Impact of triiodothyronine on the survival of high-risk patients undergoing open heart surgery

Dimitri Novitzky, Hector Fontanet, Michael Snyder, Nicholas Coblio, Daniel Smith, Victor Parsonnet

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Experimental and clinical studies have shown the beneficial effects of triiodothyronine (T3) following myocardial revascularization on cardiopulmonary bypass (CPB). In this study, open-label T3 was administered to 68 high-risk patients undergoing open heart surgery. The New Jersey Risk Assessment was used to calculate the preoperative estimated surgical mortality. A loading dose of T3 was administered: (a) at release of the aortic cross-clamp, (b) whenever the patient became CPB dependent, (c) if the patient exhibited low cardiac output after discontinuing CPB and (d) as pretreatment before initiating CPB. All therapeutic modalities were followed by a continuous T3 infusion. Following T3 therapy, CPB was discontinued in all patients. Based upon discriminant analysis, a total of 26 deaths were expected from the entire group, but only 7 patients died, therefore, the observed mortality was reduced by 72% (p < 0.007). The use of T3 had a major impact on reducing surgical mortality, and may be advocated as a new therapeutic modality in patients with high estimated mortality undergoing open heart surgery.

Original languageEnglish
Pages (from-to)509-515
Number of pages7
JournalCardiology
Volume87
Issue number6
DOIs
StatePublished - 1 Jan 1996
Externally publishedYes

Keywords

  • Cardiopulmonary bypass
  • Triiodothyronine

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