Retrograde warm blood cardioplegia preserves hypertrophied myocardium: A clinical study

Menasché, Philippe; Tronc, François; Nguyen, Alix; Veyssié, Line; Demirag, Mustapha; Lariviere, J.; Dref, Olivier Le; Piwnica, A; Bloch, G

doi:10.1016/0003-4975(94)90096-5

Cited by 32 publications

(9 citation statements)

References 31 publications

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“…Higher flow rates of 250 to 300 mL/min are advisable for operations involving valves or dilated and hypertro phic hearts, which have higher metabolic demands. 20,21 A left superior vena cava is not an absolute contraindication to this technique, but intermittent antegrade cardiople gia may be preferable, or cardioplegia can be delivered through completed vein grafts. As an alternative, the left superior vena cava can be cannulated.…”

Section: Technical Considerationsmentioning

confidence: 99%

Warm Blood Cardioplegia for Myocardial Protection: Concepts and Controversies

James

Nores

Rousou

et al. 2020

Texas Heart Institute Journal

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Warm blood cardioplegia has been an established cardioplegic method since the 1990s, yet it remains controversial in regard to myocardial protection. This review will describe the physiologic and technical concepts behind warm blood cardioplegia, as well as outline the current basic and clinical research that evaluates its usefulness. Controversies regarding this technique will also be reviewed. A long history of experimental data indicates that warm blood cardioplegia is safe and effective and thus suitable myocardial protection during cardiopulmonary bypass surgeries.

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Section: Technical Considerationsmentioning

confidence: 99%

Warm Blood Cardioplegia for Myocardial Protection: Concepts and Controversies

James

Nores

Rousou

et al. 2020

Texas Heart Institute Journal

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“…Retrograde cardioplegia is an established method of myocardial protection [14–16]. The rationale behind retrograde application is that distribution of antegrade delivered cardioplegia might be impaired due to ventricular hypertrophy or significant coronary artery stenosis and retrograde application, bypassing plagued vessels, might be of advantage.…”

Section: Cardioprotection: a Strategic Comparison Of Current Clinimentioning

confidence: 99%

Cardioprotection: A Review of Current Practice in Global Ischemia and Future Translational Perspective

Habertheuer

Kocher

Laufer

et al. 2014

BioMed Research International

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The idea of protecting the heart from ischemic insult during heart surgery to allow elective cardiac arrest is as old as the idea of cardiac surgery itself. The current gold standard in clinical routine is a high potassium regimen added either to crystalloid or blood cardioplegic solutions inducing depolarized arrest. Ongoing patient demographic changes with increasingly older, comorbidly ill patients and increasing case complexity with increasingly structurally abnormal hearts as morphological correlate paired with evolutions in pediatric cardiac surgery allowing more complex procedures than ever before redefine requirements for cardioprotection. Many, in part adversarial, regimens to protect the myocardium from ischemic insults have entered clinical routine; however, functional recovery of the heart is still often impaired due to perfusion injury. Myocardial reperfusion damage is a key determinant of postoperative organ functional recovery, morbidity, and mortality in adult and pediatric patients. There is a discrepancy between what current protective strategies are capable of and what they are expected to do in a rapidly changing cardiac surgery community. An increased understanding of the molecular players of ischemia reperfusion injury offers potential seeds for new cardioprotective regimens and may further displace boundaries of what is technically feasible.

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“…In such a way, the entire myocardium is provided with continuous, cold cardioplegic solution through coronary sinus perfusion. [224,225] After placement of newly constructed coronary artery bypass grafts, anterograde cardioplegic solution can also be given.…”

Section: Redo Cabg For Graft Failurementioning

confidence: 99%