[Discontinuous warm cardioplegia in pediatric cardiac surgery: preliminary results]

This article describes the use of warm cardioplegia in paediatric surgery. Warm blood enriched with potassium was injected every 15 minutes during aortic clamping in 770 operations. The efficacy and quality of this technique were assessed by the return of cardiac electrical activity, troponin I levels 12 hours after aortic clamping and the duration of postoperative ventilation in 3 groups of patients: ventricular septal defect under 6 months (N = 82), tetralogy of Fallot under one year (N = 55), simple transposition of the great arteries (N = 42). These results were compared retrospectively with those obtained using cold cardioplegia. The return of sinus rhythm was spontaneous in 99% of cases versus 77% with cold cardioplegia; the troponin I levels were under 10 ng/ml in 46% of cases versus 37% (NS). Patients operated for ventricular septal defect were ventilated 10 +/- 8 hours versus 13 +/- 10 hours with cold cardioplegia (p = 0.02). The children operated for tetralogy of Fallot were ventilated 8 +/- 4 hours versus 14 +/- 7 hours (p = 0.01) and those with simple transposition 56 +/- 71 hours versus 83 +/- 105 hours (NS). Warm cardioplegia, in the authors' experience, was associated with an improved postoperative course. In this group of 770 operations, 646 operated patients had a stay of less than two days in the intensive care unit.