Clinical Study of the Protective Effect of Exogenous Creatine Phosphate on Ischemic Myocardium during Open Heart Surgery

This study was designed to evaluate the myocardial protective effect of exogenous creatine phosphate (CP) added to cardioplegic solution for use in open heart surgery. Ninety-eight patients were divided into a control group (n = 44) and a CP group (n =54). The spontaneous recovery rate of heart beat after aortic declamping was recorded and changes of serum enzymes including CPK, LDH, CPK-MB, HBDH, and AST were evaluated. The ultrastructural alterations of the myocardial tissue were observed in 4 patients (2 cases from each group) who had cardiac valve replacement. The spontaneous recovery rate of heart beat in the CP group was significantly higher than the control group (39/54 versus 22/44 ), and the peak values of leakage of serum enzymes of the control group appeared earlier and receded later than those of the CP group. Electron microscope examination revealed better preservation of the ultrastructures of the myocardial tissue in the CP group than that of the control group. This data indicates that exogenous creatine phosphate added to the cardioplegic solution offers a better protective effect on the ischemic myocardium during open heart surgery.