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Impact of off-pump coronary artery surgery on myocardial performance and beta-adrenoceptor function

N Eldrup1, N H Rasmussen, S Yndgaard

  • 1Department of Anesthesiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.

Journal of Cardiothoracic and Vascular Anesthesia
|August 16, 2001
PubMed

Insights

Off-pump coronary artery bypass surgery causes temporary hemodynamic changes in major coronary arteries. Cardiovascular beta-adrenoceptor function remains stable, unlike with cardiopulmonary bypass surgery.

Area of Science:

  • Cardiovascular Anesthesia
  • Cardiac Surgery
  • Hemodynamics

Background:

  • Off-pump coronary artery bypass (OPCAB) surgery is an alternative to traditional bypass surgery.
  • Understanding hemodynamic changes and beta-adrenoceptor function during OPCAB is crucial for patient management.

Purpose of the Study:

  • To assess hemodynamic alterations during OPCAB surgery on the left anterior descending, circumflex, and right coronary arteries.
  • To evaluate cardiovascular beta-adrenoceptor function before and after OPCAB surgery.

Main Methods:

  • Prospective study in a university cardiothoracic anesthesia department.
  • Twenty patients undergoing OPCAB surgery using the Octopus 2 stabilizer system.
  • Isoproterenol administration to monitor beta-receptor function pre- and post-surgery.

Main Results:

  • Temporary decreases in stroke volume and cardiac index were observed during revascularization of all three major coronary arteries.
  • Hemodynamic variables returned to baseline within 5 minutes after releasing the heart.
  • No significant changes in hemodynamic responses to isoproterenol were detected post-surgery.

Conclusions:

  • Hemodynamic changes during OPCAB surgery on major coronary arteries are transient and similar.
  • Cardiovascular beta-adrenoceptor function is not impaired after OPCAB surgery.
  • This contrasts with impaired beta-adrenoceptor function observed after surgery with cardiopulmonary bypass.
Abstract

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