Use of XXXX during cardiac surgery for improved myocardial protection.

@entity1 @entity64 @entity712 @entity998 @entity1372 @entity594
The combined results of extended clinical trials conducted in two centers following successful laboratory trials are evaluated. From a population of 4,777 @entity1 who underwent open heart surgery, 205 high-risk @entity1 were selected for study. One hundred seventy @entity1 (3.6 percent) were given @entity594 in cardioplegic solution. The remaining 35 @entity1 served as control subjects and were compared with 39 treated @entity1 in the randomized subset of 74. One third of the @entity1 underwent valve replacement, one quarter underwent coronary artery bypass, and 40 percent underwent combinations of valve replacement, coronary artery bypass, and other procedures. Characteristically, the third group had a 50 percent increase in end-diastolic volumes and low cardiac indexes (1.7 +/- 0.1 liters/minute/m2). Average cross-clamp time was 77 minutes. At one center, an extracellular hyperkalemic-type solution was used to deliver an average dose of 407 +/- 22 micrograms @entity594 per @entity1 . At the other center, a low- @entity1372 hyperkalemic solution was used, and the average @entity594 dose was 476 +/- 22 micrograms. Hemodynamic studies in the randomized subset demonstrated approximately a twofold improvement in the treated group in cardiac index, @entity64 volume, @entity64 work index, and pulmonary vascular resistance following cardiopulmonary bypass. The incidence of acute @entity998 was 4 percent versus 11 percent in the control group. Survival for all treated @entity1 was 86 percent. It is concluded that the addition of @entity594 reduced the incidence of @entity712 in the immediate postoperative interval.
