DISTRIBUTION OF CARDIOPLEGIC SOLUTION FOL LOWING RETROGRADE INJECTION- RETROGRADE CARDIOPLEGIA CANNULA WITH MANUALLY INFLATING VERSUS SELF-INFLATING BALLOON

Retrograde cardioplegia is still debated due to heterogeneous left ven tricular flow distribution. The purpose of this study was to compare r etrogade flow distribution delivered throuyh the coronary sinus with t wo patterns of cannula. Fifty four patients were prospectively randomi zed to receive cold crystalloid retrograde coronary sinus cardioplegia with lither a manual inflating balloon cannula (group I, 24 patients) or a self-inflating balloon cannula (group II, 30 patients). Left ven tricular distribution of the cardioplegic solution was assessed by mon itoring the left ventricular wall temperatures (anterior and posterior ). The cardioplegic retrograde infusion was stopped as the anterior wa ll temperature reached 12 degrees C. In group II, 70.8% of patients ha d an identical cooling in the anterior and posterior wall of the left ventricle, versus 40.9% in group I(p < 0,05). The mean temperature dif ference between anterior and posterior wall was 2.9 degrees C (standar d deviation: 2.9 degrees C) in group II versus 5.7 degrees C (standard deviation: 4.3 degrees C) for group I (< 0.05). The retroplegia cannu la with the self-inflating balloon allows a better distribution of the cardioplegia flow than the manually inflating balloon. We think that this is due to the shape of the self-inflating balloon which more clos ely fits the morphology of the coronary sinus.