Premium
Assessment of the Position of Retrograde Cardioplegia Catheter: Comparison of Hemodynamic versus Manual Evaluation in a Prospective Randomized Trial
Author(s) -
Gaudino Mario,
Anselmi Amedeo,
Glieca Franco,
Luciani Nicola,
Perisano Mario,
Piscitelli Mariantonietta,
Possati Gianfederico
Publication year - 2008
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2008.00678.x
Subject(s) - medicine , hemodynamics , catheter , ascending aorta , cardiology , aorta , surgery
Abstract Objective: To evaluate a hemodynamic method for the assessment of the position of the retrograde cardioplegia catheter (RCC) versus conventional Manual Assessment. Methods: We randomized 200 patients undergoing aortic valve surgery to Manual (n = 101) or Hemodynamic Assessment (n = 99). In the Hemodynamic group a 25% pressure increase at the tip of the RCC when a fistula with the ascending aorta was created via a luer‐lock was considered indicative of correct RCC placement. Transesophageal echocardiography was used as a comparison evaluation method. Results: The Hemodynamic and Manual Assessment considered the RCC positioning successful in 89.9% versus 85.1% of cases. Echocardiography confirmed these results in Hemodynamic group but revealed 23 cases of misrecognized incorrect placement in the Manual group (p < 0.0001). Manual maneuvers resulted in 18 cases of secondary displacement and 19 cases of hemodynamic instability (p < 0.0001). Conclusions: The Hemodynamic Method is quantitative, reproducible, highly reliable, and safer than palpation in the posterior atrioventricular groove.