{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:44:49Z","timestamp":1787060689689,"version":"build-2736575974"},"reference-count":73,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p\/>\n                  <jats:p>Myocardial protection and specifically cardioplegia have been extensively investigated in the beginnings of cardiac surgery. After cardiopulmonary bypass had become routine, more and more cardiac operations were possible, requiring reliable and reproducible protection for times of blood flow interruptions to the most energy-demanding organ of the body. The concepts of hypothermia and cardioplegia evolved as tools to extend cardiac ischaemia tolerance to a degree considered safe for the required operation. A plethora of different solutions and delivery techniques were developed achieving remarkable outcomes with cross-clamp times of up to 120\u2009min and more. With the beginning of the new millennium, interest in myocardial protection research declined and, as a consequence, conventional cardiac surgery is currently performed using myocardial protection strategies that have not changed in decades. However, the context, in which cardiac surgery is currently performed, has changed during this time. Patients are now older and suffer from more comorbidities and, thus, other organs move more and more into the centre of risk assessment. Yet, systemic effects of cardioplegic solutions have never been in the focus of attention. They say hindsight is always 20\u201320. We therefore review the biochemical principles of ischaemia, reperfusion and cardioplegic extension of ischaemia tolerance and address the concepts of myocardial protection with \u2018hindsight from the 2020s\u2019. In light of rising patient risk profiles, minimizing surgical trauma and improving perioperative morbidity management becomes key today. For cardioplegia, this means accounting not only for cardiac, but also for systemic effects of cardioplegic solutions.<\/jats:p>","DOI":"10.1093\/ejcts\/ezad424","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T12:22:35Z","timestamp":1702902155000},"source":"Crossref","is-referenced-by-count":16,"title":["Myocardial protection in cardiac surgery\u2014hindsight from the 2020s"],"prefix":"10.1093","volume":"64","author":[{"given":"Murat","family":"Mukharyamov","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena , Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena , Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hristo","family":"Kirov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena , Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5697-2659","authenticated-orcid":false,"given":"Tulio","family":"Caldonazo","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena , Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6411-909X","authenticated-orcid":false,"given":"Torsten","family":"Doenst","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena , Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"2024012318433431000_ezad424-B1","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.3945\/ajcn.2010.29885","article-title":"Specific metabolic rates of major organs and tissues across adulthood: evaluation by mechanistic model of resting energy expenditure","volume":"92","author":"Wang","year":"2010","journal-title":"Am J Clin Nutr"},{"key":"2024012318433431000_ezad424-B2","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1161\/CIRCRESAHA.113.300376","article-title":"Cardiac metabolism in heart failure: implications beyond ATP production","volume":"113","author":"Doenst","year":"2013","journal-title":"Circ Res"},{"key":"2024012318433431000_ezad424-B3","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.recesp.2020.07.020","article-title":"Coexistence of transmural and lateral wavefront progression of myocardial infarction in the human heart","volume":"74","author":"Lorca","year":"2021","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2024012318433431000_ezad424-B4","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1038\/s41569-020-0403-y","article-title":"Myocardial ischaemia-reperfusion injury and cardioprotection in perspective","volume":"17","author":"Heusch","year":"2020","journal-title":"Nat Rev Cardiol"},{"key":"2024012318433431000_ezad424-B5","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1056\/NEJMra071667","article-title":"Myocardial reperfusion injury","volume":"357","author":"Yellon","year":"2007","journal-title":"N Engl J Med"},{"key":"2024012318433431000_ezad424-B6","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.ejcts.2007.11.010","article-title":"Effect of ischemic postconditioning in adult valve replacement","volume":"33","author":"Luo","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1055\/s-2007-1013993","article-title":"Myocardial protection and ischemia tolerance of the globally ischemic heart","volume":"38","author":"Gebhard","year":"1990","journal-title":"Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B8","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1159\/000145826","article-title":"The irreversible ischaemic lesion of human myocardium. Comparison with the experimental animal model","volume":"118","author":"Ludatscher","year":"1984","journal-title":"Acta Anat (Basel)"},{"key":"2024012318433431000_ezad424-B9","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1177\/1089253214530045","article-title":"A brief history of cardiopulmonary bypass","volume":"18","author":"Hessel","year":"2014","journal-title":"Semin Cardiothorac Vasc Anesth"},{"key":"2024012318433431000_ezad424-B10","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1152\/ajplegacy.1949.160.1.125","article-title":"Oxygen transport and utilization in dogs at low body temperatures","volume":"160","author":"Bigelow","year":"1950","journal-title":"Am J Physiol"},{"key":"2024012318433431000_ezad424-B11","first-page":"943","article-title":"The pacemaker story: a cold heart spin-off","volume":"131","author":"Bigelow","year":"1984","journal-title":"Can Med Assoc J"},{"key":"2024012318433431000_ezad424-B12","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1053\/j.semtcvs.2011.01.011","article-title":"Does straight deep hypothermic circulatory arrest suffice for brain preservation in aortic surgery?","volume":"22","author":"Ziganshin","year":"2010","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B13","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9781139871778","volume-title":"Cardiopulmonary Bypass","author":"Ghosh","year":"2015"},{"key":"2024012318433431000_ezad424-B14","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1051\/ject\/201850083","article-title":"Global cardioplegia practices: results from the global cardiopulmonary bypass survey","volume":"50","author":"Ali","year":"2018","journal-title":"J Extra Corpor Technol"},{"key":"2024012318433431000_ezad424-B15","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/0003-4975(94)00843-V","article-title":"Intermittent antegrade warm blood cardioplegia","volume":"59","author":"Calafiore","year":"1995","journal-title":"Ann Thorac Surg"},{"key":"2024012318433431000_ezad424-B16","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.jtcvs.2004.03.032","article-title":"Cold blood cardioplegia versus cold crystalloid cardioplegia: a prospective randomized study of 1440 patients undergoing coronary artery bypass grafting","volume":"128","author":"\u00d8vrum","year":"2004","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B17","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.ejcts.2010.03.052","article-title":"Cold blood versus cold crystalloid cardioplegia: a prospective randomised study of 345 aortic valve patients","volume":"38","author":"\u00d8vrum","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B18","doi-asserted-by":"crossref","first-page":"I331","DOI":"10.1161\/CIRCULATIONAHA.105.001644","article-title":"Is blood superior to crystalloid cardioplegia? A meta-analysis of randomized clinical trials","volume":"114","author":"Guru","year":"2006","journal-title":"Circulation"},{"key":"2024012318433431000_ezad424-B19","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1177\/0267659112453754","article-title":"Is there any difference between blood and crystalloid cardioplegia for myocardial protection during cardiac surgery? A meta-analysis of 5576 patients from 36 randomized trials","volume":"27","author":"S\u00e1","year":"2012","journal-title":"Perfusion"},{"key":"2024012318433431000_ezad424-B20","doi-asserted-by":"crossref","first-page":"Iii339","DOI":"10.1161\/circ.102.suppl_3.III-339","article-title":"Late results of the Warm Heart Trial: the influence of nonfatal cardiac events on late survival","volume":"102","author":"Fremes","year":"2000","journal-title":"Circulation"},{"key":"2024012318433431000_ezad424-B21","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.ejcts.2009.09.030","article-title":"Warm versus cold cardioplegia for heart surgery: a meta-analysis","volume":"37","author":"Fan","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B22","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1161\/01.CIR.92.7.1940","article-title":"Normothermic continuous antegrade blood cardioplegia does not prevent myocardial edema and cardiac dysfunction","volume":"92","author":"Mehlhorn","year":"1995","journal-title":"Circulation"},{"key":"2024012318433431000_ezad424-B23","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1016\/S0003-4975(99)00837-1","article-title":"Antegrade\/retrograde cardioplegia for valve replacement: a prospective study","volume":"68","author":"Dagenais","year":"1999","journal-title":"Ann Thorac Surg"},{"key":"2024012318433431000_ezad424-B24","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0003-4975(00)02145-7","article-title":"Retrograde versus antegrade crystalloid cardioplegia in coronary surgery: value of troponin-I measurement","volume":"71","author":"Franke","year":"2001","journal-title":"Ann Thorac Surg"},{"key":"2024012318433431000_ezad424-B25","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1093\/ejcts\/ezab493","article-title":"The value of perioperative biomarker release for the assessment of myocardial injury or infarction in cardiac surgery","volume":"61","author":"Schneider","year":"2022","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B26","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1093\/eurheartj\/ehac604","article-title":"Cardiac troponin release following coronary artery bypass grafting: mechanisms and clinical