observe any instance of right ventricular failure, perforation of the coronary sinus, phrenic nerve palsy, or wound infection. These results indicate that retrograde warm-blood cardioplegia provides excellent myocardial protection of both ventricles during valve replacement.