Abstract
Study objective involved comparison of two cardioplegic solutions: HTK-solution possessing high buffer capacity and a new ACH-solution with aminoacid buffer. Results revealed high cardioprotective efficiency during surgical repair of complex congenital heart disease both in the group that had received Custodiol and in the group that had received ACH-solution. Clinical and morphological parameters demonstrate high level of myocardial protection from intraoperative ischemia for single usage of ACH-solution during cardioplegic ischemia under 60 minutes in duration.
Highlights
Maintaining viability of myocardium following cardiac arrest remains one of the main issues in cardiosurgery since the beginning of the first operations on an open heart
All subjects were divided into two groups according to cardioplegic solution used
There was no significant difference between two study groups in mean values of age, weight, left ventricular ejection fraction (LV EF), systolic and diastolic arterial pressure, level of creatine phosphokinase MB fraction (CPK-MB) and troponin-T (TN-T) (Table 5)
Summary
Maintaining viability of myocardium following cardiac arrest remains one of the main issues in cardiosurgery since the beginning of the first operations on an open heart. In spite of great progress in the field of congenital heart pathology surgery, intraoperative myocardial damage remains the most common reason for complications and mortality following cardiac surgery. In this regard, the issue of intraoperative myocardial protection retains its relevance continually while cardiosurgery is developing. Using intracellular cardioplegic solutions possessing high buffer capacity is one of state-of-the-art developments in this field. Among available industrially produced cardioplegic solutions, only HTK-solution possesses increased buffer capacity that is twofold the blood buffer capacity. It is commonly known that protein buffer solutions are preferable for stabilizing of intracellular pH level and a better recovery of myocardial contractility compared to a bicarbonate buffer that is frequently used in extracellular solutions
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