Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Histidine alpha-ketoglutarate (HAKG) is used as a component of cardioplegic solutions for myocardial protection during cardiac surgery, particularly in heart transplantation and open-heart procedures. The scientific basis for its use is well-established. HAKG functions primarily by providing histidine to buffer extracellular pH, alpha-ketoglutarate to support myocardial metabolism, and magnesium to stabilize cell membranes and inhibit calcium influx during ischemia. These components help reduce myocardial injury during periods when blood flow is intentionally interrupted.

Multiple studies, including randomized controlled trials and clinical experience, support the efficacy of HAKG-containing solutions, such as the Bretschneider (HTK) solution, in preserving myocardial tissue and reducing postoperative cardiac dysfunction. The solution has been shown to allow for longer safe ischemic times and is particularly favored for complex or prolonged surgeries. Key references include clinical trials and meta-analyses that demonstrate similar or improved outcomes compared to other cardioplegic solutions, especially in pediatric and transplant populations.

The adoption of HAKG in cardiac surgery is thus based on both biochemical rationale and substantial clinical evidence. Guidelines from professional societies also recognize the safety and effectiveness of HTK/HAKG solutions for myocardial protection. While individual patient factors and surgical preferences may influence the choice of cardioplegia, the use of HAKG is scientifically validated for surgical preparation, especially in cardiac procedures.

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