[Hemodynamic features during coronary bypass surgery on the working heart]

Area of Science:

• Cardiology
• Anesthesiology
• Cardiovascular Surgery

Background:

• Coronary bypass surgery (CBS) involves complex physiological changes.
• Anesthesia with propofol and fentanyl is commonly used.
• Working heart surgery aims to minimize cardiopulmonary bypass effects.

Purpose of the Study:

• To assess hemodynamic and blood oxygen transport during working heart CBS.
• To compare myocardial damage between conventional and perfusionless CBS.
• To evaluate the early postoperative recovery with perfusionless technology.

Main Methods:

• Hemodynamic monitoring (cardiac index, stroke volume).
• Blood oxygen transport function assessment.
• Biomarker analysis (troponin-T, creatinine kinase-MB).
• Comparison of conventional cardiopulmonary bypass (CPB) versus perfusionless techniques.

Main Results:

• Working heart surgery caused moderate, transient reductions in cardiac index and stroke volume.
• Oxygen transport function remained adequate despite hemodynamic changes.
• Perfusionless CBS demonstrated less myocardial damage compared to CPB.
• Perfusionless techniques led to reduced inotropic support, shorter ventilation times, and shorter ICU stays.

Conclusions:

• Working heart CBS under propofol/fentanyl anesthesia is hemodynamically tolerable with preserved oxygen transport.
• Perfusionless technology in CBS offers myocardial protection and facilitates faster patient recovery.
• Minimally invasive approaches in cardiac surgery are beneficial for postoperative outcomes.