Cardiac Retroperfusion with Induced Asystole for Open Surgery upon the Aortic Valve or Coronary Arteries.

Abstract

Only 1 of 10 dogs submitted to 15-30 minutes of potassium citrate produced asystole was a long term survival (90% mortality). Ten dogs submitted to 30 minutes of re troper fusion of the coronary sinus with arterialized blood had a cardiac mortality of 4, or 40%. Ten dogs subjected to a combination of 30 minutes of retroperfusion of the coronary sinus and potassium citrate provoked asystole had a mortality from cardiac complications of 2 animals or 20%. Certain aspects of cardiac metabolism in the retroperfused heart with and without potassium citrate induced asystole were studied in 10 dogs. There appears to be an additionally reduced degree of metabolism produced in the hearts with induced asystole over that measured in the non-working bypassed heart which is allowed to continue to beat. On the basis of these experimental studies and certain clinical observations the combination of retroperfusion and potassium asystole appears valuable for precise, direct vision reparatlve procedures upon the aortic valve or coronary arteries in a quiescent operative field.