Protection of acutely ischemic myocardium by controlled reperfusion

The goal of revascularization after acute occlusion of a coronary artery is the return of contractile function and the reduction of mortality. Althoug h reperfusion of ischemic myocardium is a prerequisite for return of functi on, it may, in itself, cause further injury. Controlled blood cardioplegic reperfusion reduces this "reperfusion injury" and provides maximal myocardi al protection. In this article, we review recent advances in surgically con trolled reperfusion and speculate on future prospects for myocardial protec tive techniques in patients with acute coronary artery occlusion. (C) 1999 by The Society of Thoracic Surgeons.