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Cardiovascular Research Advance Access first published online on April 7, 2009
This version [Corrected Proof] published online on April 28, 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 ischaemia/reperfusion damage

Friedhelm Beyersdorf*

Department of Cardiovascular Surgery, Albert-Ludwigs-University Freiburg, Hugstetterstr. 55, D-79106 Freiburg i. Br., Germany

* Corresponding author. Tel: +49 761 270 2818; fax: +49 761 270 2550. E-mail address: friedhelm.beyersdorf{at}uniklinik-freiburg.de

Ischaemia 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 ischaemia and reperfusion during the operation. The cardiac surgeon is in a unique position to protect the heart before ischaemia 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 ischaemia/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 ischaemia), 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 tissue and even whole body after ischaemic periods thought previously to be irreversibly damaged.

KEYWORDS Reperfusion; Ischaemia–reperfusion; Cardiac surgery; Controlled reperfusion

Time for primary review: 19 days


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