| Systemic hyperkalemia and mild hypothermia for valve surgery in patients with patent internal mammary artery graft. | |
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MedLine Citation:
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PMID: 20385665 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Myocardial protection is compromised in patients with a patent internal mammary artery (IMA) graft. We assessed the advantages of systemic hyperkalemia with mild hypothermia for valve surgery in patients with a patent IMA graft. Nine patients (mean age 71.5+/-7.0 years) with a patent IMA graft underwent valve surgery from May 2004 to July 2009. Of those, eight underwent aortic valve replacement and one mitral repair, with two double-valve surgery. Antegrade and retrograde blood cardioplegia were performed intermittently, and systemic potassium was given to all. The lowest bladder temperature was 27.2+/-2.4 degrees C, and the initial and peak systemic potassium levels were 6.8+/-1.4 and 8.0+/-1.6 mEq/l, respectively, while potassium at the end of the cardiopulmonary bypass procedure after sufficient modified ultrafiltration was reduced to 5.5+/-0.6 mEq/l. There was one hospital death due to ischemic colitis. Cardiac arrest was easily achieved in each patient without IMA or aortocoronary graft injury. The postoperative peak creatine kinase-MB level was 33+/-17 IU/l, with no ST changes seen in electrocardiogram findings or new asynergy seen in echocardiogram findings. Systemic hyperkalemia and mild hypothermia for valve surgery in patients with a patent IMA graft is a good option to reduce graft and myocardial injuries. |
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Authors:
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Tomoyuki Fujita; Junjiro Kobayashi; Hiroyuki Nakajima; Koichi Toda |
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Publication Detail:
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Type: Journal Article Date: 2010-04-12 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 11 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-21 Completed Date: 2010-10-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 3-5 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita City, Osaka 565-8565, Japan. tomofujita@nifty.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Valve / surgery Blood Vessel Prosthesis Implantation* / adverse effects, mortality Cardiopulmonary Bypass Coronary Artery Bypass* Heart Arrest, Induced / adverse effects, methods*, mortality Humans Hyperkalemia / chemically induced*, mortality Hypothermia, Induced* / adverse effects, mortality Mammary Arteries / physiopathology, surgery* Middle Aged Mitral Valve / surgery Potassium Chloride / administration & dosage* Potassium Compounds / administration & dosage* Time Factors Treatment Outcome Vascular Patency |
| Chemical | |
Reg. No./Substance:
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0/Potassium Compounds; 0/potassium cardioplegic solution; 7447-40-7/Potassium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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