Potassium-induced cardioplegia in patients undergoing correction of congenital heart defects.

Beginning in July 1977, cold potassium-induced cardioplegia has been used in 60 consecutive patients undergoing correction of congenital heart defects in whom the aorta was cross clamped. Ages ranged from 4 weeks to 18 years (mean 5.8 years); 40 percent were less than 24 months of age. Surgery included correction of ventricular septal defect (32), tetralogy of Fallot (16), atrioventricular canal (6), transposition of great arteries (1), double outlet right ventricle (1), aortic valvotomy (3), and aortic valve replacement (1). Three patients (2 TOF, 1 AVC) died postoperatively, one most likely due to technical error, and two unexplained. We have been impressed by the incidence of spontaneous defibrillation (75 percent), the decreased need for intraoperative inotropic support (3.3 percent), the normal immediate postoperative cardiac index (mean = 2.85 L/min/M2), as well as by the improved operative exposure provided by this technique.