Clinical and Experimental Studies on Calcium and Potassium Metabolism in Heart Surgery Part I. Clinical Studies on Pre- and Postoperative Changes of Serum Calcium and Potassium in Patients with Heart Diseases

Thirty patients with heart diseases, both congenital and acquired in origin, have been treated surgically. Pre- and postoperative changes in serum calcium and potassium were studied in comparison with those in the other operations. Results obtained were as follows; 1) Preoperative Ca and K concentrations in sera remained within normal ranges, and para- and postoperative changes were almost similar to those in other operations with some exceptions. 2) Most of the cases who resulted in death showed variations in Ca and K levels before the operations which were easily influenced even by anesthesia, and many of them showed distinguishable decrease in Ca and increase in K levels. Disturbances of cardiac function due to those abnormal metabolism of electrolytes can be considered one of the causes of death. 3) Marked variations in Ca and K levels were found in cases with combined two cardiac lesions one of which was treated surgically, cases with the signs of cardiac failure, cases subjected to only exploratory thoracotomy, inadequately indicated cases and cases advanced in age. 4) Patients operated by means of pump-oxygentor showed almost same changes with patients operated on without the pump. 5) Application of pharmaceutical hibernation did not cause any significant changes in Ca and K levels. However, combined methods of pharmaceutical hibernation with general hypothermia or selective brain cooling by irrigation both showed considerable decrease in those levels, which remained in slight changes by preoperative administration of DOCA and Cortisone. In cardiac surgery, no special cares were needed on the changes in electrolytes metabolism when the pathological conditions caused by the heart diseases were correctly evaluated and treated under precise preoperative laboratory works.