Initial report of the Working Group on Frontiers in Perioperative Myocardial Management

An informal working group on perioperative myocardial management has been formed, which is predominantly composed of cardiac surgeons and anesthesiologists. The first meeting was introduced with a reminder that perioperative ischemia is still an important component of cardiac operations when sophisticated tools are used to monitor its presence and physiological effects. Moreover, perioperative ischemia is associated with adverse outcomes in many instances. The discussion touched upon generalized problems that included leukocyte activation, oxidant stress, warm cardioplegia, warm heart surgery, echocardiographic assessment of coronary blood flow, vascular endothelial responses to cardiac operations and cardiopulmonary bypass, myocardial stunning, substrate enhancement of cardioplegic solutions, tools for assessing perioperative ventricular performance, and detection of perioperative myocardial ischemia. It was agreed that a highly focused program on the agenda of myocardial stunning would be the topic for the next meeting of the group, with the results to be published in a future issue.