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BioMed Research International
Volume 2014 (2014), Article ID 678268, 11 pages
Review Article

Normoxic and Hyperoxic Cardiopulmonary Bypass in Congenital Heart Disease

Amir Mokhtari1,2,3 and Martin Lewis1,4,5

1Bristol Heart Institute, University of Bristol, Bristol BS2 8HW, UK
2Department of Cardiology, School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol BS10 5NB, UK
3Department of Cardiac Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK
4Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, UK
5School of Clinical Sciences, University of Bristol, 69 St Michael’s Hill, Bristol BS2 8DZ, UK

Received 30 June 2014; Accepted 4 August 2014; Published 18 September 2014

Academic Editor: M.-S. Suleiman

Copyright © 2014 Amir Mokhtari and Martin Lewis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cyanotic congenital heart disease comprises a diverse spectrum of anatomical pathologies. Common to all, however, is chronic hypoxia before these lesions are operated upon when cardiopulmonary bypass is initiated. A range of functional and structural adaptations take place in the chronically hypoxic heart, which, whilst protective in the hypoxic state, are deleterious when the availability of oxygen to the myocardium is suddenly improved. Conventional cardiopulmonary bypass delivers hyperoxic perfusion to the myocardium and is associated with cardiac injury and systemic stress, whilst a normoxic perfusate protects against these insults.