PHYSIOLOGICAL AND CELLULAR MECHANISMS OF MYOCARDIAL PROTECTION

BACKGROUND: Despite 40 years of clinically successful open heart surge ry, cardiac surgeons continue to seek the ideal myoprotective strategy to minimize perioperative myocardial damage and maximize clinical out come. Although crude measures, such as length of hospital stay or oper ative mortality rate, may provide useful administrative data, the ulti mate outcome measure of significance to the patient is the lack of ope ratively induced myocellular injury. METHODS: An ideal biological mark er would thus quantitate the number of viable and functioning myocytes remaining postoperatively. The purpose of the present review was to d evelop the theoretical framework for modern approaches to intraoperati ve myocardial protection when considering the fundamental principles o f physiological and cellular ischemic mechanisms. RESULTS AND CONCLUSI ONS: If is hoped that this review provides insight into the implementa tion of these fundamental concepts developed at the University of Illi nois and applied in our present experiences in advanced myocardial mus cle mechanics and molecular biology.