Clinical impact of histidine-ketoglutarate-tryptophan (HTK) cardioplegic solution on the perioperative period in open heart surgery patients

Background. Ischemia-reperfusion injury during open heart surgery related t o unsuccessful myocardial protection may increase morbidity or mortality. W e analyze the clinical outcome after cardiac surgery with a cardioplegic so lution based on intracellular components added with histidine-ketoglutarate -tryptophan. Methods. Thirty patients programmed for elective open heart surgery were ra ndomized into two groups. In group I (n = 15), myocardial protection was ca rried out with Bretschenider solution (HTK), and in group II (n = 15) with conventional crystalloid cardioplegia. The incidence of arrhythmias, inotro pic support requirement, and length-of-stay in the intensive care unit were evaluated. Results. During reperfusion, there was no difference in incidence of arrhyt hmias; however, in the postoperative period group I had a lower incidence o f arrhythmias (p = 0.001). Inotropic support (p = 0.003) and length-of-stay in the intensive care unit (p = 0.037) were lower in group I. There were n o deaths in either group. Conclusions. It was concluded that myocardial protection with Bretschneider solution effectively decreases incidence of arrhythmias, inotropic support , and length-of-stay in the intensive care unit. (C) 2001 IMSS. Published b y Elsevier Science Inc.