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Ann Thorac Surg 1975;20:86-90
© 1975 The Society of Thoracic Surgeons

Articles

Protection of the Myocardium with High-Energy Solutions

Sidney Levitsky, M.D.*,*, Harold Feinberg, Ph.D.

From the Departments of Surgery and Pharmacology, Abraham Lincoln School of Medicine and School of Basic Medical Science, University of Illinois College of Medicine, Chicago, Ill.

* Address reprint requests to Dr. Levitsky, Department of Surgery, Abraham Lincoln School of Medicine of the University of Illinois College of Medicine, P.O. Box 6998, Chicago, Ill. 60680.

An approach to intraoperative protection of the myocardium is described that attempts to increase glucose utilization by infusion of high-energy solutions during aortic cross-clamping. Infusion of hypertonic glucose or glucose plus insulin prior to aortic cross-clamping has enhanced contractility and increased high-energy phosphate moieties in animals with induced ischemia. Recent pilot experiments in our laboratory suggest that infusions of creatine may result in increased production of creatine phosphate, which in turn induces phosphorylation of adenosine diphosphate to adenosine triphosphate, possibly enhancing myocardial contractility. The intraoperative clinical benefits of these infusions remain to be proved, however.




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