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Thorac Cardiovasc Surg 1999; 47(3): 148-152
DOI: 10.1055/s-2007-1013130
Original Cardiovascular

© Georg Thieme Verlag Stuttgart · New York

Superior Myocardial Protection with a New Histidine-Buffered Crystalloid Cardioplegic Solution in Clinical Trial

K. Takeuchi, K. Maida, S. Tanaka, S. Yoshida, X. McGowan Jr1 , P. J. del Nido2
  • Department of Cardiovascular Surgery, Aomori General Hospital, Aomori, Japan
  • 1Department of Anesthesiology, Children's Hospital and Harvard Medical School, Boston, USA
  • 2Department of Cardiac Surgery, Children's Hospital and Harvard Medical School, Boston, USA
Further Information

Publication History

1998

Publication Date:
19 March 2008 (online)

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Abstract

Background: Blood cardioplegia has been widely accepted in clinical cardiac surgery based on its excellent oxygen delivery and pH buffering capacity. To further conserve blood during clinical cardiac surgery, we formulated a new crystalloid cardioplegic solution containing histidine (100 mol/L) as the pH buffering agent. Methods: Sixty patients being applied Histidine Buffered Solution (HBS) (n = 27) or Cold Blood Cardioplegic solution (CBC) (n = 33), both at 4 °C, were studied prospectively. Pre- and post-bypass left-ventricular (LV) volume was measured by echocardiography. With a ventricular pressure catheter, LV pressure-volume loops were constructed to determine the slope of the end-systolic pressure-volume relationship (Emax) without inotropes. Results: There were no postoperative deaths in either group. Thirty minutes after reperfusion Emax was significantly better in the HBS group than in the CBC group (6.0±1.0 mmHg/cm3 vs 3.7±0.8 mmHg/cm3). Cardiac Index was also significantly higher in HBS group than in CBC group with lower inotropic requirement. Homologous blood transfusion was avoided in 64% of the patients receiving HBS versus 48% of the patients with CBC. Conclusions: We conclude that the new histidine-buffered cardioplegic solution provides effective protection with excellent recovery of pump performance in clinical open heart surgery.

Key words

Cold blood cardioplegia - Crystalloid cardioplegic solution - Histidine - Open heart surgery - Clinical trial

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