title: Vasomotor dysfunction after cardiac surgery.
abstract: Cardiopulmonary bypass and cardioplegic arrest, which allow for support of the circulation and stabilization of the heart during cardiac procedures, are still used for the vast majority of cardiac operations worldwide. However, in addition to a well-recognized systemic inflammatory response, cardiopulmonary bypass and cardioplegic arrest elicit complex, multifactorial vasomotor disturbances that vary according to the affected organ bed, with reduced vascular resistances in the skeletal muscle and peripheral circulation, and increased propensity to spasm in the cardiac, pulmonary, mesenteric and cerebral vascular beds. This article outlines the nature, mechanistic basis, and clinical correlates of the vasomotor alterations encountered in patients undergoing cardiac surgery using cardiopulmonary bypass and cardioplegic arrest.
authors.affiliation: Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Ruel
authors.forename: Tanveer A
authors.initials: TA
authors.lastname: Khan
authors.forename: Pierre
authors.initials: P
authors.lastname: Voisine
authors.forename: Cesario
authors.initials: C
authors.lastname: Bianchi
authors.forename: Frank W
authors.initials: FW
authors.lastname: Sellke
mesh_terms: D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004730:Endothelium, Vascular / Q000503:physiopathology; D006324:Heart Arrest, Induced / Q000009:adverse effects*; D006801:Humans; D009131:Muscle, Smooth, Vascular / Q000503:physiopathology; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology; D009569:Nitric Oxide / Q000502:physiology; D014666:Vasomotor System / Q000503:physiopathology*
chemical_list: D009569:Nitric Oxide