How is retrograde cardioplegia?
Anterograde cardioplegia is administered into a small cannula placed in the ascending aorta or directly into the coronary ostia. Retrograde cardioplegia is delivered through a catheter placed through the right atrium into the coronary sinus. Cardioplegia is then delivered into the venous system of the heart.
What is the purpose of cardioplegia?
Cardioplegia is an essential component of cardiopulmonary bypass and with the primary goal to reduce myocardial oxygen demand by creating electrical quiescence and cooling the heart to reduce the ischemic effects of being on bypass.
What is cardiopulmonary bypass used for?
Cardiopulmonary bypass (CPB) provides a bloodless field for cardiac surgery. It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump.
When is retrograde cardioplegia used?
Retrograde coronary sinus cardioplegia is being used for myocardial protection with ever-increasing frequency during complex cardiac operations. New methods for introducing cardioplegia into the coronary sinus have been facilitated by improved balloon-tipped catheters.
Why does retrograde cardioplegia not protect the right heart?
Retrograde cardioplegia provides poor right ventricular myocardial perfusion as assessed by contrast echocardiography and coronary ostial drainage. (2) This poor perfusion is inadequate to meet myocardial demands as demonstrated by the high right ventricular oxygen extraction after a prolonged retrograde infusion.
What is a retrograde heart procedure?
The retrograde procedure consists of cannulating the 2 coronary ostia and advancing a guidewire from the unoccluded artery to the region distal to the occlusion via collaterals originating from the healthy artery.
When do you use retrograde cardioplegia?
Retrograde cardioplegia is utilized in settings where: 1. There is an inability to deliver adequate cardioplegia anterograde, as in settings of severe aortic valve insufficiency or severe coronary arterial stenosis. 2.
Who is a good candidate for ECMO?
People suffering from one or any of the conditions mentioned below are usually considered the right candidate for ECMO: Acute Respiratory Distress Syndrome (ARDS) Post Arrest Shock. Refractory Septic / Cardiogenic Shock.
Can retrograde cardioplegia be given anterograde?
To accomplish this, a cardioplegia solution can be given anterograde, retrograde, or both. This activity focuses on the relevant anatomy, applications, and complications of retrograde cardioplegia for cardiac surgery. Summarize the clinical relevance of retrograde cardioplegia.
What are the possible complications of retrograde cardioplegia delivery?
The major complication of retrograde cardioplegia delivery is the risk of coronary sinus rupture.
Why is cardioplegia necessary during cardiopulmonary bypass surgery?
For a majority of these procedures, surgeons require an empty heart to operate on via the use of cardiopulmonary bypass (the “heart and lung machine”). To ensure the protection of the heart during cardiopulmonary bypass, administration and even distribution of cardioplegia solution to the myocardium is imperative.
Cardioplegia serves to intentionally and temporarily arrest the heart for myocardial protection during cardiac surgery. This activity describes cardioplegia as well as outlines the various components and delivery methods and highlights the role of the interprofessional team in managing patients who require cardioplegia. Objectives: