One single dose of histidine-tryptophan-ketoglutarate solution gives equally good myocardial protection in elective mitral valve surgery as repetitive cold blood cardioplegia: A prospective randomized study.

OBJECTIVES: Histidine-tryptophan-ketoglutarate (HTK-Custodiol) cardioplegic solution is administered as one single dose for more than 2 hours of ischemia. No prospective randomized clinical study has compared the effects of HTK and cold blood cardioplegia on myocardial damage in elective mitral valve surgery. Thus, the main aim of the present study was to examine whether one single dose of cold antegrade HTK gives as good myocardial protection as repetitive antegrade cold blood cardioplegia in mitral valve surgery. METHODS: Eighty consecutive patients undergoing elective isolated mitral valve surgery for mitral regurgitation, with or without ablation for atrial fibrillation, were included in the study and randomized to HTK or blood cardioplegia. Markers of myocardial injury (troponin-T and creatine kinase MB) were analyzed at baseline and 7 hours, 1 day, 2 days, and 3 days after surgery. RESULTS: No significant difference in creatine kinase MB and troponin-T between HTK and blood cardioplegia groups was found at any time point. There was a significant correlation between ischemic time and markers of myocardial injury in the HTK group only and significantly more spontaneous ventricular fibrillation after release of crossclamping in the HTK group. CONCLUSIONS: One single dose of antegrade cold HTK cardioplegic solution in elective mitral valve surgery protects the myocardium equally good as repetitive antegrade cold blood cardioplegia.

Jeppsson, Anders,1960Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xjepan (author)
Scherstén, Henrik,1956Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine (author)
Hagen, Ole M (author)
Vengen, Oystein (author)
Rexius, Helena,1967Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xrexhe (author)
Lepore, Vincenzo,1961Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine (author)
Tønnessen, Theis (author)
Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin (creator_code:org_t)

In:The Journal of thoracic and cardiovascular surgery: Elsevier BV141:4, s. 995-10011097-685X0022-5223

By the author/editor: Braathen, Bjørn; Jeppsson, Anders ...; Scherstén, Henri ...; Hagen, Ole M; Vengen, Oystein; Rexius, Helena, ...; show more...; Lepore, Vincenzo ...; Tønnessen, Theis; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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