Non-oxygenated, Substrate-free Hyperpotassemic Cardioplegic Solution Affords Safe Protection of the Ischemic Myocardium during Open Heart Surgery

概要

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Three hundred patients were operated on for valvular disease, ischemic heart disease and other cardiovascular conditions employing a myocardial protective coronary perfusate consisting of non-oxygenated, substrate-free hyperpotassemic crystalloid solution (K 30, Na 138, CI 98, Ca 1, Mg 3mEq/1, papaverine 60mg/1, albumin 1.25g/dl). Preoperatively, there were incidences of NYHA Class IV in 15%, old myocardial infarction in 10%, left ventricular ejection fraction less than 0.4 in 8%, renal failure in 1%, and respiratory dysfunction in 5% of these patients. The aortic cross-clamp time was 86±38 minutes (range, 13-215) during operation. Postoperatively, the hospital mortality rate was 5.3%, but only one (0.3%) patient died of primary myocardial failure. Among surviving patients, no IABP or cardiac assist devices were used, only 14 (4.7%) patients had ventricular arrythmia, and no other major complications were seen. We believe that our current method of myocardial protection during induced ischemia in open heart operations is safe and effective. Further use of this coronary perfusate is warranted.
北里大学の論文
1995-12-31