The implementation of cardioprotective strategies involving pre-, intra-, and postoperative
interventions is key during cardiac surgery requiring extracorporeal circulation (ECC). The primary goal
of this study was to review the physiopathology and protection strategies against myocardial damage
secondary to ECC during cardiac surgery. The administration halogenated anesthetics for cardiac
anesthesia is common place due to their well-known cardioprotective effects and their capacity to ensure
hypnosis. An optimal myocardial protection strategy requires that a comprehensive approach should be
adopted to cover pre-, intra-, and post-operative interventions. Pre-conditioning and post-conditioning
share numerous pathways, mainly based on mitochondrial signaling, antiapoptotic pathways, and reduced
inflammatory mediators. However, volatile anesthetic can also be administered during ECC, in which
mechanism of action has been scantly investigated, during this period and its biology is still unknown.
Keywords: Preconditioning, postconditioning, extracorporeal circulation, hypnotic agents, cardioprotection, cardiac surgery.
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