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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 762-769, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Protection of ischemic myocardium by exogenous phosphocreatine. II. Clinical, ultrastructural, and biochemical evaluations

ML Semenovsky, VI Shumakov, VG Sharov, GM Mogilevsky, AV Asmolovsky, LA Makhotina and VA Saks
USSR Cardiology Research Center, Moscow.

In valve replacement operations on 78 patients with acquired heart disease, the efficiency of phosphocreatine in intraoperative protection of ischemic myocardium was evaluated by clinical, morphologic, and biochemical methods. Phosphocreatine (8 to 10 mmol/L) in a blood cardioplegic solution was used in operations on 41 patients; in the control group (37 patients) standard blood cardioplegia was used. In the group with phosphocreatine treatment we observed more rapid recovery of hemodynamics after release of the aortic cross-clamp, a decreased frequency of fibrillation, and more frequent restoration of sinus rhythm even if there were sinus rhythm disturbances before aortic cross-clamping. Analysis of the biopsy samples taken from the right ventricle showed protection of the sarcolemma against ischemic damage afforded by phosphocreatine and complete preservation of high-energy phosphates. The results obtained confirm the conclusion made by Robinson, Braimbridge, and Hearse (J Thorac Cardiovasc Surg 1984; 87:190-200) that phosphocreatine is an effective additional cardioprotective agent when used in cardioplegic solutions.


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D. J. Chambers, K. Haire, N. Morley, L. Fairbanks, E. Strumia, C. P. Young, and G. E. Venn
St. Thomas' Hospital Cardioplegia: Enhanced Protection With Exogenous Creatine Phosphate
Ann. Thorac. Surg., January 1, 1996; 61(1): 67 - 75.
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Copyright © 1987 by The American Association for Thoracic Surgery.