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Current Vascular Pharmacology

Editor-in-Chief

ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

Review Article

Mechanisms of Cardioprotection of Halogenated Agents During Extracorporeal Circulation in Cardiac Surgery

Author(s): M. Ramirez-Aliaga*, J.J. Escalona-Belmonte, A. Ramirez-Fernandez, M. Rubio-Navarro and J. Cruz-Manas

Volume 16, Issue 4, 2018

Page: [319 - 328] Pages: 10

DOI: 10.2174/1570161115666171116170806

Price: $65

Abstract

The implementation of cardioprotective strategies involving pre-, intra-, and postoperative interventions is key during cardiac surgery requiring extracorporeal circulation (ECC). The primary goal of this study was to review the physiopathology and protection strategies against myocardial damage secondary to ECC during cardiac surgery. The administration halogenated anesthetics for cardiac anesthesia is common place due to their well-known cardioprotective effects and their capacity to ensure hypnosis. An optimal myocardial protection strategy requires that a comprehensive approach should be adopted to cover pre-, intra-, and post-operative interventions. Pre-conditioning and post-conditioning share numerous pathways, mainly based on mitochondrial signaling, antiapoptotic pathways, and reduced inflammatory mediators. However, volatile anesthetic can also be administered during ECC, in which mechanism of action has been scantly investigated, during this period and its biology is still unknown.

Keywords: Preconditioning, postconditioning, extracorporeal circulation, hypnotic agents, cardioprotection, cardiac surgery.

Graphical Abstract


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