A Clinical Comparative Study On Myocardial Protective Effect Between HTK Solution And Cold Blood Cardioplegia In Infants With CHD Undergoing Open Heart Surgery

Objective:The aim of our study was to evaluate the value of myocardial protective effects between histidine-tryptophan-ketogutalate (HTK) solution and cold blood cardioplegic solution in the low-weight infants with congenital heart disease (CHD) undergoing cardiopulmonary bypass (CPB).Methods:40 infants (weight≤10kg) undergoing cardiopulmonary bypass were randomly divided into two groups,20 cases each, one group for cold blood cardioplegic (group X,25ml/kg perfused every 25 min), the other for HTK solution (group H,40ml/kg perfused in 6min without repeated perfusion). Plasma level of CK, CK-MB and cTnl were measured before CPB and at 12h,24h after aortic cross-clamp release. The ratio of spontaneous cardiac rhythm recovery, dose of inotropic drugs application were calculated; mechanical ventilation support time and ICU stay-time were recorded.Results:1.The basic data of age, sex, weight and sorts of the disease were no statistically significant.2.The CPB-time, aortic cross-clamp time and the ratio of spontaneous cardiac rhythm recovery (94.74%,89.47%) were no statistically significant.3.The mechanical ventilation support-time, ICU stay-time and the dose of inotropicagents (dopamine, DA) used after operation were no statistically significant. However, the DA support-time was statistically shorter in group H than that in group X (P<0.05).4.The plasma level of CK, CK-MB and cTnI were significantly lower in group H than those in group X (P<0.05). Conclusion:1.HTK solution, a kind of intracellar cardioplegic solution, which could offer an effective myocardial protection by releasing the injury of reperfusion, could help to recovery the cardial function in earlier peiroid after operation.2.Compared with cold blood cardioplegic solution, the inotropicagents (DA) support-time was statistically shorter and the plasma level of CK, CK-MB and cTnl were significantly lower in HTK solution. Thus, HTK solution, releasing the injury of reperfusion more effcctively, has a better myocardial preservation effect to the immature heart in the low-weight infant with CHD undergoing cardiopulmonary bypass.