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lüll Myocardial Protection Ismail A; Semien GStatPearls-/-ä 2024[Jan]; ä (ä): äSurgeons became aware that they would never correct or cure heart conditions unless they could stop the blood circulation through the heart, open it, and operate in a bloodless field under direct vision. Two concepts were utilized to develop the first two open-heart surgery techniques, namely 'inflow obstruction' by John Lewis & Mansur Taufic in 1953 and the 'controlled cross circulation' technique by Walton Lillehei in 1954. The latter approach was very successful and addressed pathologies previously considered impossible to surgically correct, such as VSD, AVSD, tetralogy of Fallot, and pulmonary stenosis. However, unforeseen limitations were discovered. Such limitations include difficulty operating on the beating heart, air embolism risk when the left side of the heart is exposed, and obscuring collateral flow from the coronary sinus and pulmonary veins. It was evident that the only way to achieve this was by arresting the heart. This was the genesis of the open-heart surgery era; the following is a detailed review of myocardial protection history, principles, and techniques.ä |