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HTK - SOLUTION FOR MYOCARDIAL PROTECTION. Univ.-Prof. Dr. med. Erhard Hartung Klinik für Anaesthesiologie (Direktor: Prof. Dr. J.Tarnow) Klinik Thorax u. Kardiovaskuläre Chirurgie (Direktor: Prof. Dr. Gams) Heinrich-Heine-Universität Düsseldorf , Germany.
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HTK-SOLUTION FOR MYOCARDIAL PROTECTION Univ.-Prof. Dr. med. Erhard Hartung Klinik für Anaesthesiologie (Direktor: Prof. Dr. J.Tarnow) Klinik Thorax u. Kardiovaskuläre Chirurgie (Direktor: Prof. Dr. Gams) Heinrich-Heine-Universität Düsseldorf , Germany
INDICATION FOR HTK CARDIOPLEGIC SOLUTION All cases with long lasting aortic clamping, e.g. • Multiple coronary bypass grafts • Single / multiple valve replacement • Combination : valve replacement /CBG • Congenital heart disease • Reduced myocardial function • Reduced renal function
Clinical effects HTK-solution versus cold blood cardioplegia
Conclusion • Both HTK-solution and cold blood cardioplegia provide excellent myocardial protection in uncomplicated cases • But HTK-solution provides more adequate myocardial protection. For security HTK-solution should be preferred in: • Complicated cases • Elderly or severe ill patients • congenitals
RECOMMENDATIONSFOR THE PRACTICAL USE OFHTK-SOLUTION • PERFUSION TIME: 6 MIN • PERFUSION VOLUME: ADULTS: 1500 ml CHILDREN ( 20 KG / BW ) 1.5ml/g HEART WEIGHT (CHILDREN HEART WEIGHT=0.8 % BODY WEIGHT ) • PERFUSION PRESSURE: 40-60 mmHg • DIAMETER PERFUSION LINE : 3 / 8 ZOLL(~6 mm) • PERFUSION TEMPERATURE: 4 -10 ℃ (PATIENTS TEMPERATURE: ~32℃) ASYSTOLIA WILL OCCURE WITHIN 120-180 SEC • ATTENTION CHILDREN UP TO 20 KG / BW; NO HTK - SOLUTION INTO THE CIRCUIT