Abstract
We studied 100 patients who underwent an isolated aortic valve replacement (AVR) between 1974 and 1991. The patients were divided into the following two groups and compared: group A, which consisted of 40 patients operated on before 1978 who underwent continuous left coronary perfusion with blood; and group B, which consisted of 60 patients operated on after 1979 in whom St. Thomas solution was used in combination with topical cardiac cooling. Moreover, we divided the group B patients into two subgroups: group Bl, who underwent AVR before 1986 during which we administered St. Thomas solution with ice slush every 30 min; and group B2, who had AVR after 1986 in which we used St. Thomas solution with a cold saline (4°C) solution and treated with a small amount of slushed ice every 15 min. The incidence of supraventricular tachycardias was 15% in group A, 50% in group BI, and 15% in group B2. The severity of preoperative New York Heart Association (NYHA) functional class, the type of valve lesions, cardiothoracic ratio, left ventricular function, aortic clamp time, bypass time, and use of drugs did not correlate with the incidence of supraventricular tachycardias in either group A or B. In group B2 patients, we paid a lot of attention to cooling the right atrium as well as the left ventricle by immersing the whole heart using a 4°C saline solution, which led to a remarkable reduction of the incidence of supraventricular tachycardia. This fact indicates that right atrial preservation is one of the most important factors for reducing the incidence of supraventricular tachycardia.
Similar content being viewed by others
References
Michelson EL, Morganroth J, MacVaugh H (1979) Postoperative arrhythmias after coronary artery and cardiac valvular surgery detected by long-term electrocardiographic monitoring. Am Heart J 97:442–448
Ellis RJ, Mavroudis C, Gardner C, Terly K, Ullyot D, Ebert PA (1980) Relationship between atrioventricular arrhythmias and the concentration of K+ ion in cardioplegic solution. J Thorac Cardiovasc Surg 80:517–526
Mullen JC, Khan N, Weisel RD, Christakis GT, Teoh KH, Madonik MM, Mickle DAG, Ivanov J (1987) Atrial activity during cardioplegia and postoperative arrhythmias. J Thorac Cardiovasc Surg 94:558–565
Douglas PS, Hirshfeld JW, Edmunds LH (1985) Clinical correlates of atrial tachyarrhythmias after valve replacement for aortic stenosis. Circulation 72 (suppl II):159–163
Copeland JG, Griepp RB, Stinson EB, Shumway NE (1977) Isolated aortic valve replacement in patients older than 65 years. JAMA 237:1578–1581
Tehervenkov CI, Wynands JE, Symes JF, Malcolm ID, Dobell ARC, Morin JE (1983) Persistent atrial activity during cardioplegic arrest: A possible factor in the etiology of postoperative supraventricular tachyarrhythmias. Ann Thorac Surg 36:437–443
Smith PK, Buhrman WC, Levett JM, Ferguson TB, Holman WL, Cox JL (1983) Supraventricular conduction abnormalities following cardiac operations. J Thorac Cardiovasc Surg 85:103–115
Novick RJ, Stefaniszyn HJ, Morin JE, Tehervenkov CI, Malcolm ID, Symes JF, Dobell ARC, Salerno TA (1983) Atrial electrical activity and its suppression during cardioplegic arrest in pigs. J Thorac Cardiovasc Surg 86:235–241
Hearse DJ, Braimbrige MV, Jynge P (eds) (1981) Technical aspects in clinical cardioplegia. Protection of the ischemic myocardium. Raven, New York, pp 366–367
Chen YF, Lin YT (1985) Comparison of the effectiveness of myocardial preservation in right atrium and left ventricle. Ann Thorac Surg 40:25–30
Furuse A, Kotsuka Y, Asano K (1983) Sinus node potential during cardioplegia. Jpn J Surg 13:146–151
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Shigenobu, M., Teramoto, S. The effect of myocardial preservation technique on supraventricular tachycardia following aortic valve replacement. Surg Today 24, 1–5 (1994). https://doi.org/10.1007/BF01676876
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01676876