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Eur J Cardiothorac Surg 2004;26:1002-1014
© 2004 Elsevier Science NL

Review

Vasomotor dysfunction after cardiac surgery

^a Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
^b Division of Cardiac Surgery, University of Ottawa, Ottawa, Ontario, Canada

Received 24 February 2004; received in revised form 28 June 2004; accepted 23 July 2004.

^* Corresponding author. Tel.: +1-617-632-8385; fax: +1-617-632-8287. (E-mail: fsellke{at}bidmc.harvard.edu).

Cardiopulmonary bypass and cardioplegic arrest, which allow for support of the circulation and stabilization of the heart during cardiac procedures, are still used for the vast majority of cardiac operations worldwide. However, in addition to a well-recognized systemic inflammatory response, cardiopulmonary bypass and cardioplegic arrest elicit complex, multifactorial vasomotor disturbances that vary according to the affected organ bed, with reduced vascular resistances in the skeletal muscle and peripheral circulation, and increased propensity to spasm in the cardiac, pulmonary, mesenteric and cerebral vascular beds. This article outlines the nature, mechanistic basis, and clinical correlates of the vasomotor alterations encountered in patients undergoing cardiac surgery using cardiopulmonary bypass and cardioplegic arrest.

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