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Custodial HTK Cardioplegia in conventional cardiac surgery: A retrospective analysis From UiTM

T M Syukri1, A Kasran2, W M Afham2

  • 1Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Universiti Teknologi Mara (UITM). syukrisanzo27@gmail.com.

The Medical Journal of Malaysia
|January 30, 2026
PubMed

Insights

Custodial-HTK (Histidine-Tryptophan-Ketoglutarate) solution offers comparable outcomes to blood cardioplegia in complex cardiac surgeries. This myocardial protection method is safe and effective for high-risk patients.

Area of Science:

  • Cardiovascular Surgery
  • Cardiothoracic Anesthesia
  • Cardiac Surgery Outcomes

Background:

  • Custodial-HTK solution and blood cardioplegia are standard myocardial protection methods.
  • Limited data exists on their use in complex cardiac surgeries.

Purpose of the Study:

  • To compare clinical outcomes between Custodial-HTK and blood cardioplegia.
  • To evaluate Custodial-HTK's efficacy in high-risk cardiac surgery patients.

Main Methods:

  • Retrospective analysis of 79 elective, on-pump, crossclamp cardiac surgeries.
  • Exclusion of emergency procedures, off-pump surgeries, and incomplete records.
  • Focus on patients with impaired LVEF or complex surgical needs for Custodial-HTK group.

Main Results:

  • Custodial-HTK group had higher surgical complexity and lower LVEF.
  • Longer cardiopulmonary bypass and cross-clamp times were observed.
  • No significant differences in postoperative complications, ICU/hospital stay, or 30-day mortality.

Conclusions:

  • Custodial-HTK demonstrated acceptable postoperative outcomes compared to blood cardioplegia.
  • Supports Custodial-HTK as a safe and effective alternative for high-risk cardiac surgery.
Abstract

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