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Hikaru Matsuda
Yoshiki Sawa
Fumikazu Nomura
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Susumu Nakano
Yasunaru Kawashima
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Ann Thorac Surg 1989;48:242-246
© 1989 The Society of Thoracic Surgeons

Articles

Evaluation of prostacyclin analogue OP-41483 as an adjunct to crystalloid cardioplegia in infants and children

Hikaru Matsuda, MD*, Yoshiki Sawa, MD, Satoru Kuki, MD, Fumikazu Nomura, MD, Masakatu Ohtani, MD, Hiroshi Takami, MD, Ryota Shirakura, MD, Susumu Nakano, MD, Yasunaru Kawashima, MD

First Department of Surgery, Osaka University Medical School, Osaka, Japan

Accepted for publication February 23, 1989.

* Address reprint requests to Dr Matsuda, First Department of Surgery, Osaka University Medical School, 1-1-50 Fukushima, Fukushima-ku, Osaka, 553, Japan.

A Chemically stable prostacyclin analogue (PGI2-A, carbacyclin, OP-41483) was evaluated as an adjunct to potassium cardioplegia in infants (n = 13) and children (n = 32), in whom the current potassium cardioplegia may be limited in its effects. PGI2-A was added in a dose of 300 µg/L to the potassium cardioplegic solution. Postoperatively, peak levels of the myocardial-specific isoenzyme of creatine kinase (MB-CK) were compared for the PGI2 group and a control group (n = 65). In patients 1 year of age or older (n = 32 and 49 for the PGI2 and control groups, respectively), the MB-CK level was significantly lower in the PGI2 group only when compared between the subgroups with an aortic cross-clamp time of 120 minutes or more (n = 9 and 10; MB-CK level, 35.2 ± 15.6 vs 68.3 ± 32.4 IU/L; p < 0.05). In patients less than 1 year of age, in whom aortic cross-clamp times were generally less than 120 minutes, the MB-CK level was also lower in the PGI2-A group than in the control group (n = 13 and 16; MB-CK level, 33.6 ± 14.3 vs 61.6 ± 36.3 IU/L; p < 0.05). Infants less than 6 months of age (n = 18) underwent ultrastructural assessment of left ventricular myocardial biopsy specimens, and the PGI2-A group showed better results in mitochondrial and intracellular edema scores. This clinical trial showed beneficial effects of FGI2-A used with crystalloid potassium cardioplegia in infants and children.




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