Unusual Deformity in Aortic Stenosis Preventing Coronary Artery Cannulation.

MAINTENANCE of myocardial viability is one of the major considerations during direct operations on the aortic valve. Our preference is to cannulate the coronary ostia and perfuse the myocardium with 300 ml. of blood per minute at a temperature of 30 C. Others' report satisfactory results with cardiac hypothermia and anoxic arrest. It is our habit to have iced Ringer's solution available so that cardiac hypothermia may be induced if coronary perfusion is too cumbersome. The following case report is chiefly of interest because coronary cannulation was impossible initially and local hypothermia was the only way of protecting the heart.