J.Jpn. Surg. Soc.. 83(11): 1275-1283, 1982

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Original article

MYOCARDIAL PRESERVATION DURING MITRAL VALVE REPLACEMENT: COMPARISON OF GIK-CARDIOPLEGIA AND K⁺ -Mg²⁺ -CARDIOPLEGIA

The study was aimed to compare the protective effect of GIK-cardioplegia (380mosm/L, 13 patients) and K⁺ -Mg²-cardioplegia (420mosm/L, 6 patients) on left ventricular myocardium during mitral valve replacement (MVR). The effect of cardioplegic solutions were assessed by semi-quantitative analysis of the fine structure of the left ventricular myocardium, cardiac function and biochemistry. Systemic hypothermia at 25℃ of rectal temperature was employed during cardiopulmonary bypass, and topical cooling of the heart was also performed, and the aorta was cross clamped from 63 to 143 minutes. The specimens of the anterior papillary muscle were obtained at the time of completion of MVR. Serial measurements of hemodynamics and cardiac iso-enzymes were made for 2 days after surgery.
There was no death in both groups and also no patients showed any signs of low cardiac output syndrome after the operation. The fine structure of the left ventricle and the left ventricular stroke work index at 42 hours after declamping of the aorta were well preserved in K⁺-Mg²⁺ -cardioplegia compared to those of GIK-cardioplegia. These results suggest that both GIK and K⁺ -Mg²⁺cardioplegia are effective for myocardial preservation in MVR, however K⁺ -Mg²⁺ -cardioplegia is a favourable method compared to GIK-cardioplegia.

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