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

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Hemodynamic changes during myocardial revascularization without extracorporeal circulation.

Silvia Minhye Kim¹, Luiz Marcelo Sá Malbouisson, José Otávio Costa Auler

¹Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, Brazil. silviakim@hotmail.com

Revista Brasileira De Anestesiologia

|July 5, 2011

Summary

Cardiac stabilization during myocardial revascularization without extracorporeal circulation (ECC) causes hemodynamic changes. Cardiac output decreased, particularly in the lateral wall group, indicating potential risks during surgery.

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Area of Science:

Cardiovascular Surgery
Anesthesiology
Cardiology

Background:

Myocardial revascularization without extracorporeal circulation (ECC) involves cardiac manipulation that may alter hemodynamics.
Hemodynamic changes during surgery can be site-dependent, necessitating careful monitoring.

Purpose of the Study:

To evaluate hemodynamic changes during distal coronary anastomosis in patients undergoing myocardial revascularization without ECC.
To assess the impact of cardiac positioning and stabilization on hemodynamic parameters based on coronary artery location.

Main Methods:

Twenty adult patients undergoing myocardial revascularization without ECC were monitored using pulmonary artery catheter and transesophageal Echo Doppler.
Hemodynamic data were collected at three time points during distal anastomosis.
Statistical analysis included two-way ANOVA with repetition and Newman-Keuls post-test.

Main Results:

Pulmonary artery wedge pressure and central venous pressure significantly increased during the procedure.
Overall cardiac output decreased significantly.
Transesophageal Doppler revealed a significant reduction in cardiac output and aortic blood flow specifically in the lateral wall group.

Conclusions:

Myocardial revascularization without ECC is associated with significant hemodynamic deterioration.
Cardiac output reduction is localized to the lateral wall group, highlighting the importance of surgical site in hemodynamic impact.