Intraoperative metabolic monitoring of the heart: I. Clinical assessment of coronary sinus metabolites

Numerous clinical studies have corroborated the ability of intraoperative s ampling of coronary sinus blood to measure changes in myocardial metabolism induced by ischemia and reperfusion. Among other changes, cardiac arrest i nduces a period of obligate myocardial lactate production that persists for an indeterminate amount of time after reperfusion. Coronary sinus lactate assays have been established as a standard method to compare various myocar dial protection strategies. Current methodology requires detailed sample pr ocessing, precluding realtime feedback in the operating room. Newer devices hold promise in allowing the online assessment of myocardial metabolism; h owever, these methods await precise validation. (C) 2001 by The Society of Thoracic Surgeons.