Korean J Thorac Cardiovasc Surg.  2007 Jun;40(6):399-406.

A Comparison of the Effects of Histidine-tryptophan-ketoglutarate Solution versus Cold Blood Cardioplegic Solution on Myocardial Protection in Mitral Valve Surgery

• Choi YS
• Bang SO
• Chang BC
• Lee S
• Park CH
• Kwak YL

Abstract

BACKGROUND: Ischemia-reperfusion injury related to unsuccessful myocardial protection affects postoperative ventricular function and mortality during open-heart surgery. We prospectively compared the effects of administration of histidine-tryptophan-ketoglutarate (HTK) solution and cold blood cardioplegia (CBC) on myocardial protection and clinical outcome in patients undergoing mitral valve surgery. MATERIAL AND METHOD: Seventy patients with mitral regurgitation (MR) undergoing mitral valve surgery were randomly divided into the HTK group (n=31) and the CBC group (n=31); eight patients were excluded. Perioperative hemodynamics, cardiac medications, pacing, postoperative outcomes and complications were recorded during the hospital stay. All patients received follow-up for at least 6 months postoperatively for morbidity and mortality. RESULT: There were no significant differences in the hemodynamics between the groups during the study period, except for the mean pulmonary artery pressure (MPAP), PCWP and CVP that were lower in the HTK group at 15 min after weaning of CBP. There were no differences for inotropic support and pacing during the 12 hrs postoperatively between the groups. CK-MB values on day 1 and day 2 were 77+/-54 and 41+/-23 for the HTK group and 70+/-69 and 44+/-34 for the CBC group, respectively (p=NS). Postoperative clinical outcomes were similar in both groups for at least 6 months during the follow-up period.
CONCLUSION
These results suggest that the use of HTK solution is as safe as cold blood cardioplegia in terms of myocardial protection.

Keyword

Myocardial injury; Cardioplegic solutions; Myocardial protection

MeSH Terms

Cardioplegic Solutions*
Follow-Up Studies
Heart Arrest, Induced
Hemodynamics
Humans
Length of Stay
Mitral Valve Insufficiency
Mitral Valve*
Mortality
Prospective Studies
Pulmonary Artery
Reperfusion Injury
Ventricular Function
Weaning
Cardioplegic Solutions