Serum aspartate transaminase changes following open-heart surgery with ischaemic arrest (with and without coronary artery perfusion).

Serum aspartate transaminase changes following open-heart surgery with ischaemic arrest (with and without coronary artery perfusion) Patients with aortic disease irrespective of whether they had coronary perfusion or not showed a significant difference in the level of postoperative SGOT levels compared with other groups. Aortics with coronary perfusion did not show a correlation between SGOT levels and total perfu-sion time while the other groups did. The levels were not of prognostic significance. Abundant literature is available on the alterations in the level of serum aspartate transaminase after various surgical procedures, particularly following cardiac surgery, and therefore any further work on this subject might seerm superfluous (Welbourn, Melrose, and Moss, 1966). However, several points are worth noting: the overwhelming majority of patients in the earlier studies had congenital heart disease, the results were sometimes conflicting, and there was a divergence of opinion concerning the cause of the postoperative increase in enzyme levels. More relevant to the present study is the fact that most of the previous work was published before Cooley and his colleagues (1964) introduced cross clamping of the aorta with ischaemic cardiac arrest to facilitate the insertion of prosthetic valves. (1966) found no significant difference in either the postoperative course or enzyme levels between patients having aortic occlusion plus selective coronary perfusion and those having aortic occlusion alone. Recently, Reid (1970) studied the changes in serum aspartate aminotransferase (SGOT) and serum alanine aminotransferase (SGPT) levels in 25 patients who underwent open-heart surgery with aortic occlusion and no coronary perfusion, and showed that while these enzy;me levels were initially markedly raised, they had returned to normal by the 21 st postoperative day. In the present study we were concerned principally in comparing the postoperative levels of SGOT in patients with different heart lesions and assessing what factors might be contributing to these levels. We have used only SGOT levels as it is a readily available routine laboratory estimation.