Perioperative myocardial injury in patients undergoing aortic valve replacement
Goerlach, G.; Temme, H.; Golf, S.; Dapper, F.; Scheld, H.H.; Hehrlein, F.W.
Journal of Cardiovascular Surgery 31(4): 505-508
1990
ISSN/ISBN: 0021-9509 PMID: 2145289 Document Number: 356775
In cases of myocardial hypertrophy myocardial protection may be insufficient. In order to determine the factors responsible for myocardial injury we assessed myocardial injury in 54 patients undergoing isolated aortic valve replacement. In all cases hypothermic cardioplegic arrest was induced. At 13 different times we measured the serum level of creatine-kinase (CK), myocardial bound creatine-kinase (CKmb), lactic dehydrogenase (LDH), .alpha.-hydroxybutyrate dehydrogenase (.alpha.-HBDH), glutamic oxaloacetic transferase (GOT) and myoglobin. The mean duration of ischemia was 52.6 .+-. 16.2 minutes and the mean time of extracorporeal circulation was 85.85 .+-. 20.25 minutes. By performance of a multiple regression analysis a significant correlation between ischemia and LDH and .alpha.-HBDH was found; CK, GOT, LDH and .alpha.-HBDH correlated with duration of extracorporeal circulation. In none of the patients was a low cardiac output syndrome observed. From our results we conclude that in our study myocardial protection was sufficient and therefore the detrimental effects of extracorporeal circulation were the determining factors of enzyme release.