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Ann Thorac Surg 1977;23:14-19
© 1977 The Society of Thoracic Surgeons

Articles

Can the Frequency of Myocardial Infarction Be Reduced during Coronary Artery Operations?

Jefferson F. Ray, III, M.D.*, Duane A. Tewksbury, Ph.D., William O. Myers, M.D., Frederick J. Wenzel, B.S., Richard D. Sautter, M.D.

Department of Thoracic and Cardiovascular Surgery, Marshfield Clinic and Marshfield Medical Foundation, Marshfield, WI.

Accepted for publication March 11, 1976.

* Address reprint requests to Dr. Ray, Marshfield Clinic, 1000 N Oak Ave, Marshfield, WI 54449.

A prospective experiment was carried out in 56 patients undergoing coronary artery revascularization to determine whether those having a glucose-insulin-potassium (GIK) perfusion during the procedure would have fewer myocardial infarctions (MI) compared with patients given a control perfusion of Normosol-R. Six patients (11%) developed an MI, defined as a 24-hour creatine phos-phokinase MB isoenzyme value of 100 IU per liter or greater. Four (13%) had control perfusions and 2 (8%) had GIK perfusion. One MI in a double-graft recipient who had GIK perfusion occurred because of a technical surgical error; therefore, the corrected MI rate was 13% in control patients compared with 4% for the GIK group. These data, as well as the more frequent spontaneous defibrillation in patients who had GIK perfusion, suggest that GIK was of benefit.




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