Myocardial protection in adult cardiac surgery: current options and future challenges

被引:46
作者
Nicolini, F
Beghi, C
Muscari, C
Agostinelli, A
Budillon, AM
Spaggiari, I
Gherli, T
机构
[1] Univ Parma, Cattedra & Div Cardiochirurgia, I-43100 Parma, Italy
[2] Univ Bologna, Dept Biochem, I-40126 Bologna, Italy
关键词
myocardial protection; cardioplegia; cardiac surgery;
D O I
10.1016/S1010-7940(03)00475-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Current techniques of myocardial protection are evolving with the use of less conventional modalities of cardioplegia and have reduced the morbidity and mortality of cardiac operations. Blood cardioplegic solutions appear superior to cold cardioplegia in terms of myocardial protection and adjuncts as glutamate/aspartate enhancement, antioxidant supplementation, nitric oxide donors and maintenance of calcium homeostasis seem effective. In the near future, further experimental and clinical investigations about pharmacological preconditioning, sodium-hydrogen exchangers inhibition and gene therapy need to be addressed to well define their potential role in the improvement of current techniques of myocardial protection that are suboptimal in high-risk clinical settings. (C) 2003 Elsevier B.V. All rights reserved.
引用
收藏
页码:986 / 993
页数:8
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