Comparison of clinical outcome between histidine-triptophan-ketoglutalate solution and cold blood cardioplegic solution in mitral valve replacement

Background: This study was conducted to compare the effect of histidine-triptophanketoglutalate solution (HTK) with that of cold blood cardioplegic solution (CBC) in mitral valve surgery. Method Forty-six patients who underwent mitral valve replacement between January 1994 and December 1996 were enrolled in this study. Twenty patients received HTK (HTK group), while 27 patients had CBC (CBC group) as myocardial protection. HTK was given as a single high dose, whereas CBC was used in the usual multidose format. Result: The doses of inotropic agent at the end of extracorporeal circulation did not differ between the HTK group and the CBC group. Creatine kinase values (units) on day 1 and day 2 were 1140 +/- 412, 921 +/- 436 for the HTK group and 904 +/- 335, 816 +/- 420 for the CBC group, respectively (p = NS). Spontaneous defibrillation occurred in 26% of the CBC group and 90% of the HTK group (p < 0.05). Pacing was temporarily used in 20% of the HTK group and 44% of the CBC group after extracorporeal circulation (p < 0.05). Conclusions: These results suggest that HTK provided more adequate myocardial protection in mitral valve surgery.