Premium
The Comparison of the Effects of B retschneider's Histidine‐Tryptophan‐Ketoglutarate and Conventional Crystalloid Cardioplegia on Pediatric Myocardium at Tissue Level
Author(s) -
Korun Oktay,
Özkan Murat,
Terzi Ayşen,
Aşkın Göktan,
Sezgin Atilla,
Aşlamacı Sait
Publication year - 2013
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.2012.01575.x
Subject(s) - medicine , anesthesia , clamp , cardiology , engineering , clamping , mechanical engineering
Cardioplegic arrest is one of the most common myocardial protection strategies. A wide variety of cardioplegic solutions are routinely being used. There is an ongoing discussion about the relative effectiveness of these solutions considering myocardial protection. This study aims to investigate the hypothesis that the use of histidine‐tryptophan‐ketoglutarate ( HTK ) cardioplegia leads to decreased ischemic damage on myocardium compared with the use of conventional crystalloid cardioplegia. The study population was 32 patients operated on at B aşkent U niversity, D epartment of C ardiovascular S urgery for congenital heart diseases. The first group of 16 patients received conventional crystalloid cardioplegia ( KK group) which is a modification of S t. T homas' solution, while the second group of 16 patients received HTK solution ( HTK group). The echocardiographic measurements and the laboratory values of the patients were taken as the clinical variables. Right ventricular biopsies were taken from every patient before and after cardioplegic arrest. These biopsies were histopathologically examined for apoptosis using caspase‐3 antigen and cell proliferation using Ki‐67 antigen. The statistical analysis revealed no significant difference between the two groups regarding the clinical variables, apoptotic indices and proliferation indices. The apoptotic indices in the postcardioplegic arrest biopsies positively correlated with aortic clamp time in the KK group but not in the HTK group. Liver function tests on postoperative day 1 positively correlated with aortic clamp time in both groups. On postoperative day 2, this correlation was sustained in the KK group and ceased in HTK group. The difference in the correlation of apoptotic indices and liver function tests between the groups is accepted as a supportive finding for HTK solution. However, it can be postulated that when the aortic clamp times are similar to those in the present study, the clinical manifestation of the difference between the two solutions would not be significant.