In a previous report1 we have advocated continuous coronary artery perfusion in preference to hypothermia for the mainte nance of myocardial integrity during operations on the aortic valve and aortic root.
Although the value of hypothermia during interruption of coronary flow cannot be contested, no investigator has yet demonstrated that severe cooling of the myocardium can be continued, without damage to the diseased heart, for long periods even with interrupted or continuous coronary perfusion.
Regardless of how the myocardium is supported for aortic valvular surgery, the causes of operative deaths still include such terms as "inability to get the patient off the pump," "low output syndrome," "myocardial failure," "ventricular fibrillation," "myocardial infarction," "myocardial necrosis," and "coronary artery disease." It is safe to assume that some of these patients have sustained a less than optimum coronary artery perfusion.
Every surgeon wishing to utilize coronary perfusion has been faced with the
BOSHER LH, EDWARDS JF. Automatic Pressure-Controlled Coronary Perfusion SystemIncluding Physiologic Observations Derived From Its Application in the Human. Arch Surg. 1964;88(5):752–760. doi:10.1001/archsurg.1964.01310230028008
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