Additive protection of aprotinin, protease inhibitor to cold cardioplegia from ischemic myocardium.

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Abstract
Protective action of aprotinin from ischemic myocardial damage was evaluated in 9 patients compared to 18 non-treated patients who underwent open heart surgery (22 ACB, 3 AVR [aortic valve replacement] and 2 MVR) with respect to the alterations of .beta.-glucuronidase, acid-phosphatase, MB-CPK [creatine phosphokinase MB isoenzyme] and GOT [aspartate transaminase]. Cold cardioplegia with glucose-insulin-K solution was used in this investigation. Average arrest time was 78.6% .+-. 4.9 min associated with hypothermia between 25 and 28.degree. C in rectal temperature. Aprotinin was administered in 9 patients i.v. with 5000 K IU/kg 30 min prior to CPB and then 5000 K IU/kg in the prime solution. Activity of .beta.-glucuronidase was significantly suppressed in the aprotinin-treated group compared to the non-treated group following cardioplegia; in the reperfusion period up to 6 h, acid-phosphatase failed to demonstrate significant difference among 2 groups. Serum MB-CPK and GOT levels in the aprotinin-treated group did not elevate the beginning of reperfusion following cardioplegia. Aprotinin may add myocardial protection to cold cardioplegia.