Anatomic and hemodynamic considerations influencing the efficiency of retrograde cardioplegia

One of the major issues raised by cardiac surgical procedures requiring car diopulmonary bypass is the question of myocardial protection. The preferred route for the administration of cardioplegia is controversial. A number of studies show the beneficial effects of retrograde cardioplegia but some de monstrate only partial or poor myocardial protection. This paper reviews th e anatomy and anatomic variations of the coronary sinus, the coronary sinus orifice and cardiac veins, and the major systemic venous drainage, all of which may affect the distribution of retrograde cardioplegia. (C) 2001 by T he Society of Thoracic Surgeons.