Cardiopulmonary bypass and cardioplegia

This chapter describes the history and techniques of cardiopulmonary bypass, a process that effectually excludes the heart from the general circulation and leaves it empty so that it can accommodate open cardiac surgical intervention. Since its first implementation, cardiopulmonary bypass has improved significantly to become a very highly sophisticated, but reliably performed procedure. The near future promises even more improvements because research and innovations continue to make cardiac operations safer and more efficient. With the advent of coronary bypass in the late 1960s and early 1970s, surgeons became increasingly interested in finding ways to protect the heart during the period of global ischemia via infusion of cold perfusates into the coronary circulation (i.e., cardioplegia). Therefore, this chapter further details the advantages and disadvantages of various cardioplegia solutions which have been developed at several separate institutions, including extracellular-and intracellular-type solutions.