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Related Experiment Videos

Right ventricular function after coronary surgery with or without bypass.

Michel Durand1, Olivier Chavanon, Yannick Tessier

  • 1Department of Anaesthesia, Grenoble University Hospital, Grenoble, France. MDurand@chu-grenoble.fr

Journal of Cardiac Surgery
|January 24, 2006
PubMed
Summary

Off-pump cardiac surgery better protects the right ventricle during coronary artery bypass surgery in patients with severe right coronary stenosis. This approach maintained right ventricular ejection fraction, unlike on-pump surgery.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Anesthesia
  • Cardiothoracic Surgery

Background:

  • Myocardial protection during aortic clamping can be insufficient, particularly for the right ventricle.
  • Right ventricular dysfunction is a concern in cardiac surgery patients.

Purpose of the Study:

  • To compare right ventricle function in patients undergoing cardiac surgery with or without cardiopulmonary bypass.
  • To evaluate the impact of on-pump versus off-pump coronary artery bypass grafting on right ventricular protection.

Main Methods:

  • A prospective observational cohort study included 29 patients with multivessel coronary artery disease and severe right coronary lesions.
  • Pulmonary artery catheterization monitored continuous right ventricular function.
  • Right ventricular ejection fraction was assessed at multiple time points post-operatively.

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Main Results:

  • The on-pump group received more grafts (4.0 ± 1.3) than the off-pump group (2.6 ± 0.6).
  • Right ventricular ejection fraction significantly decreased in the on-pump group (32.9% to 26.1%) but remained stable in the off-pump group (32.4% to 31.9%).
  • Central venous pressure was significantly lower in the off-pump group.

Conclusions:

  • Off-pump coronary artery bypass surgery appears to offer superior right ventricular protection in patients with severe right coronary stenosis.
  • This finding suggests potential benefits of off-pump techniques for preserving right ventricular function in specific patient populations.