Clinical Studies Of HTK Cardioplegic Solution On Myocardial Protection

Objective: To evaluate the myocardial protective effects of HTK cardioplegic solution in the patients undergoing cardiac valve replacement, in comparison with St ?Thomas II cardioplegia and 4 : 1 cold blood cardioplegia.Methods: Thirty-six patients with rheumatic heart valve disease programmed for elective cardiac valve replacement were randomized into three groups. In group A (n=12), myocardial protection was carried out with conventional crystalloid cardioplegia (St ?Thomas II cardioplegia), in group B (n = 12) with cold blood cardioplegia, and in group C (n = 12) with HTK solution. Serum levels of cardiac troponin T(cTnT) , creatine kinase MB(CK-MB),myoglobin(MYO) were measured after anesthesia, and at 5m, 2h, 6h, 12h, 24h 48h and 72h after aortic declamping or intra-cardiac manipulation finished. The following clinical parameters were recorded, such as the auto-beating ratio, the incidence of arrhythmias, inotropic support requirement, the hours of mechanical ventilation, and length-of-stay in the intensive care unit, etc. Myocardial ultrastructures were observed.Results: In the postoperative period, serum levels of cardiac cTnT, CK-MB in group B-. C were lower than that in groug A(P<0.01). Group B, C had a lower incidence of arrhythmias . Inotropic support, the hours of mechanical ventilation and length-of-stay in the intensive care unit were lower in group B, C(P<0.05). Electron microscopy showed that the mitochondria in group B, C were better than that in group A(P<0.05). There were no diferences in group B, C(P>0. 05).Conclusions: It was concluded that the HTK cardioplegia reperfusion is of benefit to the myocardial protection in patients undergoing valve replacement.