[Exogenous adenosine in cardioplegia].

The nucleoside adenosine is used clinically for the treatment of paroxysmal atrioventricular junctional tachycardia. Surgically oriented experimental studies indicate an improvement of myocardial protection when adenosine is administered as an adjunct to cardioplegic protection. This regards both postischemic functional recovery and the regeneration of myocardial energy-rich phosphates. However, as yet it remains to be determined which of the various effects of adenosine is truly protective. Likewise it is still unclear if the beneficial effects of "ischemic preconditioning" may be simulated by administration of adenosine. Current knowledge about this substance warrants careful evaluation of its protective capabilities in clinical studies during open-heart surgery.