Retrograde cardioplegia in CABG: Is it really useful? The microcirculation and a capillary unit model

Kouerinis, IA; Manopoulos, CG; Zografos, GC; Apostolakis, EI; Tsilimingas, NB; Argiriou, ME; Gorgoulis, VG; Dedeilias, PG; Tsoukas, A; Bolos, K; Tsangaris, SG

dc.contributor.author	Kouerinis, IA	en
dc.contributor.author	Manopoulos, CG	en
dc.contributor.author	Zografos, GC	en
dc.contributor.author	Apostolakis, EI	en
dc.contributor.author	Tsilimingas, NB	en
dc.contributor.author	Argiriou, ME	en
dc.contributor.author	Gorgoulis, VG	en
dc.contributor.author	Dedeilias, PG	en
dc.contributor.author	Tsoukas, A	en
dc.contributor.author	Bolos, K	en
dc.contributor.author	Tsangaris, SG	en
dc.date.accessioned	2014-03-01T11:46:15Z
dc.date.available	2014-03-01T11:46:15Z
dc.date.issued	2006	en
dc.identifier.issn	1234-1010	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/37747
dc.subject	retrograde cardioplegia	en
dc.subject	CABG surgery	en
dc.subject	capillary anatomy	en
dc.subject	collateral blood flow	en
dc.subject	myocardial protection	en
dc.subject.classification	Medicine, Research & Experimental	en
dc.subject.other	CORONARY SINUS OCCLUSION	en
dc.subject.other	MICROVASCULAR DISTRIBUTION	en
dc.subject.other	COLLATERALS	en
dc.subject.other	ANTEGRADE	en
dc.subject.other	PRESSURE	en
dc.subject.other	HEARTS	en
dc.title	Retrograde cardioplegia in CABG: Is it really useful? The microcirculation and a capillary unit model	en
heal.type	other	en
heal.language	English	en
heal.publicationDate	2006	en
heal.abstract	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.	en
heal.publisher	INT SCIENTIFIC LITERATURE, INC	en
heal.journalName	MEDICAL SCIENCE MONITOR	en
dc.identifier.isi	ISI:000242137900020	en
dc.identifier.volume	12	en
dc.identifier.issue	11	en
dc.identifier.spage	RA265	en
dc.identifier.epage	RA268	en