Myocardial Protection in Cardiac Surgery – What is the Ideal Method?

The study of myocardial protection has improved together with cardiac surgery, aiming to prevent intraoperative myocardial injury, which can lead to ventricular dysfunction, arrhythmias, low cardiac output and other complications, often irreversible ones.

Since the first cardiac surgeries with cardiopulmonary bypass (CPB) in 1953 performed by Dr. Gibbon at Massachusetts General Hospital, several methods of myocardial protection have been studied, allowing more extensive cardiac surgeries to be performed, with longer aortic clamping time. In the first surgeries, hypothermia was the method used for myocardial protection, but it showed to be insufficient for longer periods of ischemia.

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