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The coronary perfusion system used at Oulu University Central Hospital is described and the importance of physiological coronary perfusion stressed. Our method of protecting the myocardium from ischemic injury during aortic valve replacement included the following: phasic constant-pressure coronary perfusion, maintenance of coronary perfusion pressure larger than or equal to 80 mmHg, maintenance of the heart in a beating, empty, oxygenated state, and the use of the largest possible coronary canula. Under these circumstances, autoregulation of the coronary vascular bed was maintained. When small coronary cannulae were used a significant pressure drop occured across the tubing system, especially at high flow rates. Flow measurements recorded by an on-line electromagnetic flowmeter proved reliable.
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