A Comparative Study for the Efficacy of Blood Cardioplegia Versus Histidine-Tryptophan Ketoglutarate (HTK) Cardioplegia in Pediatric Patients Undergoing Total Corrective Cardiac Surgery
/ 0
- Details
- Category: Vol. 84, December 2016
- Hits: 513
A Comparative Study for the Efficacy of Blood Cardioplegia Versus Histidine-Tryptophan Ketoglutarate (HTK) Cardioplegia in Pediatric Patients Undergoing Total Corrective Cardiac Surgery, REHAM MAHROUS, AMEL ABO EL-ELA, AHMED MUKHTAR, DALIA SAAD, ASHRAF ABD AL-REHEEM, AHMED KAREEM and HOSSAM HASANIEN
Abstract
Background: The main principle of the commonly used cardioplegia solutions is producing pharmacological arrest of the myocardium in diastole to minimize energy production and reduce the effects of ischemic damage on the myocardium.
HTK cardioplegia minimizes disruption to the technical flow of the operation as it is administered as a single dose infusion when compared to other types of cardioplegia, which are administered repeatedly. Some authors used HTK as a single dose cold cardioplegic solution in pediatrics. They compared it to other methods of cardioplegia as repeated oxygenated warm blood cardioplegia and conventional crys-talloid cardioplegia.
Methods: This study was done on 64 pediatric patients with congenital heart disease in the Cardiothoracic Department in Abo Al-Reesh Hospital scheduled for open total corrective surgery who were randomly assigned to receive either repeated doses of cold blood cardioplegia 20mL/kg of the blood cardi-olpegic solution was administrated initially followed by 10 ml/kg (32 patients) or a single dose of 50ml/kg HTK car-dioplegic solution (32 patients).
Results: The standard cardioplegic solution is associated with less Troponin release than HTK solution in pediatric patients undergoing open heart surgery suggesting better myocardial protection with no significant difference in mor-tality among both groups but the HTK solution had the advantages of less interruption to the surgeon. It is also a very good alternative in cases where there is shortage in the blood to be added to the blood cardioplegic solution.
Conclusion: The standard cardioplegic has better myocar-dial protection after 4 hours post CPB with no significant difference in troponin I 24 hours post-CPB or mortality among both groups.