title: [Problem in myocardial protection in coronary artery bypass surgery; regional difference of myocardial tolerance to global ischemia].
abstract: This study was aimed to evaluate the hypothesis that the left ventricular myocardium has different resistance to ischemic stress, thus, perioperative myocardial infarction occurs in the myocardium with poor resistance to ischemia. Patients who died of acute low output syndrome after coronary artery bypass graft under potassium induced cardioplegia associated with topical and systemic hypothermia were studied by histopathology of the left ventricular muscle taken at the time of autopsy. Distal regions of the myocardium to various degree of stenosis of the coronary artery were selected for examination. Ischemic myocardial damage that appears most likely the events in the perioperative period was observed sporadically in the normal myocardial architecture independent of the degree of stenosis of the coronary arteries. Thus, this result suggests that the regional myocardium has different resistance to global ischemia, and it may be responsible to perioperative myocardial infarction.
mesh_terms: D002303:Cardiac Output, Low / Q000473:pathology; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000473:pathology*; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011183:Postoperative Complications