Prophylactic and Therapeutic Use of Digitalis in Open-Heart Operations

Abstract

Physicians have long debated the advisability of giving digitalis as a prophylaxis against cardiac failure which may occur in connection with the stress of general surgical operations. While there is agreement as to its benefits for the failing heart, in the nonfailing heart it has often been considered not only useless but even harmful. The problem has recently been brought into sharper focus by the widespread use of cardiotomy for correction of intracardiac defects, especially when such physical trauma to the myocardium is accompanied by the metabolic insult of induced cardiac arrest. We have recently demonstrated the beneficial effects of digitalis in experimental animals subjected to periods of induced cardiac arrest.⁶ With 30 minutes of potassium cardioplegia in dogs, there is profound depression of ventricular function.¹⁵ The digitalized canine heart arrested with potassium citrate is subsequently able to perform more than 19.5 grammeters stroke work in response to