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In patients undergoing coronary artery bypass grafting (CABG), use of hypothermic cardioplegia for myocardial protection may not always achieve even cooling in the areas distal to a severely obstructed artery. Employing simultaneous myocardial temperature measurements, we documented "warm" areas in some patients having CABG. We then devised a technique of combined aortic root and intracoronary cardioplegic infusion. This has achieved prompt cooling of the warm areas and has resulted in uniform myocardial temperatures of 5 degrees to 8 degrees C.
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