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Cardiovascular Research Advance Access [Accepted Manuscript] published online on April 7, 2009
Cardiovascular Research, doi:10.1093/cvr/cvp110
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

The Use of Controlled Reperfusion Strategies in Cardiac Surgery to Minimize Ischemia/Reperfusion Damage

Friedhelm Beyersdorf, MD, PhD

Professor of Surgery and Chairman, Department of Cardiovascular Surgery, Albert-Ludwigs-University Freiburg, Hugstetterstr. 55, D-79106 Freiburg i. Br., Germany, Tel 0049-761-270-2818, FAX 0049-761-270-2550, e-mail: friedhelm.beyersdorf{at}uniklinik-freiburg.de

Ischemia and reperfusion occur during almost every cardiac operation, and one of the key elements to achieve a successful operation is to counteract the detrimental effects of induced ischemia and reperfsuion during the operation. The cardiac surgeon is in the unique position to protect the heart before ischemia is induced and to avoid further damage during the reperfusion period. The surgeon can alter the composition of the reperfusate and the conditions of reperfusion so that the ischemia/reperfusion injury is minimal, even after very complex procedures that require long aortic cross-clamp periods. This in turn allows him to perform a near perfect surgical repair of the underlying disease without the pressure of time. The vast knowledge gained in this field over the years has led to application in other organs, such as the limbs (acute limb ischemia), lungs (lung transplantation), kidney and liver (kidney and liver transplantation), and more recently even for the brain (acute cerebral artery occlusion (stroke)) and the whole body (cardiopulmonary resuscitation). Further improvements in reperfusion strategies will allow salvage of tissues and even whole bodies after ischemic periods thought previously to be irreversibly damaged.

Time for primary review: 19 Days


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