© 2003 by BMJ Publishing Group & British Cardiac Society
EDITORIAL
Protecting the damaged heart during coronary surgery
Correspondence to:
Correspondence to:
Professor David H Wheatley, Department of Cardiac Surgery, University of Glasgow at Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK;
d.j.wheatley@clinmed.gla.ac.uk
In coronary surgery, protective strategies that offer adequate safety for patients with healthy ventricles may not be adequate for those with severe impairment of ventricular function
Keywords: coronary surgery; cardioplegia; left ventricular dysfunction
| The first 150 words of the full text of this article appear below. |
In this issue of Heart Antunes and colleagues,1 in reporting excellent outcomes for coronary surgery in patients with advanced left ventricular dysfunction, highlight a source of continued controversy concerning the best way of protecting the heart in these circumstances. What has heightened current interest, and prompted reassessment of existing techniques, is the advent of beating heart surgery2 to add to available strategies for conducting the operation in those whose myocardium has been severely damaged by the effects of coronary disease.
The value of revascularisation in those with impaired left ventricular function is well established.3 However, when non-working "hibernating" myocardium or fibrous tissue has replaced much contractile myocardium, there are reduced reserves for coping with the injury that so often accompanies coronary surgery. Thus, protective strategies that offer adequate safety for patients with healthy ventricles may not be adequate for those with severe impairment of ventricular function, leading to postoperative low
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This article has been cited by other articles:
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Venugopal, V., Ludman, A., Yellon, D. M., Hausenloy, D. J.
(2009). 'Conditioning' the heart during surgery. Eur. J. Cardiothorac. Surg.
35: 977-987
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