Does warm blood retrograde cardioplegia preserve right ventricular function?

• Published in: The Annals of thoracic surgery Vol. 72; no. 5; pp. 1572 - 1575
• Main Authors: Kulshrestha, Pankaj, Rousou, John A., Engelman, Richard M., Flack, Joseph E., Deaton, David W., Wait, Richard B., Hampf, Heather M.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2001; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Heart Arrest, Induced - methods; Heart Valve Diseases - surgery; Hemodynamics; Humans; Male; Medical sciences; Middle Aged; Postoperative Care; Preoperative Care; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Temperature; Ventricular Function, Right; 31; Heart; Radionuclide study; Human; Postoperative; Retrograde; Right ventricle performance; Cardioplegia; Exploration; Surgery; Hemodynamics; Preoperative; Technique; Comparative study
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(01)03200-3

Background. Efficacy of warm blood retrograde cardioplegia in preserving right heart function remains controversial. The current study was conducted to gauge the preservation of right ventricular function after warm blood retrograde cardioplegia. Methods. We studied 75 consecutive patients undergoing isolated heart valve procedures with warm blood retrograde cardioplegia as the exclusive mode of preservation. Right ventricular radionuclide ejection fraction and hemodynamic measurements using a pulmonary artery catheter were calculated before and within 3 days after operation. Results. Postoperative radionuclide right ventricular ejection fraction was well preserved at 0.4686 ± 0.0122 compared with 0.4327 ± 0.0255 preoperatively ( p = 0.7064). Right ventricular systolic work index improved from 5.82 ± 0.52 to 8.97 ± 0.60 g-m/m 2 ( p < 0.0001) and cardiac index increased from 2.40 ± 0.09 to 2.92 ± 0.11 L/m 2 ( p < 0.0001). When right ventricular systolic work index was correlated with preload, 30 patients moved up and down on the same ventricular function curve and 42 moved to a higher inotropic curve postoperatively. Only 3 patients demonstrated decreased inotropy. Conclusions. In the clinical setting warm blood retrograde cardioplegia used as the exclusive mode of myocardial preservation provides adequate protection of the right heart.