Resistance and tolerance of the myocardium to ischemia.
Since 1967, the authors have abandoned coronary perfusion in valve, particularly aortic, surgery. Some of the difficulties encountered during defibrillation at the period where coronary perfusion was always used have dramatically decreased. Extra-corporeal-circulation is now performed under moderate hypothermia--28 to 30 degrees C--which gives excellent myocardial protection for aortic cross clamping time of 30 to 60 minutes. In coronary artery surgery, the same technique is now used, after having wrongly believed previously that coronary perfusion was indicated. In conclusion, we feel that coronary perfusion is not indicated any more but in very exceptional cases.
D001021:Aortic Valve; D001219:Aspartate Aminotransferases / Q000097:blood; D001783:Blood Flow Velocity; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003327:Coronary Disease / Q000517:prevention & control*; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005112:Extracorporeal Circulation / Q000009:adverse effects; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D007036:Hypothermia, Induced; D007770:L-Lactate Dehydrogenase / Q000097:blood; D009206:Myocardium / Q000378:metabolism*; D009336:Necrosis; D013997:Time Factors
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase