Adequate distribution of cardioplegic solution in the mycardium and adaptable strategies for its delivery in varius clinical situations are two prerequisities for optimal myocardial protection. Using a combined method of antegrate and retrograde delivery of cold blood cardioplegia we have achieved better myocardial protection in comparison with previously applied methods.
In critical coronary artery stenoses as well as oclusions, antegradedly delivered cardioplegia results in poor distribution and subsequently inadequate myocardial protection.

On the other hand the retrograte route of delivering cardioplegia takes advantage of a patent and low-pressure network of veins and makes the proportional distribution of the cardioplegia solution possiple.