implications","volume":"44","author":"Heuts","year":"2023","journal-title":"Eur Heart J"},{"key":"2024012318433431000_ezad424-B27","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.jtcvs.2019.07.109","article-title":"Single- versus multidose cardioplegia in adult cardiac surgery patients: a meta-analysis","volume":"160","author":"Gambardella","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B28","first-page":"263","article-title":"Myocardial protection: a forgotten modality","volume":"57","author":"Allen","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B29","doi-asserted-by":"crossref","first-page":"2248","DOI":"10.1111\/jocs.14764","article-title":"United States national trends in comorbidity and outcomes of adult cardiac surgery patients","volume":"35","author":"Mullan","year":"2020","journal-title":"J Card Surg"},{"key":"2024012318433431000_ezad424-B30","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.ejcts.2008.01.001","article-title":"Relation between aortic cross-clamp time and mortality\u2014not as straightforward as expected","volume":"33","author":"Doenst","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B31","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1097\/TP.0b013e31818149b9","article-title":"The importance of cold and warm cardiac ischemia for survival after heart transplantation","volume":"86","author":"Banner","year":"2008","journal-title":"Transplantation"},{"key":"2024012318433431000_ezad424-B32","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1053\/j.jvca.2021.03.005","article-title":"Scoring systems for risk stratification in patients undergoing cardiac surgery","volume":"36","author":"Pittams","year":"2022","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2024012318433431000_ezad424-B33","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.yjmcc.2004.09.014","article-title":"Age-related changes in ischemic tolerance in male and female mouse hearts","volume":"38","author":"Willems","year":"2005","journal-title":"J Mol Cell Cardiol"},{"key":"2024012318433431000_ezad424-B34","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1067\/mtc.2000.106528","article-title":"Tolerance to ischemia and hypoxia is reduced in aged human myocardium","volume":"120","author":"Mariani","year":"2000","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B35","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.3390\/jcm12041698","article-title":"Cardioplegia in open heart surgery: age matters","volume":"12","author":"Bradi\u0107","year":"2023","journal-title":"J Clin Med"},{"key":"2024012318433431000_ezad424-B36","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.athoracsur.2009.04.135","article-title":"Off-pump coronary artery bypass disproportionately benefits high-risk patients","volume":"88","author":"Puskas","year":"2009","journal-title":"Ann Thorac Surg"},{"key":"2024012318433431000_ezad424-B37","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1161\/CIRCULATIONAHA.119.044574","article-title":"Echocardiographic results of transcatheter versus surgical aortic valve replacement in low-risk patients: the PARTNER 3 trial","volume":"141","author":"Pibarot","year":"2020","journal-title":"Circulation"},{"key":"2024012318433431000_ezad424-B38","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1007\/s10554-019-01616-7","article-title":"Severe loss of right ventricular longitudinal contraction occurs after cardiopulmonary bypass in patients with preserved right ventricular output","volume":"35","author":"Gr\u00f8nlykke","year":"2019","journal-title":"Int J Cardiovasc Imaging"},{"key":"2024012318433431000_ezad424-B39","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1111\/echo.12973","article-title":"Changes in right ventricular shape and deformation following coronary artery bypass surgery-insights from echocardiography with strain rate and magnetic resonance imaging","volume":"32","author":"R\u00f6sner","year":"2015","journal-title":"Echocardiography"},{"key":"2024012318433431000_ezad424-B40","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1093\/ejechocard\/jep015","article-title":"Is right ventricular systolic function reduced after cardiac surgery? A two- and three-dimensional echocardiographic study","volume":"10","author":"Tamborini","year":"2009","journal-title":"Eur J Echocardiogr"},{"key":"2024012318433431000_ezad424-B41","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/j.jtcvs.2018.02.092","article-title":"Comparison of transcatheter versus surgical aortic valve implantation in high-risk patients: a nationwide study in France","volume":"156","author":"Armoiry","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B42","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ejim.2017.01.023","article-title":"Comparison of late mortality after transcatheter aortic valve implantation versus surgical aortic valve replacement: insights from a meta-analysis","volume":"40","author":"Ando","year":"2017","journal-title":"Eur J Intern Med"},{"key":"2024012318433431000_ezad424-B43","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/SLA.0000000000003906","article-title":"Long-term and temporal outcomes of transcatheter versus surgical aortic-valve replacement in severe aortic stenosis: a