Myocardial perfusion during warm antegrade and retrograde cardioplegia: a contrast echo study Michael A Borger, MD, Kevin S Wei, MD, Richard D Weisel,

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Presentation transcript:

Myocardial perfusion during warm antegrade and retrograde cardioplegia: a contrast echo study Michael A Borger, MD, Kevin S Wei, MD, Richard D Weisel, MD, John S Ikonomidis, MD, PhD, Vivek Rao, MD, PhD, Gideon Cohen, MD, Toshizumi Shirai, MD, PhD, Ahmad S Omran, MD, Samuel C Siu, MD, Harry Rakowski, MD The Annals of Thoracic Surgery Volume 68, Issue 3, Pages 955-961 (September 1999) DOI: 10.1016/S0003-4975(99)00797-3

Fig 1 Segmental perfusion of the left ventricle (LV) during antegrade (Ante) and retrograde (Retro) cardioplegia before and after coronary artery bypass grafting (CABG). Stacked bars show the percentage of visualized segments in which contrast enhancement was weak (score = 1), optimal (score = 2), or excessive (score = 3). Antegrade cardioplegic delivery resulted in better perfusion both pre- and post-CABG. The Annals of Thoracic Surgery 1999 68, 955-961DOI: (10.1016/S0003-4975(99)00797-3)

Fig 2 Left ventricular perfusion scores (mean ± SEM) during antegrade and retrograde cardioplegia before and after CABG. Antegrade cardioplegic delivery resulted in better mean perfusion scores both pre- and post-CABG. The Annals of Thoracic Surgery 1999 68, 955-961DOI: (10.1016/S0003-4975(99)00797-3)

Fig 3 Segmental perfusion of the right ventricle (RV) during antegrade and retrograde cardioplegia before and after CABG. RV perfusion was poor with both techniques pre-CABG, but was better with antegrade delivery post-CABG. The Annals of Thoracic Surgery 1999 68, 955-961DOI: (10.1016/S0003-4975(99)00797-3)

Fig 4 Long axis epicardial echocardiographic view of the left ventricle during retrograde cardioplegic administration. Injection of sonicated albumin contrast identified the presence of direct vascular communications (arrows) to the ventricular cavity in all patients. These channels may represent Thebesian veins. The Annals of Thoracic Surgery 1999 68, 955-961DOI: (10.1016/S0003-4975(99)00797-3)