Open-heart surgery causes injury of the heart muscle. Although this is usually mild, temporary and reversible, if it is severe it can endanger life and require additional high cost care. During surgery, techniques are used to protect the heart from injury, but these remain imperfect. This study assesses the effect of facilitating sugar metabolism (a more efficient fuel) by the heart muscle using the drug Perhexiline given before the operation. This treatment has a sound experimental basis for improving outcome. If this improvement is confirmed surgical results could be improved. The investigators will be studying heart function, heart muscle energy stores and chemicals which quantify the amount of heart muscle injury. The investigators' hypothesis is that Perhexiline will improve the protection of the heart by decreasing damage that may occur during heart surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
290
Tablets. Dose: 200mg BD for 3 days, then 100mg BD until surgery. Duration of therapy: 5-31 days.
Tablets. Dose: 200mg BD for 3 days, then 100mg BD until surgery. Duration of therapy: 5-31 days.
University Hospital Birmingham
Birmingham, West Midlands, United Kingdom
Brighton & Sussex University Hospitals NHS Trust
Brighton, West Sussex, United Kingdom
Incidence of Low Cardiac Output Syndrome
Time frame: 6 hours post-removal of aortic X-clamp
Increase in Cardiac index of greater than or equal to 0.3 L/min/m2
Time frame: 6 hours post-removal of aortic X-clamp
Incidence of inotropes use according to protocol
Time frame: 6 and 12 hours post-removal of aortic X-clamp
Peak and total release of Troponin
Time frame: 6, 12 and 24 hours post-release of aortic X-clamp
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