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

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ID Serval
serval:BIB_D989D3AEFD05
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Hemodynamics optimization during off-pump coronary artery bypass: the 'no compression' technique
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur⸱e⸱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)
Statut éditorial
Publié
Date de publication
08/2002
Volume
22
Numéro
2
Pages
249-54
Notes
Journal Article --- Old month value: Aug
Résumé
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.
Mots-clé
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
Oui
Création de la notice
28/01/2008 10:43
Dernière modification de la notice
14/02/2022 7:57
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