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Updated: May 22, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Preservation of myocardium during coronary artery bypass surgery
Takeshi Kinoshita1, Tohru Asai
1Division of Cardiovascular Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Japan. kinotake@belle.shiga-med.ac.jp
Insights
Effective myocardial protection strategies are crucial for preventing heart damage during coronary artery bypass surgery. This review explores clinical challenges and new perspectives in cardioprotection to reduce patient morbidity and mortality.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardioprotection
Background:
- Myocardial stunning and infarction are risks during coronary artery bypass grafting (CABG).
- Despite reduced mortality, myocardial death remains common due to issues like suboptimal protection and ischemia.
- There's a need for improved cardioprotective strategies in CABG.
Purpose of the Study:
- To review clinical problems in myocardial protection during CABG.
- To summarize outcomes of Phase III trials on cardioprotective strategies.
- To introduce novel perspectives in myocardial protection for CABG.
Main Methods:
- Literature review of clinical challenges in myocardial protection.
- Analysis of selected Phase III clinical trials.
- Discussion of new perspectives in cardioprotection.
Main Results:
- Suboptimal cardioprotection contributes to myocardial damage in CABG.
- Existing strategies have limitations in preventing myocardial infarction.
- New approaches are needed to enhance myocardial protection.
Conclusions:
- Improving myocardial protection is essential for reducing CABG-related morbidity and mortality.
- Further research into novel cardioprotective strategies is warranted.
- Effective cardioprotection can enhance outcomes in coronary artery bypass surgery.
Abstract:
Myocardial protection aims to prevent reversible post-ischemic cardiac dysfunction (myocardial stunning) and irreversible myocardial cell death (myocardial infarction) that occur as a consequence of myocardial ischemia and/or ischemic-reperfusion injury. Although the mortality rate for isolated coronary artery bypass grafting has been markedly reduced during the past decade, myocardial death, as evidenced by elevation in creatine kinase-myocardial band and/or cardiac troponin, is common. This is ascribed to suboptimal myocardial protection during cardiopulmonary bypass or with off-pump technique, early graft failure, distal embolization, and regional or global myocardial ischemia during surgery. An unmet need in contemporary coronary bypass surgery is to find more effective cardioprotective strategies that have the potential for decreasing the morbidity and mortality associated with suboptimal cardioprotection. In the present review article on myocardial protection in contemporary coronary artery bypass surgery, we attempt to elucidate the clinical problems, summarize the outcomes of selected phase III trials, and introduce new perspectives.
