Comparison of clinical outcome between histidine-triptophan-ketoglutalate solution and cold blood cardioplegic solution in mitral valve replacement

Background: This study was conducted to compare the effect of histidine-tri ptophanketoglutalate solution (HTK) with that of cold blood cardioplegic so lution (CBC) in mitral valve surgery. Method Forty-six patients who underwe nt mitral valve replacement between January 1994 and December 1996 were enr olled in this study. Twenty patients received HTK (HTK group), while 27 pat ients had CBC (CBC group) as myocardial protection. HTK was given as a sing le high dose, whereas CBC was used in the usual multidose format. Result: T he doses of inotropic agent at the end of extracorporeal circulation did no t differ between the HTK group and the CBC group. Creatine kinase values (u nits) on day 1 and day 2 were 1140 +/- 412, 921 +/- 436 for the HTK group a nd 904 +/- 335, 816 +/- 420 for the CBC group, respectively (p = NS). Spont aneous defibrillation occurred in 26% of the CBC group and 90% of the HTK g roup (p < 0.05). Pacing was temporarily used in 20% of the HTK group and 44 % of the CBC group after extracorporeal circulation (p < 0.05). Conclusions : These results suggest that HTK provided more adequate myocardial protecti on in mitral valve surgery.