Comparison of Femoral to Radial Artery Pressure during Coronary Artery bypass Graft and Valvular Surgery. |
Young Lan Kwak, Yong Woo Hong, Sou Ouk Bang, Eun Sook Yoo |
1Department of Anesthesiology,Yonsei Cardiovascular Center and Research Institute,Yonsei University Colleage of Medicine, Seoul, Korea. 2Department of Anesthesiology, Kyungpook National University College of Medicine, Taegu, Korea. |
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Abstract |
BACKGROUND It has been known that pressure gradient(PG) between systolic radial arterial pressure(RAP) and systolic aortic pressure(AP) is often altered after cardiopulmonary bypass(CPB). In this study, we compared radial to femoral arterial pressure(FAP) difference between valve replacement(VR) group(n=189) and coronary artery bypass graft (CABG) group(n=90). METHODS With IRB approval, anesthesia management followed the standard method for cardiac surgery. Heart rate, RAP, FAP, cardiac index(CI), forearm skin temperature, hematocirt and systemic vascular resistance index(SVRI) were recorded at before-CPB, after-CPB and after sternal closure. RESULTS In CABG group, there was no change of PG between RAP and FAP before and after CPB. In VR group, systolic RAP was similar with FAP before CPB but the radial-femoral arterial pressure gradient was reversed with statistical significance after bypass. Compare with CAGB group, change of pressure gradient after CPB cousiderded statistical significant in valve replacement group. CI was increased and SVRI was decreased with statistical significance. CONCLUSION In our study, patients in VR group who demonstrated high CI and low SVRI showed reversal of PG upon cessation of CPB. Reversal of PG at post-CPB probably partially depends on the degree of systemic vasodilation upon discontinuation of CPB. |
Key Words:
Monitoring blood pressure; Surgery coronary artery bypass graft valvular replacement |
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