Ischemia and Cardiopulmonary Bypass (CPB) Complications

• Clinical ischemia before cardiopulmonary bypass (CPB) is a common complication in patients with acute coronary syndromes.
• In most cases, ischemia is active in both the distribution of the principally involved artery (cardiologists call this the “infarct artery”) but also distributions in which preexistent collateral flow may be compromised.
• Patients referred for bypass surgery in these circumstances almost always have multi-vessel disease patterns making the myocardial substrate dangerous from the standpoint of the severity and duration of the syndrome, which can be extremely difficult if not impossible to determine.
• Reperfusion and reoxygenation injury occur when these conditions change abruptly before effective measures are implemented.

Explore the complications of clinical ischemia before cardiopulmonary bypass (CPB), including reperfusion and reoxygenation injury. Understand the challenges in determining the severity and duration of the syndrome in patients with multi-vessel disease patterns.