Myocardial protection and cardioplegia thoracic key. The proplege peripheral retrograde cardioplegia device in minimally invasive cardiac surgery. Retrograde cardioplegia cannulae with handle surge. Coronary sinus cannula a sterile, rigid or semirigid tube designed to be surgically inserted, temporarily, into the ostium of the coronary sinus to provide retrograde coronary perfusion cardioplegia during cardiopulmonary bypass or minimally invasive surgery. Coronary sinus cannula a sterile, rigid or semirigid tube designed to be surgically inserted, temporarily, into the ostium of the coronary sinus to provide retrograde coronary perfusioncardioplegia during cardiopulmonary bypass or. Myocardial perfusion was evaluated with magnetic resonance imaging in pig hearts. Edwards retrograde cardioplegia catheters are specifically designed to help you protect your patients during onpump cardiac surgery by maximizing myocardial protection.
Development of an innovative drug delivery device technology platform for. This poor perfusion is inadequate to meet myocardial demands as demonstrated by the high right ventricular oxygen extraction after a prolonged retrograde infusion. Pr9, proplege peripheral retrograde cardioplegia device, edwards lifesciences, irvine, ca left atrial retractor ergar, ergonic atrial retractor with articulating blades, edwards lifesciences, irvine. Myocardial protection during minimally invasive mitral valve surgery. Edwards thruport systems proplege peripheral retrograde.
When solution is introduced into the aortic root with an aortic crossclamp on the distal aorta to limit systemic circulation, this is called antegrade cardioplegia. The medical device set cardioplegia is realized by edwards lifesciences llc. Retrograde cardioplegia is a widespread method for myocardial protection in coronary bypass surgery and to abroad range of open heart surgical procedures in addition to. Retrograde cardioplegia provides poor right ventricular myocardial perfusion as assessed by contrast echocardiography and coronary ostial drainage. Myocardial protection during minimally invasive mitral.
Portaccess mitral valve surgeryan evolution of technique. Retrograde cardioplegia prepare for delivering retrograde cardioplegia verify green stopcock off to the patient connect the retrograde cardioplegia line to the proplege device. Cardioplegia circuit products cardioplegia adapters. Additional doses of cardioplegia are given directly into the coronary ostia if blood return is not visualized from both ostia during delivery of retrograde cardioplegia or if there is a suspicion that the coronary sinus cannula was not properly placed. Retrograde cardioplegia catheters edwards lifesciences. A retrograde delivery catheter includes at its distal end a balloon configured to occlude the coronary sinus of a patients heart, and has a length and flexibility which allow the distal end to be positioned in the coronary sinus with the proximal end extending transluminally to a peripheral vein such as an internal jugular vein and out of the body through a puncture therein. Retrograde cardioplegia the annals of thoracic surgery. Perfusion safety,cardioplegia delivery management ns. Device for retrograde cardioplegia is realized by edwards lifesciences llc trade name. This device, otherwise known as the heartlung machine, takes over the functions of gas exchange by the lung and blood circulation by the heart. Cardioplegic myocardial protection in patients with cor onary artery disease is effective only if there is adequate delivery of cardioplegic solution beyond coronary sten oses. Retrograde continuous cold blood cardioplegia how is. Andocor retrograde cardioplegia cannulae are intended to be connected to the cardioplegia line in order to infuse cardioplegic solution and blood into the patients coronary sinus during open heart procedure. Edwards retrograde cardioplegia catheters are specificallydesigned to help you protect your patients during onpumpcardiac surgery by maximizing myocardial protection.
Paralysis of the heart, as may be done electively in stopping the heart during cardiac surgery. Retrograde cardioplegia does not adequately perfuse the right. For the best experience on our site, be sure to turn on javascript in your browser. Cardioplegia types, mechanism, antegrade, retrograde. Retrograde cardioplegia cannulae catalog sku product name manualinflating qty rmh0015s smooth balloon, rigid insertion stylet, 15fr 5box rmh1015s smooth balloon, stopcock in the pressure line, rigid insertion stylet, 15fr 5box rmht015s textured balloon, stopcock in the pressure line, rigid insertion stylet, 15fr 5box. Retrograde continuous cold blood cardioplegia listed as rcbc. Cardioplegia solutions may be delivered antegrade i. Does simultaneous antegraderetrograde cardioplegia improve. This study was undertaken to compare the efficacy of retrograde cardioplegia for myocardial perfusion with that of antegrade cardioplegia at the same flow rate. When introduced into the coronary sinus, it is called retrograde cardioplegia. Retrograde cardioplegia cannulae surge cardiovascular. The pressure required for injection of solution should be 30 to 50 mm hg and higher pressure than this range can cause injury to the coronary sinus. We do not use retrograde cardioplegia during isolated minimv because of the difficulty inserting the retrograde cardioplegia catheter into the coronary sinus cs. Diameter ranges from 3 15 mm in size 8 mm on average.
