Cardiac reperfusion injury is a well-established outcome following treatment of acute myocardial infarction and other types of ischemic heart conditions. Numerous cardioprotection protocols and therapies have been pursued with success in pre-clinical models. Unfortunately, there has been lack of successful large-scale clinical translation, perhaps in part due to the multiple pathways that reperfusion can contribute to cell death. The search continues for new cardioprotection protocols based on what has been learned from past results. One class of cardioprotection protocols that remain under active investigation is that of controlled reperfusion. This class consists of those approaches that modify, in a controlled manner, the content of the reperfusate or the mechanical properties of the reperfusate (e.g., pressure and flow). This review article first provides a basic overview of the primary pathways to cell death that have the potential to be addressed by various forms of controlled reperfusion, including no-reflow phenomenon, ion imbalances (particularly calcium overload), and oxidative stress. Descriptions of various controlled reperfusion approaches are described, along with summaries of both mechanistic and outcome-oriented studies at the pre-clinical and clinical phases. This review will constrain itself to approaches that modify endogenously-occurring blood components. These approaches include ischemic postconditioning, gentle reperfusion, controlled hypoxic reperfusion, controlled hyperoxic reperfusion, controlled acidotic reperfusion, and controlled ionic reperfusion. This review concludes with a discussion of the limitations of past approaches and how they point to potential directions of investigation for the future.

心脏再灌注损伤是急性心肌梗死和其他类型的缺血性心脏病治疗后公认的结果。许多心脏保护方案和疗法已在临床前模型中取得成功。不幸的是，缺乏成功的大规模临床转化，部分原因可能是再灌注可导致细胞死亡的多种途径。根据从过去的结果中学到的知识，继续寻找新的心脏保护方案。一类仍在积极研究中的心脏保护方案是受控再灌注方案。此类包括以受控方式改变再灌注液的含量或再灌注液的机械性能（例如压力和流量）的那些方法。这篇综述文章首先对细胞死亡的主要途径进行了基本概述，这些途径有可能通过各种形式的受控再灌注来解决，包括无回流现象、离子失衡（特别是钙超载）和氧化应激。描述了各种受控再灌注方法的描述，以及临床前和临床阶段的机械和结果导向研究的总结。这篇综述将把自己限制在修改内源性血液成分的方法上。这些方法包括缺血后处理、温和再灌注、受控低氧再灌注、受控高氧再灌注、受控酸中毒再灌注和受控离子再灌注。