SynthesisJournal of cardiothoracic surgery2022
Histidine-tryptophan-ketoglutarate solution versus multidose cardioplegia for myocardial protection in cardiac surgeries: a systematic review and meta-analysis.
Synthesis in Journal of cardiothoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- National Heart Center Perfusion Guidelines.Saudi medical journal · 2026Guideline
- Perioperative Factors Associated with Delayed Extubation After the Ross Procedure for Aortic Regurgitation: A Retrospective Cohort Study.Pediatric cardiology · 2026Article
- Cardioplegia Strategies in Minimally Invasive Aortic Valve Replacement: An Inverse Probability of Treatment Weighting Analysis.Medicina (Kaunas, Lithuania) · 2026Article
- Safety of Custodiol for Myocardial Protection in Minimally Invasive Mitral Valve Repair: A Japanese Single-Center Retrospective Comparison with Blood Cardioplegia in Conventional Sternotomy Repair.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2026Article
- Minimally invasive mitral valve repair for commissural prolapse: Safety, success, and long-term efficacy.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Evaluation of Myocardial Protection in Prolonged Aortic Cross-Clamp Times: Del Nido and HTK Cardioplegia in Adult Cardiac Surgery.Medicina (Kaunas, Lithuania) · 2025Article
- Blood cardioplegia or custodiol for myocardial protection during valvular or aortic surgery: a propensity score adjusted comparison.Journal of cardiothoracic surgery · 2025Article
- Mitochondrial Dysfunction in Cardiac Surgery.Anesthesiology clinics · 2025Review
- Article
- Single-dose modified bloodless del Nido cardioplegia for minimally invasive cardiac surgery.Frontiers in cardiovascular medicine · 2025Article
- Signaling Pathways (TNF-α-NF-κB, TLR2-TLR4 as well as ROS-MDA) and Cardiac Damages during Cardiac Surgeries (Coronary Stenting, Permanent Pacemaker Implantations, Radiofrequency Ablations).Current topics in medicinal chemistry · 2025Article
- Myocardial protection: comparing histological effects of single-dose cardioplegic solutions-study protocol for a secondary analysis of the CARDIOPLEGIA trial.Journal of thoracic disease · 2024Article
- Melatonin enhanced the cardioprotective effects of HTK solution on Langendorff-perfused mouse hearts subjected to ischemia/reperfusion.Iranian journal of basic medical sciences · 2024Article
- Comparison of "Huaxi-1" or "histidine-tryptophan-ketoglutarate" cardioplegia in an animal model.Frontiers in cardiovascular medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgical procedures in the heart requires protection of the heart from ischemia-reperfusion injury. Cardioplegia is the primary myocardial protective method in use. Histidine-tryptophan-ketoglutarate (HTK) solution is an intracellular cardioplegic solution that was initially used to preserve organs for transplantation.
methodsA systematic electronic search was conducted in July 2021, in four databases; PubMed, Scopus, Web of Science, and Cochrane Library for eligible randomized controlled trials. The results were screened and the eligible trials were identified. Thereafter, the relevant data were extracted and pooled as mean difference or risk ratio, and 95% confidence interval in an inverse variance method using RevMan software.
resultsThis review included 12 trials (n = 1327). HTK solution has resulted significantly in shorter intensive care unit stay (MD = - 0.09; 95% CI [- 0.15, - 0.03], p = 0.006), and shorter hospital stay (MD = - 0.51; 95% CI [- 0.71, - 0.31], p < 0.00001). Moreover, the patients who received the HTK solution had significantly lower levels of creatine kinase (after 4-7 h (MD = - 157.52; 95% CI [- 272.31, - 42.19], p = 0.007), and 24 h (MD = - 136.62; 95% CI [- 267.20, - 6.05], p = 0.04)), as well as creatine kinase muscle brain band (after 44-48 h (MD = - 3.35; 95% CI [- 5.69, - 1.02], p = 0.005)).
conclusionHTK solution had the same efficacy and safety as other cardioplegic solutions in most of the clinical parameters. Furthermore, the solution showed superiority in fastening the recovery and protecting the myocardium at the biochemical level. HTK solution provides longer myocardial protection; therefore, it limits surgical interruption. HTK solution can be used as an alternative to the currently used cardioplegic solutions.
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Registered trials
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