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Beta-blockade in 200 coronary bypass grafting procedures
F Kuhn-Régnier1, H J Geissler, S Marohl
1Department of Cardiothoracic Surgery University of Cologne; Cologne, Germany. Ferdinand.Kuhn-Regaier@medizin.uni-koeln.de
The Thoracic and Cardiovascular Surgeon
|June 22, 2002
Summary
Continuous high-dose beta-blocker (esmolol) perfusion during coronary artery bypass grafting (CABG) offers myocardial protection. This safe and effective technique is particularly beneficial for high-risk patients undergoing CABG.
Area of Science:
- Cardiology
- Cardiac Surgery
- Pharmacology
Background:
- Continuous perfusion with high-dose beta-blocker (esmolol)-enriched blood is an alternative for myocardial protection during coronary artery bypass grafting (CABG).
- This study reports on the application of this technique in 200 unselected consecutive cases.
Purpose of the Study:
- To evaluate the safety and efficacy of continuous high-dose esmolol perfusion for myocardial protection during CABG.
- To assess outcomes in a large cohort of unselected patients undergoing CABG with this technique.
Main Methods:
- 200 patients undergoing CABG with continuous esmolol infusion.
- Induction of a slow hypocontractile beating heart using esmolol (788 +/- 20 mg per operation).
- Normothermic cardiopulmonary bypass with an aortic cross-clamp time of 52 +/- 1.2 min and 2.9 +/- 0.1 distal anastomoses performed.
Main Results:
- Postoperative ventilation: 25 +/- 5.1 hours; ICU stay: 2.3 +/- 0.3 days.
- Postoperative myocardial infarction rate: 4%.
- Hospital stay: 11.2 +/- 0.4 days; 30-day mortality: 2.5%; 3-month mortality: 3%.
Conclusions:
- High-dose beta-blockade via continuous esmolol perfusion is a safe and effective strategy in CABG.
- This technique demonstrates particular advantages for high-risk patient populations undergoing CABG.