Rare Complication of Retrograde Cardioplegia: Inner Wall Perforation of the Right Atrium

Retrograde cardioplegia has been widely applied with satisfactory results. This report presents a case in which the retrograde cannula was inserted into the coronary sinus by penetrating the inner wall of the right atrium rather than through the orifice of the coronary sinus. Surgeons should be cautious of this possibility, particularly in patients with a dilated right atrium in which the space between trabeculae is enlarged and the atrial tissue is friable. Under this situation, the tip of the cannula is easily caught in such a space and may penetrate the wall of the right atrium, which affects the delivery of cardioplegia.