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Ischemic preconditioning has been proved to be the most effective mode of endogenouse myocardial protection. However, studies of IP effects in cardiac surgery are rare and controversal. Myocardial protection in severely stenosed three-vessel disease is unsatisfactory in patients with RCA critical stenosis or occlusion.Thus consideration of strategies employing IP in myocardial protection against ischemia-reperfusion injury appears necessary and useful. Of importance is the suggestion that IP only provides protection to the unprotected ischemic heart and that it may be detrimential to the human myocardium protected from ischemia using cardioplegia.

IP can protect the heart from I/R injury, as manifested here in the better recovery of left ventricular and right ventricular function after the operation. However, it doesnot alter FR generation. The association of better hemodynamic recovery after CABG with FR generation during the IP period suggests that FRs might possibly act as one of the triggers for IP.

PS: FR- free radicals

I/R ischemia - reperfusion