Does warm blood retrograde cardioplegia preserve right ventricular function?

Background. Efficacy of warm blood retrograde cardioplegia. in preserving r ight heart function remains controversial. The current study was conducted to gauge the preservation of right ventricular function after warm blood re trograde cardioplegia. Methods. We studied 75 consecutive patients undergoing isolated heart valve procedures with warm blood retrograde cardioplegia as the exclusive mode o f preservation. Right ventricular radionuclide ejection fraction and hemody namic 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 preope ratively (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 incr eased from 2.40 +/- 0.09 to 2.92 +/- 0.11 L/m(2) (p < 0.0001). When right v entricular systolic work index was correlated with preload, 30 patients mov ed up and down on the same ventricular function curve and 42 moved to a hig her inotropic curve postoperatively. Only 3 patients demonstrated decreased inotropy. Conclusions. In the clinical setting warm blood retrograde cardioplegia use d as the exclusive mode of myocardial preservation provides adequate protec tion of the right heart. (C) 2001 by The Society of Thoracic Surgeons.