Verapamil-potassium cardioplegia: a two-year experience with 470 patients

Abstract

This prospective clinical study in cardiac surgery involves a 2-year experience with verapamil-potassium cardioplegia in 470 patients. Protective benefits, associated with calcium channel blockers during cellular ischemia, have increased their utilization in cardioplegic solutions during open-heart surgery. Analysis of the group includes preoperative, intraoperative, and postoperative variables. Preoperative data encompasses age, previous myocardial infarctions, ejection fraction, cardiac index, and risk factors. Analysis of operative data includes the type of operation performed, anesthetic agents, amount of cardioplegia solution, total peripheral resistance, fluid requirements, cross-clamp time and arrhythmias during reperfusion. In this study, verapamil proved to be a safe and effective additive to standard potassium cardioplegia. Beneficial hemodynamic actions with myocardial preservative and antiarrhythmic effects were demonstrated. Although the "perfect solution" to myocardial preservation remains unknown, because of favorable experimental data and successful clinical trials, the continued use of verapamil-potassium cardioplegia appears justified.