Document Detail


Systemic hyperkalemia and mild hypothermia for valve surgery in patients with patent internal mammary artery graft.
MedLine Citation:
PMID:  20385665     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Tomoyuki Fujita; Junjiro Kobayashi; Hiroyuki Nakajima; Koichi Toda
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Publication Detail:
Type:  Journal Article     Date:  2010-04-12
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  11     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-21     Completed Date:  2010-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  3-5     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita City, Osaka 565-8565, Japan. tomofujita@nifty.com
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MeSH Terms
Descriptor/Qualifier:
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:
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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