Creatine phosphate protection of the ischemic myocardium during cardiac surgery

The clinical effects of creatine phosphate (CP) plus St. Thomas Hospital (STH) II cardioplegic solution were investigated in 151 patients undergoing open heart surgry. Patients were divided into two groups: 79 patients were treated with STH plus CP and 72 were used as the control group (STH alone). CP 10.0 mmol/L was added to the cardioplegic solution (shown to be optimal in previous experiments) and infused into the aortic root at aortic cross-clamping time. The control group received simple STH cardoplegic solution with the same modality. In the CP group a significantly lower number of patients required intraoperative inotropic drugs, or presented cardiac arrhythmias. A significantly higher cardiac index was also observed in the CP group. The addition of CP to the cardioplegic solution induced a more efficacious protection of the myocardium during ischemia, with improved functional recovery, a positive inotropic effect, an antiarrhythmic action, and the reduction of enzymatic movement.