Q: Which of the following condition may decrease the the effectiveness of antegrade cardioplegia during Coronary Artery Bypass surgery?

A) Aortic regurgitation
B) Mitral regurgitation
C) ventricular septal defect
D) Mitral stenosis
E) Aortic stenosis


Answer: A

Aortic regurgitation (preexisting) may limit the effectiveness of antegrade delivery of cardioplegia solution into the coronary artery ostia after the ascending aorta is cross-clamped, as much of the cardioplegia solution will regurgitate back into the left ventricle. To avoid complications like left ventricular distension, retrograde cardioplegia through the coronary sinus may be a wise choice.