Retrograde definition of retrograde by merriamwebster. Retrograde perfusion into coronary sinus during coronary artery bypass graft cabg surgery reduces the need for cardioplegic interruptions and ensures the distribution of cardioplegia to stenosed vessel territories, therefore enhancing the delivery of cardioplegia to the subendocardium. Retrograde cardioplegiacatheters multiple handle and stylet options to accommodate a variety of surgical preferences shorterlength femaleluerinsteadofstopcock smooth. Thruport systems proplege peripheral retrograde cardioplegia device. Feasibility and safety of continuous retrograde administration of del nido cardioplegia. A retrospective analysis of myocardial preservation. Localized phosphorus 31 spectra showed that retrograde cardioplegia required. Retrograde cardioplegia cannulae adult javascript seems to be disabled in your browser. Surgeons often rely primarily on retrograde cardioplegia for myocardial protection. Thereafter, retrograde cardioplegia is delivered at 20minute intervals or sooner, if required. A cardioplegia system for delivering cardioplegic solution to the heart during open heart surgery in cooperation with an extracorporeal blood circuit employing a heartlung machine, includes a conduit diverting a portion of the blood flow from the heartlung machine to a cardioplegia delivery line. A heat exchanger for controlling fluid temperature is provided in the cardioplegia delivery line. Edwards retrograde cardioplegia catheters offer a variety of features designed to meet various surgical needs and preferences. Use of retrograde cardioplegia in coronary artery bypass graft surgery adil k.
Retrograde cardioplegia catheters by edwards lifesciences. Cardiomyocyte apoptosis after antegrade and retrograde cardioplegia during. This is further augmented by the cardioplegia component which is high in potassium. Retrograde cardioplegia does not adequately perfuse the. Retrograde cardioplegia the journal of thoracic and. Additional adapters are available to extend the length of the cardioplegia circuit, recirculate the cardioplegia solution, or provide an extension to the pressure monitoring line.
A variety of features are designed to meet various surgical needs andpreferences. Retrograde cardioplegia when the cardioplegic solution is entered into the circulation via coronary sinus then this is known as retrograde cardioplegia. Cardioplegia adapters 42 home products cannulae cardioplegia adapters allow for customization of the cardioplegia circuit to accommodate a variety of surgical techniques. Cardioplegia adapters are designed to permit customization of the cardioplegia circuit. The proplege peripheral retrograde cardioplegia device. Retrograde coronary sinus cardioplegia is being used for. Us5738652a retrograde delivery catheter and method for. I hope i can inform you about some new aspects concerning myocardial protection.
To accomplish this, a cardioplegia solution can be given anterograde, retrograde, or both. Fda releases full edwards lifesciences warning letter. Adapters can be used to connect multiple cardioplegia cannulae andor vein graft cannulae to a single inlet source, switch between antegrade and retrograde delivery of cardioplegia and provide the option for attaching a vent line to the cardioplegia cannulae. Imageguided quantification of cardioplegia delivery during cardiac surgery article in heart surgery forum 105. Retrograde cardioplegiacatheters edwards lifesciences. Imageguided quantification of cardioplegia delivery. Use of retrograde cardioplegia in coronary artery bypass. The total amount of car dioplegic solution was the same in the two groups, but flow rates were greater in the simultaneous group to. Remove cap from hose barb adapter and attach tubing or remove hose barb and connect male luer remove white cap on side port of green stopcock. Myocardial reperfusion damage following cardioplegic ischemic arrest is a key. Driver fc276r curved valve xs needleholder, aesculap, center valley, pa. Does simultaneous antegraderetrograde cardioplegia improve myocardial perfusion in the areas at risk. Antegrade cardioplegia, retrograde cardioplegia, or both.
E3816 february 2007 with 24 reads how we measure reads. Learn how the livanova csc14 cardioplegia heat exchanger features a total visibility design. Buy medtronic myotherm cardioplegia delivery system at. Once cpb was established, retrograde cardioplegia administration was attempted but there was difficulty achieving pressurization of the coronary sinus. It is retrograde continuous cold blood cardioplegia. Andocor cardioplegia adapters connect to the aortic root cannula or vessel cannulae and are intended for the delivery of cardioplegia solution or venting the heart during cardiopulmonary bypass.
From special incentive programs and sales to the newest products, the amd newsletter is a great way to keep tabs on everything thats important to you. Cardioplegia is intentional and temporary cessation of cardiac activity, primarily for cardiac. Shapes are tubular, funnel or windsock shaped and can. Given the severe aortic insufficiency, retrograde was preferred over antegrade cardioplegia. The medtronic myotherm cardioplegia delivery system was specifically designed to effectively handle air, in a lowprime design, while providing fast responses through efficient heat transfer. Colored microspheres were used in rat hearts to assess the capillary flow of cardioplegia solution. Pdf most surgeons, ourselves including, use retrograde cardioplegia in. The proplege peripheral retrograde cardioplegia device is indicated for occlusion of the coronary sinus, delivery of cardioplegia solution, and monitoring of coronary sinus pressure during cardiopulmonary bypass.
Perioperative myocardial injury pmi, as measured by the rise of serum level of cardiac biomarkers, has. Chairman, it is my great pleasure, but mainly it is an honor for me to be invited for lecturing this audience. Retrograde continuous normothermic blood cardioplegia. The proplege peripheral retrograde cardioplegia device is indicated for occlusion of the coronary sinus, delivery of cardioplegia solution, and monitoring of. Comparison of intermittent antegrade cardioplegia and. Randolph chitwood, jr, md division of cardiothoracic surgery, east carolina university school of medicine, greenville, north carolina retrograde coronary sinus cardioplegia is being used for myocardial protection with everincreasing frequency. Continuous retrograde blood cardioplegia ensures prolonged.