meta-analysis","volume":"273","author":"Zhang","year":"2021","journal-title":"Ann Surg"},{"key":"2024012318433431000_ezad424-B44","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/j.1540-8191.2000.tb00470.x","article-title":"Low systemic vascular resistance after cardiopulmonary bypass: incidence, etiology, and clinical importance","volume":"15","author":"Carrel","year":"2000","journal-title":"J Card Surg"},{"key":"2024012318433431000_ezad424-B45","doi-asserted-by":"crossref","first-page":"101200","DOI":"10.1016\/j.accpm.2023.101200","article-title":"Epidemiology, risk factors and outcomes of norepinephrine use in cardiac surgery with cardiopulmonary bypass: a multicentric prospective study","volume":"42","author":"Guinot","year":"2023","journal-title":"Anaesth Crit Care Pain Med"},{"key":"2024012318433431000_ezad424-B46","first-page":"210","article-title":"Single atriocaval cannulation is associated with increased incidence of hypercirculatory failure after cardiopulmonary bypass","volume":"7","author":"Busch","year":"2001","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B47","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S0022-5223(97)70055-2","article-title":"Superiority of hyperpolarizing to depolarizing cardioplegia in protection of coronary endothelial function","volume":"114","author":"He","year":"1997","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B48","doi-asserted-by":"crossref","first-page":"687","DOI":"10.4103\/0971-9784.191578","article-title":"Cardiac surgery-associated acute kidney injury","volume":"19","author":"Ortega-Loubon","year":"2016","journal-title":"Ann Card Anaesth"},{"key":"2024012318433431000_ezad424-B49","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1111\/nep.12506","article-title":"Comparison of renal outcomes in off-pump versus on-pump coronary artery bypass grafting: a systematic review and meta-analysis of randomized controlled trials","volume":"20","author":"Cheungpasitporn","year":"2015","journal-title":"Nephrology (Carlton)"},{"key":"2024012318433431000_ezad424-B50","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1016\/j.jtcvs.2019.05.083","article-title":"The del Nido versus cold blood cardioplegia in aortic valve replacement: a randomized trial","volume":"159","author":"Sanetra","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B51","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1111\/1440-1681.13236","article-title":"Impact of Custodiol-N cardioplegia on acute kidney injury after cardiopulmonary bypass","volume":"47","author":"Feirer","year":"2020","journal-title":"Clin Exp Pharmacol Physiol"},{"key":"2024012318433431000_ezad424-B52","doi-asserted-by":"crossref","first-page":"e149-57","DOI":"10.1016\/j.jss.2011.05.020","article-title":"UW is superior compared with HTK after prolonged preservation of renal grafts","volume":"170","author":"Hoeger","year":"2011","journal-title":"J Surg Res"},{"key":"2024012318433431000_ezad424-B53","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1038\/nrneph.2017.119","article-title":"Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment","volume":"13","author":"Wang","year":"2017","journal-title":"Nat Rev Nephrol"},{"key":"2024012318433431000_ezad424-B54","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.athoracsur.2011.09.073","article-title":"Risk factors for perioperative acute kidney injury after adult cardiac surgery: role of perioperative management","volume":"93","author":"Parolari","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2024012318433431000_ezad424-B55","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.jtcvs.2004.06.028","article-title":"Hemodilution during cardiopulmonary bypass is an independent risk factor for acute renal failure in adult cardiac surgery","volume":"129","author":"Karkouti","year":"2005","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B56","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1051\/ject\/201749231","article-title":"Does the type of cardioplegic technique influence hemodilution and transfusion requirements in adult patients undergoing cardiac surgery?","volume":"49","author":"Stammers","year":"2017","journal-title":"J Extra Corpor Technol"},{"key":"2024012318433431000_ezad424-B57","doi-asserted-by":"crossref","first-page":"370612","DOI":"10.1155\/2015\/370612","article-title":"Risk factors associated with cognitive decline after cardiac surgery: a systematic review","volume":"2015","author":"Patel","year":"2015","journal-title":"Cardiovasc Psychiatry Neurol"},{"key":"2024012318433431000_ezad424-B58","doi-asserted-by":"crossref","first-page":"4670","DOI":"10.1111\/jocs.17059","article-title":"Influence of cardioplegic solution on incidence of delirium after CABG surgery: use of Calafiore blood cardioplegia versus HTK\u2014Bretschneider\u2014solution in a single-center retrospective analysis from 2017 to 2021","volume":"37","author":"Irqsusi","year":"2022","journal-title":"J Card Surg"},{"key":"2024012318433431000_ezad424-B59","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1053\/j.jvca.2015.03.022","article-title":"Hemodilution combined with hypercapnia impairs cerebral autoregulation during normothermic cardiopulmonary