01 November 2006
Retrograde cardioplegia in CABG: is it really useful? The microcirculation and a capillary unit model.Ilias A. Kouerinis, Christos G. Manopoulos, George C. Zografos, Eustratios I. Apostolakis, Nikolaos B. Tsilimingas, Michalis E. Argiriou, Vassilios G. Gorgoulis, Panagiotis G. Dedeilias, Antonios Tsoukas, Konstantinos Bolos, Socrates G. Tsangaris
Med Sci Monit 2006; 12(11): RA265-268 :: ID: 462723
Most surgeons, ourselves including, use retrograde cardioplegia in numerable operations in cardiac surgery. It is believed to be not only supplementary to antegrade, but also a unique alternative in special complicated cases. Regarding CABGs (coronary artery bypass grafts), many authors advocate its routine use together with antegrade, while others do not suggest it for standard practice. The existing disagreement on this special item is consequential to the different results among various protocols which have studied the effect of antegrade and retrograde perfusion. In these studies, fundamental variations in design, materials, and methods have resulted in an inability to compare results. Additionally, most of the published protocols studying cardioplegic arrest offer only a gross estimation of the microcirculatory perfusion, which is the basis of myocardial protection. Our present review is an attempt to elucidate the differences, explain the necessity of comparing retrograde cardioplegia alone with antegrade in CABGs for the reproduction of safe results, clarify the role of Thebesian veins and venovenous connections during retroperfusion, consider the critical anatomic differences between human hearts and those of animals which may result in serious study bias, and, finally, offer an explanation of what may really be going on in the microcirculation during antegrade and retrograde perfusion using a human capillary model.
Keywords: Capillaries - pathology, Blood Flow Velocity, Cardioplegic Solutions - administration & dosage, Computer Simulation, Coronary Artery Bypass - methods, Coronary Circulation, Heart Arrest, Induced, Microcirculation, Models, Anatomic, Myocardium - pathology
01 December 2021 : EditorialEditorial: Cardiovascular Complications at One Year After SARS-CoV-2 Infection are Independent of Underlying Cardiovascular Risk Factors or Severity of COVID-19
Med Sci Monit 2022; 28:e937048
04 May 2022 : Clinical ResearchEffects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects ...
Med Sci Monit In Press; DOI: 10.12659/MSM.936069
22 April 2022 : Clinical ResearchFactors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)
Med Sci Monit In Press; DOI: 10.12659/MSM.936547
27 April 2022 : Meta-AnalysisEffect of the COVID-19 Pandemic on Serum Vitamin D Levels in People Under Age 18 Years: A Systematic Review...
Med Sci Monit In Press; DOI: 10.12659/MSM.935823
20 May 2022 : Clinical ResearchEfficacy of Focused Extracorporeal Shock Wave Therapy in Chronic Low Back Pain: A Prospective Randomized 3-...
Med Sci Monit In Press; DOI: 10.12659/MSM.936614
19 May 2022 : Clinical ResearchAssociation Between Serum Homocysteine Levels and Severity of Diabetic Kidney Disease in 489 Patients with ...
Med Sci Monit In Press; DOI: 10.12659/MSM.936323
18 May 2022 : Clinical ResearchPhysical and Psychosocial Concept Domains Related to Health-Related Quality of Life (HRQL) in 50 Girls and ...
Med Sci Monit In Press; DOI: 10.12659/MSM.936801
Most Viewed Current Articles
31 Dec 1969 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
31 Dec 1969 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
31 Dec 1969 : Review articleLong-Term Respiratory and Neurological Sequelae of COVID-19
Med Sci Monit 2020; 26:e928996