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Do we need hypothermia in myocardial protection?
1Department of Cardiovascular Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
Background:
Since the concept of "elective cardiac arrest" has been introduced by Melrose et al., rapid arrest, hypothermia and additional protection has been employed in surgical myocardial protection in clinical and experimental settings. And cardioplegia technique employed these components improved clinical results of open heart surgery except special cases which require longer cardiac arrest. In 1991, Salemo et al. offered striking impact on most of cardiac surgeon with the report of retrograde continuous warm blood cardioplegia. Since then several reports pointed out the benefit of warm blood cardioplegia although inherent disadvantage of continuous cardioplegia were the inadequate visualization of the operative field. These reports recently lead some cardiac surgeon to intermittent warm blood cardioplegia.
Methods:
This review introduced and examined our experimental and clinical data with reference to establish new surgical myocardial protection.
Conclusions:
Experimental and clinical data might encourage us to employ intermittent tepid (29 ) blood cardioplegia as a practical cardioplegia in open heart surgery.