HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Francesco Nicolini Cesare Beghi Andrea Agostinelli Alessandro Maria Budillon Tiziano Gherli Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nicolini, F. Articles by Gherli, T. Search for Related Content PubMed PubMed Citation Articles by Nicolini, F. Articles by Gherli, T. Related Collections Extracorporeal circulation Myocardial protection

Eur J Cardiothorac Surg 2003;24:986-993
© 2003 Elsevier Science NL

Review

Myocardial protection in adult cardiac surgery: current options and future challenges

^a Department of Cardiac Surgery, University of Parma, Parma, Italy
^b Department of Biochemistry ‘G. Moruzzi’, University of Bologna, Bologna, Italy

Received 24 December 2002; received in revised form 31 May 2003; accepted 23 July 2003.

^* Corresponding author. Cattedra e Divisione di Cardiochirurgia, Università degli Studi, Via A. Gramsci, 14, 43100 Parma, Italy. Tel.: +39-0521-290470; fax: +39-0521-293196
e-mail: francesconicolini{at}libero.it

Current techniques of myocardial protection are evolving with the use of less conventional modalities of cardioplegia and have reduced the morbidity and mortality of cardiac operations. Blood cardioplegic solutions appear superior to cold cardioplegia in terms of myocardial protection and adjuncts as glutamate/aspartate enhancement, antioxidant supplementation, nitric oxide donors and maintenance of calcium homeostasis seem effective. In the near future, further experimental and clinical investigations about pharmacological preconditioning, sodium–hydrogen exchangers inhibition and gene therapy need to be addressed to well define their potential role in the improvement of current techniques of myocardial protection that are suboptimal in high-risk clinical settings.

Key Words: Myocardial protection • Cardioplegia • Cardiac surgery

This article has been cited by other articles:

				D. H. Freed, A. J. Drain, J. Kitcat, M. T. Jones, and S. A.M. Nashef Death in low-risk cardiac surgery: the failure to achieve a satisfactory cardiac outcome (FIASCO) study Interactive CardioVascular and Thoracic Surgery, October 1, 2009; 9(4): 623 - 625. [Abstract] [Full Text] [PDF]

				T. J. Pegg, J. B. Selvanayagam, J. M. Francis, T. D. Karamitsos, Z. Maunsell, L.-M. Yu, S. Neubauer, and D. P. Taggart A Randomized Trial of On-Pump Beating Heart and Conventional Cardioplegic Arrest in Coronary Artery Bypass Surgery Patients With Impaired Left Ventricular Function Using Cardiac Magnetic Resonance Imaging and Biochemical Markers Circulation, November 18, 2008; 118(21): 2130 - 2138. [Abstract] [Full Text] [PDF]

				Z. Zhu, P. A. Hofmann, and J. K. Buolamwini Cardioprotective effects of novel tetrahydroisoquinoline analogs of nitrobenzylmercaptopurine riboside in an isolated perfused rat heart model of acute myocardial infarction Am J Physiol Heart Circ Physiol, June 1, 2007; 292(6): H2921 - H2926. [Abstract] [Full Text] [PDF]

				C. Beghi, F. Nicolini, A. Agostinelli, B. Borrello, A. M. Budillon, F. Bacciottini, M. Friggeri, A. Costa, L. Belli, L. Battistelli, et al. Mini-Cardiopulmonary Bypass System: Results of a Prospective Randomized Study Ann. Thorac. Surg., April 1, 2006; 81(4): 1396 - 1400. [Abstract] [Full Text] [PDF]

				C. Rergkliang, A. Chetpaophan, V. Chittithavorn, P. Vasinanukorn, and V. Chowchuvech Terminal Warm Blood Cardioplegia in Mitral Valve Replacement: Prospective Study Asian Cardiovasc Thorac Ann, April 1, 2006; 14(2): 134 - 138. [Abstract] [Full Text] [PDF]

				M. Licker, C. Ellenberger, J. Sierra, A. Kalangos, J. Diaper, and D. Morel Cardioprotective Effects of Acute Normovolemic Hemodilution in Patients Undergoing Coronary Artery Bypass Surgery Chest, August 1, 2005; 128(2): 838 - 847. [Abstract] [Full Text] [PDF]

				A. A Albert, B. Arnrich, J. A Walter, W. M Hassanein, U. P Rosendahl, P. Gehle, F. Schon, and J. Ennker Hyperkalemic Blood versus Crystalloid Cardioplegia in Longer Clamping Times Asian Cardiovasc Thorac Ann, June 1, 2004; 12(2): 115 - 120. [Abstract] [Full Text] [PDF]