Cardiopulmonary bypass and cardioplegia

This chapter describes the history and techniques of cardiopulmonary bypass, an intervention that excludes the heart from the general circulation and leaves it empty in order to accommodate cardiac surgical intervention. Since its first use nearly 70 years ago, cardiopulmonary bypass has evolved to become a highly sophisticated and reliably performed procedure. The near future promises additional improvements as research and innovation continue to make cardiac operations safer. With the advent of longer and more complex cardiac operations, surgeons became increasingly interested in finding ways to protect the heart during the period of induced cardiac arrest, via infusion of cold perfusates into the coronary circulation (i.e., cardioplegia). Therefore, this chapter further reviews various cardioplegia solutions, and their use as an adjunct to cardiopulmonary bypass.