Cardioplegia: mechanisms of protection revisited

Abstract

A number of factors may influence the myocardial outcome after cardiac surgery, some of which are related to the actual handling of the patient during the perioperative period, and, in particular, to the absence or presence of protective procedures during periods of aortic occlusion. Cold chemical cardioplegia offers the present best alternative for ischaemic protection. The intermittent coronary infusion of cold cardioplegic solutions provides an effective low cost procedure that proves effective for the majority of surgical corrections. However, increasing knowledge to the ischaemic process and its amelioration and the continuing problem of poor postoperative cardiac function of patients in preoperative heart failure, should encourage further experimental and clinical research into perioperative myocardial protection.