bypass","volume":"29","author":"\u0160everdija","year":"2015","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2024012318433431000_ezad424-B60","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/0003-4975(94)90987-3","article-title":"Prospective, randomized trial of retrograde warm blood cardioplegia: myocardial benefit and neurologic threat","volume":"57","author":"Martin","year":"1994","journal-title":"Ann Thorac Surg"},{"key":"2024012318433431000_ezad424-B61","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/0003-4975(95)00128-8","article-title":"Cerebral microemboli during coronary artery bypass using different cardioplegia techniques","volume":"59","author":"Baker","year":"1995","journal-title":"Ann Thorac Surg"},{"key":"2024012318433431000_ezad424-B62","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1051\/ject\/201850143","article-title":"Incidence of cerebral microemboli in single-dose vs. multidose cardioplegia in adult cardiac surgery","volume":"50","author":"Mukdad","year":"2018","journal-title":"J Extra Corpor Technol"},{"key":"2024012318433431000_ezad424-B63","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jtcvs.2020.08.098","article-title":"Scavenging right atrial Bretschneider histidine-tryptophan-ketoglutarate cardioplegia: impact on hyponatremia and seizures in pediatric cardiac surgery patients","volume":"162","author":"Turner","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024012318433431000_ezad424-B64","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1093\/icvts\/ivy347","article-title":"Custodiol-N\u2122 cardioplegia lowers cerebral inflammation and activation of hypoxia-inducible factor-1\u03b1","volume":"28","author":"Hoyer","year":"2019","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2024012318433431000_ezad424-B65","doi-asserted-by":"crossref","first-page":"228","DOI":"10.3389\/fphys.2013.00228","article-title":"Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?","volume":"4","author":"Dobson","year":"2013","journal-title":"Front Physiol"},{"key":"2024012318433431000_ezad424-B66","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1093\/ejcts\/ezab466","article-title":"Short-term outcome of adenosine-lidocaine-magnesium polarizing cardioplegia in humans","volume":"61","author":"Francica","year":"2022","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B67","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1177\/0267659116681437","article-title":"Esmolol before cardioplegia and as cardioplegia adjuvant reduces cardiac troponin release after cardiac surgery. A randomized trial","volume":"32","author":"Bignami","year":"2017","journal-title":"Perfusion"},{"key":"2024012318433431000_ezad424-B68","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/S1010-7940(03)00070-8","article-title":"Superior myocardial protection with nicorandil cardioplegia","volume":"23","author":"Steensrud","year":"2003","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B69","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13019-015-0226-9","article-title":"Custodiol-N, the novel cardioplegic solution reduces ischemia\/reperfusion injury after cardiopulmonary bypass","volume":"10","author":"Veres","year":"2015","journal-title":"J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B70","doi-asserted-by":"crossref","DOI":"10.1093\/ejcts\/ezac287","article-title":"Custodiol-N versus Custodiol: a prospective randomized double-blind multicentre phase III trial in patients undergoing elective coronary bypass surgery","volume":"62","author":"Szab\u00f3","year":"2022","journal-title":"Eur J Cardiothorac Surg"},{"key":"2024012318433431000_ezad424-B71","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1161\/01.CIR.87.3.893","article-title":"Regional ischemic \u2018preconditioning\u2019 protects remote virgin myocardium from subsequent sustained coronary occlusion","volume":"87","author":"Przyklenk","year":"1993","journal-title":"Circulation"},{"key":"2024012318433431000_ezad424-B72","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.jcin.2013.05.011","article-title":"Remote ischemic post-conditioning of the lower limb during primary percutaneous coronary intervention safely reduces enzymatic infarct size in anterior myocardial infarction: a randomized controlled trial","volume":"6","author":"Crimi","year":"2013","journal-title":"JACC Cardiovasc Interv"},{"key":"2024012318433431000_ezad424-B73","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1056\/NEJMoa1413534","article-title":"Remote ischemic preconditioning and outcomes of cardiac surgery","volume":"373","author":"Hausenloy","year":"2015","journal-title":"N Engl J Med"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezad424\/54642235\/ezad424.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/64\/6\/ezad424\/56336067\/ezad424.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/64\/6\/ezad424\/56336067\/ezad424.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T13:44:12Z","timestamp":1706017452000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezad424\/7479690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,1]]},"references-count":73,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezad424","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,12,1]]},"published":{"date-parts":[[2023,12,1]]},"article-number":"ezad424"}}