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European Journal of Cardio-Thoracic Surgery, Vol 5, 74-81, Copyright © 1991 by European Association for Cardio-thoracic Surgery

ARTICLES

Creatine phosphate (Neoton) as an additive to St. Thomas' Hospital cardioplegic solution (Plegisol). Results of a clinical study

DJ Chambers, MV Braimbridge, S Kosker, M Yamada, RA Jupp and A Crowther
Cardiovascular Research (Surgical Cytochemistry), Rayne Institute, London.

Experimentally, creatine phosphate (CP) added to St. Thomas' Hospital cardioplegic solution (STH) improved post-ischaemic recovery of cardiac function in the rat heart. We investigated the effect of adding CP (10.0 mmol/l) to STH. Fifty open-heart surgery patients were randomized into control (STH) and treated (STH + CP) groups (25 per group). Patients underwent (a) monitoring for peri- and postoperative arrhythmias (48-h Holter monitoring). (b) quantitative birefringence assessment of intraoperative myocardial protection in left and right ventricular biopsies sampled at start of bypass (pre-isch.), end of bypass (end-isch.) and after 10 min reperfusion (post-isch.), and (c) measurement of serum creatine kinase-MB isozyme (CK-MB) values for up to 4 days postoperatively; results were assessed with respect to (d) haemodynamics and postoperative clinical outcome. Inotropic support (adrenaline) was required in three patients (12%) from each group; no patient died. All patients required defibrillation, and the number of direct current shocks required for sinus rhythm was the same in each group. The occurrence and incidence of reperfusion-induced arrhythmias were the same in both groups. Serum CK and CK-MB values were similar throughout the sampling period in both groups of patients; one patient in the control group had raised CK-MB levels postoperatively, but perioperative infarction was not indicated by the electrocardiogram.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				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. [Abstract] [Full Text]