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Hemodynamic changes during off-pump CABG surgery.

Quoc-Bao Do1, Caroline Goyer, Olivier Chavanon

  • 1Department of Surgery, Montreal Heart Institute, Quebec, Montreal, Canada.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|March 13, 2002
PubMed
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Off-pump coronary artery bypass graft (OPCABG) surgery causes significant hemodynamic changes, including blood pressure fluctuations and decreased cardiac output. These changes were well tolerated by patients, suggesting adaptability during the procedure.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Intensive Care Medicine

Background:

  • Off-pump coronary artery bypass graft (OPCABG) surgery is a complex procedure requiring careful hemodynamic monitoring.
  • Understanding hemodynamic responses during OPCABG is crucial for patient safety and optimal surgical outcomes.

Purpose of the Study:

  • To assess hemodynamic changes in patients undergoing off-pump coronary artery bypass graft (OPCABG) surgery.
  • To evaluate the impact of surgical manipulations on systemic arterial pressure, pulmonary arterial pressure, oxygen saturation, and cardiac output.

Main Methods:

  • Continuous monitoring of systemic arterial pressure (SAP), pulmonary arterial pressure (PAP), mixed venous oxygen saturation (SvO(2)), and cardiac output index (COI) in 55 patients.
  • Hemodynamic parameters were recorded at specific points during OPCABG surgery and compared to baseline values.

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Main Results:

  • Significant drops in SAP and increases in PAP were observed across different coronary territories during surgical manipulations.
  • Cardiac output index (COI) showed significant variations, particularly during anterior territory manipulations.
  • Mixed venous oxygen saturation (SvO(2)) changes were minimal and reached only borderline significance.

Conclusions:

  • Manipulation of the beating heart during OPCABG surgery induces significant hemodynamic fluctuations.
  • Increased mean PAP and decreased COI during anterior territory manipulation suggest potential diastolic restrictive disease.
  • The observed hemodynamic changes were generally well-tolerated by the patient cohort.