| Intraoperative Management of Patients Undergoing Off-pump Coronary Artery Bypass Graft Using the Tissue Stabilizer. |
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Ji Hee Hong, Sung Wook Han, Jin Mo Kim, Ae Ra Kim |
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Department of Anesthesiology, Keimyung University School of Medicine, Daegu, Korea. |
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| Abstract |
BACKGROUND
Coronary artery bypass graft with cardiopulmonary bypass is the standard surgical coronary revascularization procedure; however, there are many adverse effects such as air embolism, and high rate of neurologic and coagulation complications. In this article, we describe hemodynamic alterations during coronary bypass grafting (CABG) without cardiopulmonary bypass but using a medical tissue stabilizer.
METHODS
Thirty patients were included in our study who underwent an off-pump CABG (OPCAB) between 1/1999 and 12/1999.
RESULTS
We created 73 anastomoses. Movement of the heart to reach the target site of anastomosis caused hemodynamic alterations. These could be corrected by anesthetic interventions such as fluid load and low dose inotropics. Complications included postoperative panperitonitis (one patient), and delirium tremens (one patient).
On the other hand, major complications, such as intraoperative myocardial infarction and stroke did not occur. The median postoperative length of hospital stay was 14 days. Overall operative mortality was 3.3% (one patient).
CONCLUSIONS
On the basis of the present data, off-pump coronary artery bypass grafting appeared to be a safe and effective technique in selected patients with appropriate coronary lesions. Off-pump CABG surgery requires anesthetic interventions because hemodynamic alterations are caused by the presentation of the heart to the surgeon. |
| Key Words:
Anesthesia: cardiac; Equipment: tissue stabilizer; Surgery: off-pump coronary artery bypass graft |
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