The efficacy of cold blood potassium cardioplegia during periods of ischemic arrest was assessed in 88 patients undergoing open heart surgical procedures at Chonnam National University Medical School from December, 1987 to January, 1989.
The purpose of this study was to determine if the aortic cross clamping time(ACCT) over 120 minutes correlated with operative mortality, incidence of postoperative ventricular tachyarrhythmias, needs of postoperative inotropic support and serum enzyme levels.
The patients were divided according to aortic cross clamping time(less than 120 minutes and 120 miutes or greater).
The results were as follows
1. The operative mortality was 3.2% in ACCT<120min group and 7.7% in ACCT 3120 min group.
2. The incidence of postoperative ventricular tachyarrhythmia was 1.6% in ACCT <120min group and 11.5% in ACCT> 120min group (P3. The incidence of postoperative inotropic support in congenital heart disease was 13.0% in ACCT<120min group and 45.0% in ACCT,>120min group(p<0.05). The incidence in acquired heart disease was 26.0% in ACCT<120min group and 40.0% in ACCT 120min group.
4. After cardiopulmonary bypass, serum GOT, LDH, CPK and CPKMB were elevated prominently. Children showed higher value of the enzymes examined than adults did before and after cardiopulmonary bypass. In congenital heart diseases, postoperative serum GOT, LDH, CPK and CPKMB levels of ACCT.120min group were significantly higher than those of ACCT<120min group. Postoperative serum GOT, LDH and CPKMB levels of ACCT>,120min group were significantly higher than those of ACCT<120min group also in acquired heart ´diseases.
The results suggest that the myocardial protective effect with cold blood potassium cardioplegic solutions was not sufficient when the aortic cross clamping time was over 120 minutes.
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