RESULTS OF THE USE OF HIGH VOLUME CARDIOPLEGIA BY HTK SOLUTION (CUSTODIOL) IN ASCENDING AORTIC ANEURYSMS

M.L. Semenovsky, V.V. Sokolov, Ye.V. Kovaleva, V.B. Myakishev
Research Institute of Transplantology and Artificial Organs,
Ministry of Public Health of the Russian Federation,
Moscow, Russia

We summarize the experience gained with the clinical use of custodiol, an intracellular cardioplegic solution, in Bentall-De Bono operations for ascending aortic aneurysms. Between 1993 and 1998 years 50 such operations were performed. Intraoperative ischemia lasted from 90 to 215 minutes (123±11 min on the average). The early postoperative lethality was 2%. Presented herein is a detailed methodical scheme for custodiol cardioplegia, which is unsophisticated and standard. To evaluate the efficacy of high volume cardioplegia by HTK solution, we have analyzed the routine indices (the nature of heart function recovery, the level of inotropic support, etc), the data of cardiac index and creatine phosphokinase MB fraction monitoring, and the findings of electron microscopy of myocardial biopsy specimens. The data obtained indicate the high efficacy of high volume cardioplegia using custodiol, an intracellular type solution. The time course of changes in the cardiac index, in the level of MB fraction of creatine phosphokinase and in the status of the myocardial ultrastructure the cardiac protection adequacy attained with the use of the given method of cardioplegia which manifests itself in a high degree of heart function and structure preservation. The simplicity and efficacy of high volume cardioplegia by HTK solution demonstrated with special reference to the Bentall-De Bono operation permit recommending this method in large reconstructive operations on the heart.

P. 107-113

« Back