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Cardioplegia.

D J Hearse

    Postgraduate Medical Journal
    |January 1, 1983
    PubMed
    Summary

    Effective myocardial protection involves pre- and post-ischemic strategies, alongside interventions during ischemia. Cold chemical cardioplegia significantly extends tolerance to myocardial ischemia during cardiac surgery.

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    Area of Science:

    • Cardiology
    • Cardiovascular Surgery
    • Biochemistry

    Background:

    • Transient myocardial ischemia poses risks during cardiac surgery.
    • Effective protection requires addressing pre-, during, and post-ischemic periods.
    • Current strategies focus on mitigating ischemia's consequences.

    Purpose of the Study:

    • To review principles of myocardial protection during cardiac surgery.
    • To analyze components of effective protection strategies.
    • To discuss the critical role of calcium in myocardial protection.

    Main Methods:

    • Review of principles underlying cold chemical cardioplegia.
    • Analysis of energy conservation, metabolic rate reduction, and protective agents.
    • Examination of calcium movement control mechanisms.

    Main Results:

    • Cold chemical cardioplegia extends ischemia tolerance from <1 hour to >3 hours in surgery.
    • Experimental studies report up to 24 hours of reversible ischemia.
    • Control of calcium movement is identified as critical for myocardial protection.

    Conclusions:

    • Myocardial protection strategies must encompass pre-, during, and post-ischemic phases.
    • Cold chemical cardioplegia is highly effective in extending ischemia tolerance.
    • Future advances in myocardial protection depend on understanding calcium regulation.

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