title: [Protection of the myocardium during the coronary bypass operation. The status of the problem in the USA today].
abstract: Hypothermia is the mainstay of myocardial protection during deliberately induced operative myocardial ischaemia. Completely isolating the heart from the systemic circulation significantly aids myocardial temperature reduction and maintenance. Cooling is most effectively distributed throughout the myocardium by intracoronary administration of a cold solution. Noncoronary collateral myocardial blood flow, always present in varying degree, will rewarm the heart. Replenishment of intracoronary cooling solutions at frequent intervals is essential to counteract this detrimental occurrence. Chemical cardioplegia effectively extends the safe period of myocardial ischaemia and reduces the incidence of operative myocardial injury and death. Currently potassium is the most frequently used cardioplegic agent in the United States. Calcium influx blockers are being evaluated extensively and bear significant promise as additional agents to further improve the results achieved by hypothermic chemical cardioplegia.
mesh_terms: D002121:Calcium Channel Blockers / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000401:mortality; D006321:Heart / Q000503:physiopathology*; D006324:Heart Arrest, Induced / Q000379:methods; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D007430:Intraoperative Care / Q000379:methods; D014481:United States
chemical_list: D002121:Calcium Channel Blockers
vernacular_title: Zashchita miokarda vo vremia operatsii koronarnogo shuntirovaniia. Sostoianie problemy v SShA v nastoiashchee vremia.