J.Jpn. Surg. Soc.. 86(9): 1199-1202, 1985

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Report on the annual meeting

EVALUATION OF EFFECTIVENESS AND SAFETY IN THE USE OF COLD- DILTIAZEM-POTASSIUM CARDIOPLEGIA IN CORONARY ARTERY BYPASS SURGERY：A FIRST CLINICAL TRIAL

The effectiveness and safety of diltiazem (DIL), a slow channel calcium blocker, added in cold potassium cardioplegic (CP) solution was evaluated in coronary artery bypass graft (CABG) surgery for 2 purposes ; (1) protection of ischemic myocardium during cardiac arrest and (2) prevention of perioperative coronary artery spasm (PCS). Diltiazem of 15mg was added to a liter of CP which was administered 10ml/kg BW. initially and 5mg/kg thereafter. The serum concentration of DIL was 570ng/ml at the time of aortic declamping, 210ng/ml at cardioversion and 150ng/ml one hour after surgery.
The left ventricular stroke work index was increased significantly (p＜0.05) in patients treated by DIL-CP, compared with the patients treated by regular CP without DIL. However, CPK-MB values were not significantly different in either group. The incidence of PCS has decreased from 9.1％ to 0.8％ (p＜ 0.01) after the use of DIL-CP. Perioperative myocardial infarction rate has also decreased from 5.5％ to 1.6％. No major or long-lasting side-effects were encountered. We consider that DIL-CP is a safe and excellent CP in CABG surgery and we are now utilizing this CP in all patients requiring CABG surgery.

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