Does combined antegrade retrograde cardioplegia have any superiority over antegrade cardioplegia?
Conclusions: Retrograde continuous infusion of cardioplegia by gravitational force combined with antegrade cardioplegia, provides satisfactory myocardial protection and eliminates the need for inotropic support compared with antegrade technique alone.
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.
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.
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.
Where does the retrograde cannula go?
A retrograde cardioplegia cannula is inserted into the coronary sinus and an antegrade cannula is placed in the ascending aorta.
What is a retrograde angiogram?
Retrograde angiography (RA) is routinely used to image this region of the access system. Traditionally, RA is performed by manually occluding the outflow track of an arteriovenous fistula (AVF) and forcing the radiocontrast into the inflow segment against arterial pressure.
How do you give 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 retrograde puncture?
The contralateral retrograde puncture is the routine chosen approach for iliac, SFA, and popliteal lesions, but can be impractical in a variety of circumstances including infections of the groin, severe scarring from previous surgery, severe femoral atheromatous or iliac occlusive lesions.
What does antegrade approach mean?
(an’tĕ-grād), In the direction of normal movement, as in blood flow or peristalsis. [ante- + L. gradior, to walk]
What is an antegrade puncture?
Antegrade puncture is a routinely used technique of obtaining access to the common femoral artery to perform infrainguinal interventions. However, antegrade arterial access can be challenging in the presence of hostile, scarred groins, obesity, or a high common femoral artery bifurcation.
What is the difference between antegrade and retrograde?
The word antegrade refers to moving or extending forward as opposed to retrograde which implies moving backward or opposite to the direction of flow.
What is retrograde approach?
In the retrograde approach, a guidewire is advanced through a collateral channel into the distal true lumen, followed by CTO crossing using various techniques.
What is retrograde angiography?
What is the difference between anterograde flow and retrograde flow?
The key difference between anterograde and retrograde transport is that anterograde transport moves physiological materials towards presynaptic terminals while retrograde transport moves physiological materials back to the cell body from the periphery.
What is an antegrade approach?
The antegrade femoral approach is a routinely used technique for the percutaneous treatment of the lower extremities vascular disease. However, this approach can be challenging in case of obese patients or due to special anatomy of the femoral bifurcation.
What is retrograde filling in heart?
In severe coronary artery disease, i.e. patients with at least 90 percent obstruction of one vessel, the presence of collaterals (retrograde filling) will cause total obstruction of the vessel in at least 3 months. Conversely, in the absence of collaterals, after 3 months the antegrade flow was still present.
What is retrograde and anterograde direction?
Figure 3 – (A) Axonal transport can occur in two directions: anterograde transport is from the cell body toward the axon tip, and retrograde transport is from the axon tip back toward the cell body.
What does retrograde approach mean?
The attempt of the retrograde approach was defined as the introduction of a guidewire into the collateral channels, which connecting with the target coronary artery distal to the target CTO lesion.
What are retrograde filling materials?
For teeth that cannot be treated with orthograde root canal therapy, or for which it has failed, retrograde root filling, which seals the root canal from the root apex, is a good alternative. Many materials, such as amalgam, zinc oxide eugenol and mineral trioxide aggregate (MTA), are generally used.
What is antegrade approach?
What is the difference between combination cardioplegia and antegrade and retrograde?
The two techniques of combination cardioplegia were only marginally different and both required additional maneuvers by the surgeon. However, the additional infusions provide better protection than that achieved by either antegrade or retrograde cardioplegia alone.
What is the pathophysiology of retrograde cardioplegia?
Continuous retrograde cardioplegia was associated with considerable anaerobic lactate accumulation in the myocardium. Both intermittent antegrade infusions and vein graft infusions washed out the lactate and facilitated the recovery of aerobic metabolism and ventricular function.
What is the relationship between intermittent antegrade cardioplegia and myocardial acid release?
Myocardial acid release was greatest with intermittent antegrade cardioplegia ( p = 0.007 by ANOVA). Myocardial oxygen consumption was significantly greater (group p = 0.0001 by ANOVA) during intermittent antegrade cardioplegia than during continuous retrograde cardioplegia in the alternate group.
What is the arresting time in antegrade cardioplegia?
The arresting time in antegrade Cardioplegia is fast and may be ranging between 30 to 60 sec. if there is any delay in cardiac arrest then following reasons could be behind it; Problem in delivery system and AR is unrecognized.