Myocardial protection in hypoxic immature hearts

Current myocardial protection techniques in cyanotic immature hearts are no t optimal. Despite successful surgical correction of congenital cardiac def ects causing hypoxemia, myocardial dysfunction remains the leading cause of postoperative mortality. New studies indicate that the intraoperative rein troduction of molecular oxygen on cardiopulmonary bypass causes a reoxygena tion injury leading to postoperative cardiac dysfunction. Biochemical and f unctional changes of reoxygenation injury can be avoided by several methods aimed at reducing oxygen free radical production and nitric oxide release. The present investigation provides an overview of our current understandin g of pathogenesis, implication, and treatment of myocardial reoxygenation i njury. New surgical concepts of myocardial protection including normoxic CP B and controlled reoxygenation are introduced.