Metabolic and functional evidence that retrograde warm blood cardioplegia does not injure the right ventricle in human beings

Background Retrograde warm blood cardioplegia is now recognized as an effective method of myocardial protection, but concerns persist about its ability to adequately preserve the right ventricle. Methods and Results A total of 75 patients in whom warm blood cardioplegia was continuously given through the coronary sinus were included in this three-part study. Part 1, which involved 30 patients undergoing coronary artery bypass grafting operations, was designed to assess whether the right ventricle incurred a greater degree of anaerobic metabolism than the left ventricle during warm arrest. Immediately before aortic unclamping, antegrade perfusion was resumed and, within 1 minute of washout, blood samples were simultaneously taken from the right ventricle and coronary sinus and assayed for lactate