HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Menasche, P. Articles by Piwnica, A. Search for Related Content PubMed PubMed Citation Articles by Menasche, P. Articles by Piwnica, A.

European Journal of Cardio-Thoracic Surgery, Vol 1, 33-36, Copyright © 1987 by European Association for Cardio-thoracic Surgery

ARTICLES

Decreased incidence of supraventricular arrhythmias achieved by selective atrial cooling during aortic valve replacement

P Menasche, P Maisonblanche, D Bousseau, P Lorente and A Piwnica
Department of Cardiovascular Surgery, Hopital Lariboisiere, Paris, France.

Inadequate atrial hypothermia and subsequent ischemic injury have been recognized as the major causes of supraventricular arrhythmias (SVAs) and conduction defects following cold chemical cardioplegia. This study was designed to assess the effects of right atrial cooling (15 degrees- 20 degrees C) during cardioplegic arrest upon the incidence of postoperative SVAs and conduction defects in 40 consecutive patients undergoing isolated aortic valve replacement. Atrial preservation was ensured by combining systemic (24 degrees C) and topical hypothermia with snared double caval cannulation during arrest. Myocardial temperatures in the right atrial septum and anterior wall of the right ventricle were recorded before and after each cardioplegic infusion and upon release of caval tapes. Postoperatively, the incidence of SVAs and conduction defects was assessed by continuous rhythm monitoring, bipolar atrial electrograms and, in ten patients, 24-h Holter recordings during the first postoperative day. With the venae cavae snared, temperatures in the right atrial septum were not significantly different from those measured simultaneously in the right ventricle. Release of caval tapes resulted in right atrial temperatures increasing to systemic temperature (from 17.1 +/- 2.9 degrees C to 25.9 +/- 5.6 degrees C [m +/- SD]; P less than 0.01). Atrial rewarming between cardioplegic infusions did not exceed 2.9 degrees +/- 3.2 degrees C. Postoperatively, four patients (10%) developed sustained atrial fibrillation. One additional patient had a single episode of paroxysmal atrial fibrillation and two patients experienced asymptomatic episodes of junctional rhythm.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				H. Dorge, F. A. Schoendube, M. Schoberer, C. Stellbrink, M. Voss, and B. J. Messmer Intraoperative amiodarone as prophylaxis against atrial fibrillation after coronary operations Ann. Thorac. Surg., May 1, 2000; 69(5): 1358 - 1362. [Abstract] [Full Text] [PDF]