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Right arrow Myocardial protection

Ann Thorac Surg 2002;73:682-690
© 2002 The Society of Thoracic Surgeons

Review

Endothelial damage during myocardial preservation and storage

Alessandro Parolari, MD, PhD*a, Patrizia Rubini, MD, PhDb, Aldo Cannata, MDa,b, Luigi Bonati, MDb, Francesco Alamanni, MDa, Elena Tremoli, PhDc, Paolo Biglioli, MDa

a Department of Cardiac Surgery, University of Milan, Centro Cardiologico, Fondazione Monzino IRCCS, Milan, Italy
b Institute of General Surgery and Organ Transplantation, University of Parma, Parma, Italy
c Department of Pharmacological Sciences, University of Milan, Milan, Italy

* Address reprint requests to Dr Parolari, Department of Cardiac Surgery, University of Milan, Centro Cardiologico, Fondazione Monzino IRCCS, Via Parea, 4, 20138, Milan, Italy
e-mail: alessandro.parolari{at}cardiologicomonzino.it

Preservation and storage techniques represent two major issues in routine cardiac surgery and heart transplantation. Historically, these methods were conceived to prevent ischemic injury to myocardium after cardiac arrest during heart operations. Evidence shows that endothelium plays a critical role in the maintenance of normal heart function after cardiac operation, mainly by controlling the coronary circulation. Methods for preservation and storage, developed initially to protect cardiomyocyte function, may be deleterious for vascular endothelium and compromise myocardial protection. In this review article the present knowledge about endothelial injury secondary to preservation and storage techniques is discussed.




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