Efficacy of myocardial preservation using GIK solution for prolonged ischemic heart

• Published in: [Zasshi] [Journal]. Nihon Kyobu Geka Gakkai Vol. 41; no. 8; p. 1368
• Main Authors: Hachida, M, Nonoyama, M, Bonkohara, Y, Saitou, S, Katsumata, T, Aomi, S, Endo, M, Hashimoto, A, Koyanagi, H
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.08.1993
• Subjects: Aortic Valve Insufficiency - physiopathology; Aortic Valve Insufficiency - surgery; Cardiac Volume; Cardioplegic Solutions - therapeutic use; Glucose - therapeutic use; Heart Arrest, Induced - methods; Humans; Insulin - therapeutic use; Perfusion; Potassium - therapeutic use; Ventricular Function, Left
• ISSN: 0369-4739

The efficacy of myocardial preservation using GIK solution combined with continuous cold blood perfusion was assessed in patients with prolonged ischemia. Fifteen patients receiving more than 4 hours' ischemia were divided into two groups. In Group A, seven patients were associated with severe aortic regurgitation and showed increased left ventricular volume of more than 60 mm in LVDd and 45 mm in LVDs. In Group B, eight patients had a normal left ventricular volume of less than 60 mm in LVDd and 45 mm in LVDs echocardiographically. There was no significant difference in ischemic time, or preoperative hemodynamic parameters between the two groups. The postoperative cardiac index was 2.93 +/- 0.87 in Group A and 4.3 +/- 0.8 in Group B (p < 0.01). The postoperative shortening fraction was 0.17 +/- 0.01 in Group A, 0.43 +/- 0.12 in Group B (p < 0.01). These parameters significantly deteriorated in Group A compared to Group B. Released enzymes (GOT, CK-MB) were significantly increased in Group A with prolonged ischemic time. In conclusion, postoperative cardiac function after 4 hours' ischemia using GIK solution deteriorated in the patients with a dilated heart due to aortic regurgitation.