Related Experiment Video

Updated: Jul 11, 2026

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
05:25

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft

Published on: September 15, 2023

Anaesthetic considerations for noncoronary surgery on a perfused beating heart under cardiopulmonary bypass

Akhlesh S Tomar1, Amit Banerjee, Kunal Hazari

  • 1Department of Anaesthesiology, Govind Ballabh Pant Hospital, New Delhi, India.

Annals of Cardiac Anaesthesia
|September 25, 2007
PubMed

Insights

Performing open heart surgery on a beating heart for non-coronary conditions avoids cardioplegic myocardial injury. This technique under cardiopulmonary bypass offers a safe and effective alternative to traditional methods.

Area of Science:

  • Cardiac Surgery
  • Anesthesiology
  • Cardiopulmonary Bypass

Background:

  • Myocardial revascularization on a beating heart reduces cardioplegic injury.
  • Non-coronary open heart surgery traditionally involves cardioplegic arrest.
  • Beating heart surgery offers potential myocardial protection.

Purpose of the Study:

  • To evaluate the anesthetic management and outcomes of non-coronary open heart surgery performed on a beating heart under cardiopulmonary bypass.
  • To assess the feasibility and safety of maintaining myocardial function during cardiopulmonary bypass for non-coronary procedures.

Main Methods:

  • Thirty-three patients (aged 14-56) underwent non-coronary open heart surgery on a beating heart with cardiopulmonary bypass.
  • Procedures included mitral valvotomy, mitral valve replacement, atrial septal defect repair, and left atrial myxoma removal.
  • Anesthetic management focused on maintaining the beating state via electrolyte balance, perfusion pressure, and ST monitoring; trans-esophageal echocardiography was used.

Main Results:

  • All patients were successfully weaned from cardiopulmonary bypass without defibrillation or significant inotropic support.
  • No operative mortality was observed.
  • Continuous coronary perfusion via aortic root needle maintained myocardial function during aortic cross-clamping.

Conclusions:

  • Open heart surgery on a beating heart for non-coronary conditions is a viable and reproducible option.
  • This approach effectively protects the myocardium from the adverse effects of cardioplegic arrest.
  • Careful anesthetic management is crucial for successful outcomes in beating heart non-coronary surgery.

More Related Videos

Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism09:10

Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism

Published on: January 12, 2019

Non-Intubated Video-Assisted Thoracoscopic Surgery05:39

Non-Intubated Video-Assisted Thoracoscopic Surgery

Published on: May 26, 2023

Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...