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[Myocardial protection: the current status and the future prospect]
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 1, 1989
Summary
Perioperative myocardial damage after heart surgery is a major concern. Advances in myocardial protection strategies have significantly reduced injury, but challenges remain, especially for neonatal patients.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Context:
- Perioperative myocardial damage is a leading cause of morbidity and mortality after cardiac operations.
- This damage stems from an imbalance in myocardial energy supply and demand during extracorporeal circulation.
- Historically, efforts have focused on achieving a safe and bloodless surgical field.
Purpose:
- To review recent advancements and current clinical techniques in myocardial protection during open-heart surgery.
- To discuss ongoing controversies and emerging research areas in the field.
- To highlight persistent challenges in myocardial protection.
Summary:
- Significant progress has been made in understanding the pathophysiology of ischemic myocardium and reperfusion injury, leading to reduced perioperative myocardial injury.
- Current clinical techniques and recent developments in myocardial protection are presented.
- The article examines controversial topics and new investigations, emphasizing that challenges persist.
Impact:
- Improved myocardial protection strategies have led to a significant reduction in perioperative myocardial injury.
- The review provides insights into current practices and future research directions.
- Identifies critical unresolved issues, including protection of neonatal myocardium and management of reperfusion injury.