Background: Minimally invasive cardiac surgery (MICS) is a safe and satisfactory approach used mainly in mitral valve surgery with excellent results in many centers. Cardioplegia administration can be still a problem, especially when an endoaortic clamp is used. We retrospectively analyzed our early results with histidine-triptophane-ketoglutarate (HTK) solution used for myocardial protection in MICS. Methods: Between February 2003 and February 2004, 8 patients underwent mitral valve surgery using an endocardiopulmonary bypass (CPB) system and HTK solution as myocardial protection. The mean patient age was 67.7 ± 9.2 years, and the preoperative ejection fraction was normal in all patients. Three patients had valve repair and 5 had valve replacement. Mean CPB time was 129.2 ± 19.4 minutes, and aortic cross-clamp duration was 88.5 ± 15.4 minutes. Results: In every case HTK solution was used for only a single dose for cardioplegia at the beginning of the procedure, without any recalls. The heart restarted spontaneously at reperfusion in 6 of 8 cases (75%), and there were no significant modifications in electrocardiogram results or myocardial cytonecrosis enzymes (creatine kinase and its MB fraction) during the postoperative period. Conclusions: HTK solution is a cold crystalloid cardioplegia solution that has demonstrated its utility in MICS because it provides a safe long cardioplegic arrest time and it reduces the risk of inadequate coronary perfusion due to dislodgement of the endoaortic clamp. © 2004 Forum Multimedia Publishing, LLC.

Myocardial protection using HTK solution in minimally invasive mitral valve surgery

SAVINI, CARLO;CAMURRI, NICOLA;CASTELLI, ANDREA;DELL'AMORE, ANDREA;PACINI, DAVIDE;MARTIN SUAREZ, SOFIA;GRILLONE, GIOVANNI;DI BARTOLOMEO, ROBERTO
2005

Abstract

Background: Minimally invasive cardiac surgery (MICS) is a safe and satisfactory approach used mainly in mitral valve surgery with excellent results in many centers. Cardioplegia administration can be still a problem, especially when an endoaortic clamp is used. We retrospectively analyzed our early results with histidine-triptophane-ketoglutarate (HTK) solution used for myocardial protection in MICS. Methods: Between February 2003 and February 2004, 8 patients underwent mitral valve surgery using an endocardiopulmonary bypass (CPB) system and HTK solution as myocardial protection. The mean patient age was 67.7 ± 9.2 years, and the preoperative ejection fraction was normal in all patients. Three patients had valve repair and 5 had valve replacement. Mean CPB time was 129.2 ± 19.4 minutes, and aortic cross-clamp duration was 88.5 ± 15.4 minutes. Results: In every case HTK solution was used for only a single dose for cardioplegia at the beginning of the procedure, without any recalls. The heart restarted spontaneously at reperfusion in 6 of 8 cases (75%), and there were no significant modifications in electrocardiogram results or myocardial cytonecrosis enzymes (creatine kinase and its MB fraction) during the postoperative period. Conclusions: HTK solution is a cold crystalloid cardioplegia solution that has demonstrated its utility in MICS because it provides a safe long cardioplegic arrest time and it reduces the risk of inadequate coronary perfusion due to dislodgement of the endoaortic clamp. © 2004 Forum Multimedia Publishing, LLC.
Savini, C.; Camurri, N.; Castelli, A.; Dell'Amore, A.; Pacini, D.; Martin Suarez, S.; Grillone, G.; Di Bartolomeo, R.
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/524893
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 16
  • ???jsp.display-item.citation.isi??? 15
social impact