Prevention of myocardial damage during cardiac operations

J. W. Kirklin, Vincent Conti, E. H. Blackstone

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When the cardiopulmonary-bypass technic for cardiac operations began to evolve in the mid-1950's, there was wide enthusiasm for its potential benefits. It soon became apparent, however, that some operations resulted in early postoperative deaths and that most were due to some of acute cardiac failure, usually manifested by low cardiac output. These deaths, it was assumed, happened because the patients had serious heart disease. Only recently has it been realized that death from acute cardiac failure soon after cardiac operations is usually related to new, and often extensive, perioperative (during or within 24 hours of the procedure) myocardial necrosis and that necrosis has also been induced in many patients who survive. Even more recently, new technics of myocardial protection have reduced the occurrence and extent of perioperative myocardial necrosis. These technics promise to improve dramatically the early and late results of cardiac operations and also to allow more extensive and precise operating procedures.

Original languageEnglish (US)
Pages (from-to)135-141
Number of pages7
JournalNew England Journal of Medicine
Issue number3
StatePublished - 1979
Externally publishedYes


ASJC Scopus subject areas

  • Medicine(all)

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