Intraoperative protection of the myocardium

It appears obvious that in evaluating gross mortality and morbidity, clinical statistics are insufficient to demonstrate which form of a myocardial protective measure is safest. Previous studies indicate that significant ischemic injury may not be detectable by routine measurements of contractility. Only microscopic examination of the heart at a later period will allow detection of the patchy ischemic injury. In patients, loss of cardiac reserve as measured by postoperative catheterization, particularly compliance studies, and stress testing may be the final clinical arbiter of this controversy.