الفهرس 
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Abstract
I
ntraoperative myocardial protection determines the success of any cardiac surgery. The combination of hypothermia and hyperkalemic cardioplegia has become the most common method of myocardial protection. Blood is added to cardioplegia solution to supply myocardium with oxygen, nutrients and for buffering purposes. The advantages of blood cardioplegia include rapid cardiac arrest in an oxygenated environment.
Histidine-tryptophan-ketoglutarate (HTK–Custodiol) cardioplegic solution is an intracellular crystalloid solution, administered as one single dose and works by reducing the extracellular sodium concentration, thus produces cardiac arrest in diastole.
Among the earliest studiest comparing crystalloid and blood cardioplegia, Young and colleagues demonstrated that no clear clinical superiority of blood cardioplegia over crystalloid cardioplegia in pediatric cardiac surgery.
Congenital cardiac defects (CHD) are considered the most common congenital defects. CHD can generally be classified as cyanotic defects, acyanotic shunt defects, and obstructive lesions. However, there are other classifications depending on pulmonary blood flow.
In our study, we compared two types of cardioplegic solutions regarding their efficiency in myocardial preservation in patients undergoing total repair of acyanotic congenital heart diseases. 60 patients aged from 6 months to 2 years of both sexes were included in this study, 30 of them were given cold crystalloid HTK cardioplegia and the other 30 were given hypothermic hyperkalemic cardioplegia. Both solutions were given antegrade in the aortic root after clamping of the aorta at 4-8 c °.
We found that HHB cardioplegia does not elevate troponin level as much as HTK solution at all times of measurement. And there was a statistically significant difference between both groups regarding troponin level after 8, 12, and 24 hours post bypass in HHB group. This outcome raised the assumption that HHB cardioplegia is more effective in the myocardial preservation. However, by comparing both solutions in the matter of myocardial function (EF% and fractional shortening), no significant correlation was proved. Also, both groups showed no statistically significant difference as regard inotropic support.
It was concluded that hypothermic hyperkalemic cardioplegia was more effective than HTK solution in the myocardial preservation in pediatric cardiac surgeries.