A New Technique of Myocardial Protection during Aortic Root Replacement: Antegrade/Retrograde Coronary Perfusion

Introduction

The conventional technique for aortic root surgery consists of cardiopulmonary bypass (CPB), aortic cross-clamping, systemic cooling and cardioplegic arrest of the heart [[1], [2]]. The whole operation is time consuming and exposes the heart to ischemic reperfusion injury after the removal of aortic cross-clamping. These factors become especially important in patients with impaired left ventricular function or with a calcified aneurysm partially occluding the coronary artery ostia. There is consensus among surgeons that the adverse and damaging effects of cardioplegic techniques are ischemia and reperfusion injury, especially in cases with longer cross-clamping times [[3]]. More recently, perfect results have been reported with warm, beating heart surgery [[4], [5]].

A case of aortic root replacement with the Cabrol technique performed for ascending aortic aneurysm on a beating heart, which was continuously perfused via the antegrade and retrograde routes with normothermic blood throughout the procedure, is presented here.

References

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