[The use of systemic phosphocreatine in heart surgery]

Phosphocreatine (PC) has been widely used in cardiac surgery as a component of cardioplegic solutions because of its positive effects in preventing ischemic heart damage; we have researched the efficacy of PC in cardiac surgery when infused through the intravenous route before and after cardiac arrest. Two groups of patients who had undergone aortocoronary by-pass grafts were matched: group A (20 patients) did not receive any particular treatment; PC was administered intravenously to patients in group B after the induction of anaesthesia, immediately prior to cardiac arrest and after the release of aortic cross-clamp. To test the efficacy of the drug, the following parameters were evaluated: the recovery as the incidence of low cardiac output and/or need of inotropic drugs; dysrhythmias; electrocardiographic signs of myocardial ischemia or infarction; release of cardiac necrosis enzymes. Treated patients were found to have a better recovery, a lower incidence of dysrhythmias, an easier resumption of normal sinus rhythm with a lower number of electric defibrillations and a significantly lower release of cardiac enzymes. It can be therefore said that PC has a marked protective effect on myocardial anoxia in cardiac surgery, even when administered intravenously.