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Coronary Flow Response After Myocardial Ischemia May Predict Level of Functional Recovery

  • R. J. F. Houston
  • S. H. Skotnicki
  • A. Heerschap
  • B. Oeseburg
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 411)

Abstract

After its widespread introduction in the 1970s, cold crystalloid cardioplegia rapidly became standard practice in cardiac surgery. A changing patient population, with more elderly patients, patients requiring reoperation, and undergoing more complex procedures, s creating a demand for more sophisticated cardioprotective protocols. Continuous blood cardioplegia has been used, conferring the advantages of blood perfusion, including greater oxygen-carrying and buffering capacity, and avoiding ischemia and thus reperfusion injury, but creating the problem of an obscured operating field. The most recent proposal, intermittent warm blood cardioplegia, offers a still, clear operating field, with ischemic intervals short enough to prevent serious damage. Buckberg et al (1995) review the history of cardioprotection, detail the various options now available, and plead for the introduction of integrated myocardial management, in which the surgeon adapts the cardioprotective strategy to the needs of each patient, rather than adopting an adversarial position. Buckberg (1994) also observes that new cardioprotective techniques are being introduced without an adequate scientific basis.

Keywords

Coronary Flow Reserve Coronary Flow Reactive Hyperemia Erythrocyte Suspension Blood Cardioplegia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • R. J. F. Houston
    • 1
  • S. H. Skotnicki
    • 2
  • A. Heerschap
    • 3
  • B. Oeseburg
    • 1
  1. 1.Physiology DepartmentUniversity of NijmegenNijmegenThe Netherlands
  2. 2.Cardiothoracic Surgery InstituteUniversity of NijmegenNijmegenThe Netherlands
  3. 3.Radiodiagnostic Institute Faculty of Medical SciencesUniversity of NijmegenNijmegenThe Netherlands

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