The intent of this chapter was to outline the principles of ischemia and reperfusion injury and introduce the concept of cardioprotection. Although the intent of many of the past cardioprotective therapies was to protect the myocardium from ischemic necrosis, it may be that reperfusion injury following ischemia in the forms of stunning, arrhythmias, or additional cellular necrosis may occur despite such cardiopro-tective efforts. Therefore, as a new era in the operating room and catheterization laboratories evolves and allows for surgery on patients in poorer health, it is imperative that current myocardial protective strategies again be rigorously enhanced to counter the potential increased risks of ischemia and reperfusion injuries in such populations.

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