Physiological and cellular mechanisms of myocardial protection

Despite 40 years of clinically successful open heart surgery, cardiac surgeons continue to seek the ideal myoprotective strategy to minimize perioperative myocardial damage and maximize clinical outcome. Although crude measures, such as length of hospital stay or operative mortality rate, may provid...

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Bibliographic Details
Published in:The American journal of surgery 1996-07, Vol.172 (1), p.79-84
Main Authors: Krukenkamp, Irvin B., Levitsky, Sidney
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Biomarkers
Cardioplegic Solutions - therapeutic use
Heart Arrest, Induced
Heart surgery
Humans
Ischemia
Medical sciences
Molecular biology
Myocardial Ischemia - physiopathology
Myocardial Reperfusion Injury - physiopathology
Myocardial Reperfusion Injury - prevention & control
Myocytes
Physiology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Temperature
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Description
Summary:Despite 40 years of clinically successful open heart surgery, cardiac surgeons continue to seek the ideal myoprotective strategy to minimize perioperative myocardial damage and maximize clinical outcome. Although crude measures, such as length of hospital stay or operative mortality rate, may provide useful administrative data, the ultimate outcome measure of significance to the patient is the lack of operatively induced myocellular injury. An ideal biological marker would thus quantitate the number of viable and functioning myocytes remaining postoperatively. The purpose of the present review was to develop the theoretical framework for modern approaches to intraoperative myocardial protection when considering the fundamental principles of physiological and cellular ischemic mechanisms. It is hoped that this review provides insight into the implementation of these fundamental concepts developed at the University of Illinois and applied in our present experiences in advanced myocardial muscle mechanics and molecular biology.
ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(96)00075-X