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
Current Vascular Pharmacology
Title:Mechanisms of Cardioprotection of Halogenated Agents During Extracorporeal Circulation in Cardiac Surgery
Volume: 16 Issue: 4
Author(s): M. Ramirez-Aliaga*, J.J. Escalona-Belmonte, A. Ramirez-Fernandez, M. Rubio-Navarro and J. Cruz-Manas
Affiliation:
- Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga,Spain
Keywords: Preconditioning, postconditioning, extracorporeal circulation, hypnotic agents, cardioprotection, cardiac surgery.
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.
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Cite this article as:
Ramirez-Aliaga M. *, Escalona-Belmonte J.J. , Ramirez-Fernandez A., Rubio-Navarro M. and Cruz-Manas J. , Mechanisms of Cardioprotection of Halogenated Agents During Extracorporeal Circulation in Cardiac Surgery, Current Vascular Pharmacology 2018; 16 (4) . https://dx.doi.org/10.2174/1570161115666171116170806
DOI https://dx.doi.org/10.2174/1570161115666171116170806 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
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