A total of 50 patients undergoing isolated aortic valve replacement received either aortic root (anterograde 〔AGC〕: 25 patients) or coronary sinus (retrograde 〔RGC〕: 25 patients) perfusion with cold blood cardioplegic solution and were compared. The groups were similar with respect to age, sex, preoperative NYHA Class, aortic cross-clamping time and mean dose of cardioplegic solution. There were no significant differences in low cardiac output syndrome, rhythm disturbances and surgical mortality between the two groups. There were also no significant differences in right ventricular stroke work and postoperative cardiac enzymatic levels after surgery in the groups. However, there was a significant improvement in left ventricular stroke work after RGC over that after AGC and significantly more inotropic agents were required with aortic root perfusion than with coronary sinus delivery of cardioplegic solution. These findings indicate that coronary sinus perfusion has benefits not only as a surgical technique but also better preserves the hypertrophied left ventricle more effectively than aortic root perfusion
