Ventricular Fibrillation after Aortic Cross-Clamp Removal in Patients Undergoing Heart Valve Surgery: HTK Solution vs. Blood Cardioplegia
Rimphanitchayakit J, MD1, Chanmayka T, MD2, Wongbuddha C, MD2, Karunasumetta C, MD2, Prathanee S, MD2, Kuptarnond C, MD2
Affiliation : 1 Resident in Cardiovascular and Thoracic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : Single-dose cardioplegia for myocardial protection is non-interupting option for a cardiac procedure. Histidine-
Tryptophan-Ketoglutarate (HTK) solution has been used for cardioplegia in many cardiac centers; but the incidence of associated
intraoperative ventricular fibrillation has been frequently observed. The current study determined the outcomes of HTK cardioplegia
for simple cardiac operations compared to conventional blood cardioplegia.
Materials and Methods: A retrospective study was conducted among patients who underwent heart valve operations between
January 2014 and December 2014. Sixty-four patients were included into the study. The medical records were source for detailed
demographics, preoperative status, operative technique, and post-operative hospital course.
Results : Sixty-four patients were included in the study; 31 patients received HTK solution. Ventricular fibrillation after aortic cross-
clamp removal occurred in 26 patients (40%), 14 in the HTK group (45%). There was no perioperative myocardial infarction.
Ventricular fibrillation after aortic cross clamp removal occurred more frequently in patients receiving HTK solution, albeit the
difference was not statistically different.
Conclusion : The use of HTK solution has no significant different outcomes compare to conventional cold blood cardioplegia in heart
valve operation. Ventricular fibrillation occurred after aortic cross clamp removal tends to be temporary and there was no evidence
of postoperative myocardial infarction.
Keywords : Cardioplegia, HTK, Custodiol, Ventricular fibrillation
