Innovative CCC Solution for Open Heart Surgery

Introduction: Miocardial effects during and after ischemia were studied using cryoprotective crystalloid cardioplegic (CCC) solution colled below 0o C to -5o C during open heart surgery.Objective: Comparison of structural and functional parameters of the heart in cardiopulmonary bypass patients undergoing cardioplegia. Methods:Protected by patent No. 819 dated 02.2020, it contains: pH 7,74; pCO2 is low; pO2 163,1 mmHg; BE +4,9 mmol/l; K+ 10,0 mmol/l; Ca++ 0 mmol/l; less Na+ mmol/l; Cl -110 mmol/l; Glucose 273 mmol/l; Lactate 0 mmol/l.The composition of the solution includes: Glucose 5% 450,0 ml; 10 ml of potassium chloride 4%; 31 ml of sodium bicarbonate 4%; cryoprotectants 9 ml.The tests were conducted on pigs between 2016 and 2018.Since the beginning of 2020, it has been used in our hospital during cardiac surgery in patients with congenital heart defects, later acquired heart failure and ischemic heart disease. Results:The dose of the solution is 7,5-10,0 ml/kg of the patient.The effect of the introduction of this solution into the coronary arteries occurs after 35-45 seconds through bradycardia, after which asystole continues for more than 90 minutes.If it is necessary to extend the myocardial protection time to 120 minutes, half the calculated dose of this solution should be administered.Restoration of the heart rhythm after removing the clamp from the aorta occurs after 3-4 minutes on its own through bradycardia (nodal rhythm) or large-wave fibrillation without cardioversion and cardiotonics.The solution acts due to a non-penetrating cryoprotectant of general action and membrane-stabilizing, enzyme-differentiating penetrating cryoprotectors with conformational flexibility and refrigerant capacity.Histological studies of the myocardium after 60 and 120 minutes of cardioplegia revealed edema in 25% and 45% of cardiomycs.After 15-30 minutes of myocardial reperfusion, cardiomyocyte edema disappears.Cardiomarkers: Creatine kinase -MB -initially less than 1.0 ng/ml; after cardioplegia 1,0 ng/ml.Myoglobin -initially 56,9 ng/ml; after 51,2 ng/ml.Troponin -initially 0,03 μg/l; after 0,03 μg/l.All myocardial structures during heart surgery remain intact. Conclusion:With a 500 ml volume of a new CCC solution, the heart can be protected from ischemia continuously, safely and the best during surgery.