Myocardial protection in hypoxic immature hearts.
Current myocardial protection techniques in cyanotic immature hearts are not optimal. Despite successful surgical correction of congenital cardiac defects causing hypoxemia, myocardial dysfunction remains the leading cause of postoperative mortality. New studies indicate that the intraoperative reintroduction of molecular oxygen on cardiopulmonary bypass causes a reoxygenation injury leading to postoperative cardiac dysfunction. Biochemical and functional changes of reoxygenation injury can be avoided by several methods aimed at reducing oxygen free radical production and nitric oxide release. The present investigation provides an overview of our current understanding of pathogenesis, implication, and treatment of myocardial reoxygenation injury. New surgical concepts of myocardial protection including normoxic CPB and controlled reoxygenation are introduced.
Ihnken
K
K
Department of Surgery, Stanford University Hospital, CA 94305, USA.
D000818:Animals; D000975:Antioxidants / Q000032:analysis; D002315:Cardiopulmonary Bypass; D006324:Heart Arrest, Induced; D006801:Humans; D000860:Hypoxia / Q000378:metabolism / Q000503:physiopathology*; D015227:Lipid Peroxidation; D009200:Myocardial Contraction; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control* / Q000628:therapy; D009206:Myocardium / Q000378:metabolism; D009569:Nitric Oxide / Q000096:biosynthesis; D010100:Oxygen / Q000008:administration & dosage*
D000975:Antioxidants; D009569:Nitric Oxide; D010100:Oxygen