Miocardioprotezione cristalloide: efficacia e sicurezza nel paziente pediatrico con peso inferiore a 15 Kg

The objective of this study is to verify the safety and efficacy of the myocardial protection obtained with the cardioplegic histidine-tryptophan ketoglutarate (HTK) solution (Custodiol®) in patients weighing less than 15 kg, undergoing an isolated closure of interventricular defect. In this retrospective study, 360 consecutive patients undergoing isolated closure of an interventricular defect weighing less than 15 kg were evaluated. A series of preoperative, operative and postoperative factors were assessed to evaluate the effectiveness of myocardial protection. A univariate and multivariate statistical analysis was performed to correlate the various factors with each other and in relation to the time of myocardial ischemia and extracorporeal circulation. Troponin and creatine kinase-MB levels, left ventricular function and electrophysiological activity of the myocardium were monitored in the postoperative period. The use of the Custodiol HTK crystalloid intracellular cardioplegic solution in patients under 15 kg of body weight is safe and effective in protecting the immature or transitioning myocardium even in interventions that require not particularly prolonged myocardial ischemia times.