Intraoperative Myocardial Protection in the Context of Coronary Revascularization

I T IS NOT BY CHANCE that advances in the diagnosis and treatment of ischemic heart disease have paralleled the development of efficacious modalities for intraoperative myocardial protection. The manifestations of coronary artery disease are the consequences of an uncontrolled ischemic event. Knowledge gleaned from this disease process could be applied to a surgically planned period of ischemia to devise strategies about the pathophysiologic consequences attendant to deprivation of coronary blood flow. It is the purpose of this review to track the rationale and development of current myoprotective regimens, to summarize the experimental and clinical results, and to amplify current issues that are unique to the surgical treatment of occlusive coronary artery disease.