Annals of Cardiac Anaesthesia (Jan 2015)

Mechanisms of oxidative stress and myocardial protection during open-heart surgery

  • Nikolaos G Baikoussis,
  • Nikolaos A Papakonstantinou,
  • Chrysoula Verra,
  • Georgios Kakouris,
  • Maria Chounti,
  • Panagiotis Hountis,
  • Panagiotis Dedeilias,
  • Michalis Argiriou

DOI
https://doi.org/10.4103/0971-9784.166465
Journal volume & issue
Vol. 18, no. 4
pp. 555 – 564

Abstract

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Cold heart protection via cardioplegia administration, limits the amount of oxygen demand. Systemic normothermia with warm cardioplegia was introduced due to the abundance of detrimental effects of hypothermia. A temperature of 32-33°C in combination with tepid blood cardioplegia of the same temperature appears to be protective enough for both; heart and brain. Reduction of nitric oxide (NO) concentration is in part responsible for myocardial injury after the cardioplegic cardiac arrest. Restoration of NO balance with exogenous NO supplementation has been shown useful to prevent inflammation and apoptosis. In this article, we discuss the "deleterious" effects of the oxidative stress of the extracorporeal circulation and the up-to-date theories of "ideal′′ myocardial protection.

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