Mohl W
Ann Chir Gynaecol. 1987;76(1):61-7.
The coronary sinus, collecting about 70% of the venous blood draining the myocardium lends itself particularly well to retrograde concepts of cardioplegia. It has been gaining wide acceptance as a safe means of access to the myocardium in the presence of atherosclerotic disease and as an important modality in providing a more homogeneous distribution of cardioplegic delivery. This article attempts to review all knowledge available on the pathophysiology of retroinfusion of cardioplegia as well as the state of the art of the technique involved. A new concept is being presented, which, in the form of antegrade delivery with postcapillary redistribution, this achieved either by pressure elevation of the venous effluent or pressure-controlled intermittent coronary sinus occlusion (PICSO), takes advantage of both antegrade and retrograde concepts. First experimental results suggest great potential for this combined approach in the effective delivery of cardioplegia.
冠状静脉窦收集约70%引流心肌的静脉血，特别适合逆行性心脏停搏的概念。在存在动脉粥样硬化疾病的情况下，它作为一种安全的进入心肌的途径以及作为提供更均匀的心脏停搏液分布的重要方式已获得广泛认可。本文试图回顾关于心脏停搏液逆行灌注的病理生理学以及所涉及技术的最新进展的所有现有知识。正在提出一种新的概念，即以毛细血管后再分布的顺行给药形式，通过提高静脉流出压力或压力控制的间歇性冠状静脉窦闭塞（PICSO）来实现，它利用了顺行和逆行概念。初步实验结果表明这种联合方法在有效输送心脏停搏液方面具有巨大潜力。
