Comparative Results of Cardioplegic ACH and HTK Solutions Use in Open Heart Surgery for Congenital Heart Disease in Children under One Year of Age

Methods: the study includes 40 patients at the age not older than 1 year (3-384 days, 146+/-31, 5 days) weighing 3,3–10 kg (5.8+/-0,5 kg), who have undergo the radical correction of congenital heart defects during extracorporeal circulation. The patients were divided into 2 groups accordingly to each kind of cardioplegic solution. The first group, where the ACH solution was used, includes 20 patients (11 boys, 9 girls) at the age of 3-335 days (154+/-50,4) weighing 3,5-10 kg (5,8+/-0,9 kg). The second group (HTK-group) have also 20 babies (14 boys, 6 girls) at the age of 8-384 days (138,1+/-39,5 days) weighing 3,3–9 kg (5,7+/-0,6 kg). Heart rate, arterial blood pressure, central venous pressure and left atrium pressure monitoring was performing intraoperatively. The biochemical blood serum analysis and myocardium biopsy of RVOT and right atrium for morphological study were also made. In the early postoperative period the cardiac activity and biochemical blood composition were also controlling.

Results: In the first group the electromechanical cardiac arrest took place significantly earlier (on 15,3+/-2,7 sec, in the second group – 27,4+/-4,0 sec, p<0,0001). The heart resuscitation time has no significant difference. The next clinical, instrumental and laboratory data has no significant difference between 2 groups: ventricle ejection fraction, arterial blood pressure, catecholamine index, artificial ventilation time, the residence time in ICU, biochemical parameters. The ultra-structural myocardial study data demonstrated the equal high cardioprotective activity of both solutions.

Conclusions: cardioplegic ACH solution provides effective myocardial protection during the open heart surgery in children of the first year of life if cardioplegic ischemia is less than 60 minutes. The ACH solution is comparable with Custodiol on its cardioprotective properties.