Background and Objective: Ventriculararrhythmia is a common complication during declamping aorta in open heart surgery. Myocardial preservation during aortic clamping plays a major role in prevention of ventricular arrhythmia. Cardioplegia usage is one of the techniques to promote myocardial preservation.Cold blood cardioplegia solution is delivered repeatedly to coronary artery just after aortic clamping and every 20-30 minutes. Bretschneider-HTK, a newer solution is delivered once just after aortic clamp. In this study, we compared the incidence of ventricular arrhythmia after aortic de-clamping during mitral valve surgery between Bretschneider-HTK and cold blood cardioplegia
Methods: This study was a retrospective, descriptive study. 232 consecutive patients undergoing elective isolated mitral valve surgery in Queen Sirikit Heart Center of the Northeast and Srinagarind hospital, Khon Kaen university were included in the study. We collected the information from anesthetic and medical records and divided into two groups. 192 patients received cold blood cardioplegia (CB group) and 40 patients received Bretschneider-HTK (HTK group). Incidences of ventricular arrhythmia after aortic de-clamping were compared between two groups. We also analyzed extubated time, length of ICU and length of hospital stay.
Results: There was no difference in baseline characteristics between the two groups. The incidence of ventricular arrhythmia after aortic de-clamping was significant higher in the HTK group (32.5 %) compared with the CB group (15.6%) (Odd ratio 2.6, 95%CI 1.2-5.6, p=0.02). We found that no significant difference in extubated time (p=0.85), length of ICU stay (p=0.93) and length of hospital stay (p=0.43) between CB and HTK group.
Conclusions: The incidence of ventricular arrhythmia after aortic de-clamping was higher when using Bretschneider-HTK cardioplegia during mitral valve surgery more than using cold blood cardioplegia. But there was no significant difference in extubated time, length of ICU stays and length of hospital stays.