Hemodynamics optimization during off-pump coronary artery bypass: the 'no compression' technique

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Serval ID
serval:BIB_D989D3AEFD05
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Hemodynamics optimization during off-pump coronary artery bypass: the 'no compression' technique
Journal
European Journal of Cardio-Thoracic Surgery
Author(s)
Mueller  X. M., Chassot  P. G., Zhou  J., Eisa  K. M., Chappuis  C., Tevaearai  H. T., von Segesser  L. K.
ISSN
1010-7940 (Print)
Publication state
Published
Issued date
08/2002
Volume
22
Number
2
Pages
249-54
Notes
Journal Article --- Old month value: Aug
Abstract
OBJECTIVE: Heart manipulation during OPCAB may cause hemodynamical instability in particular for access to the posterior and lateral walls. The 'no compression' technique involves enucleation of the heart without any compression on the cavities, and stabilization of the target area with a suction device. The impact of this technique on hemodynamics is assessed. METHODS: In order to analyze a homogeneous group, 26 consecutive patients with triple grafts, one to each side of the heart in the same sequential order (posterior, lateral and anterior wall successively) were selected. Heart rate (HR), mean pulmonary arterial pressure (PAP, mmHg), pulmonary capillary wedge pressure (PCWP, mmHg), mean arterial pressure (MAP, mmHg), cardiac output index (COI, l/min per m(2)), and central venous saturation (SvO(2),%) were monitored. A coronary shunt was used for all the anastomoses. RESULTS: HR was stable with baseline value of 60+/-10 and the highest value for the anterior wall, 63.6+/-8 (P=0.23). PAP and PCWP exhibited their highest increase, when compared with baseline, for the lateral wall, 23.9+/-4.7 vs. 20.7+/-6.2 (P=0.06), and 17.2+/-4.7 vs. 14.9+/-5.6 (P=0.16), respectively. MAP, COI and SvO(2), exhibited their largest drop, when compared with baseline, for the lateral wall too, 73.1+/-9.1 vs. 77.1+/-7.5 (P=0.12), 1.99+/-0.47 vs. 2.26+/-0.55 (P=0.09), and 70.5+/-8.4 vs. 74.8+/-9.3 (P=0.12), respectively. CONCLUSIONS: None of the hemodynamical parameter differed significantly from baseline value for all three territories. While hemodynamics was perfectly maintained during the posterior and anterior walls revascularization, exposure of the lateral wall led to marginal changes only.
Keywords
Aged Cardiopulmonary Bypass/methods *Coronary Artery Bypass Female Hemodynamic Processes/*physiology Humans Intraoperative Care Male Middle Aged Monitoring, Intraoperative
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 10:43
Last modification date
25/09/2019 6:10
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