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Updated: May 15, 2026
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Effect of on-pump versus off-pump coronary bypass surgery on cardiac function assessed by intraoperative
K Sochon1, B Sobkowicz, A Lewczuk
1Department of Anesthesiology, Medical University of Bialystok, Bialystok, Poland.
Insights
Cardiac function assessed by transesophageal echocardiography showed no significant differences between on-pump and off-pump cardiac revascularization. Biomarker levels were higher in the on-pump group, indicating myocardial strain.
Area of Science:
- Cardiovascular Surgery
- Cardiac Anesthesia
- Echocardiography
Background:
- Cardiac revascularization can be performed with or without cardiopulmonary bypass (on-pump vs. off-pump).
- Intraoperative assessment of cardiac function is crucial for patient outcomes.
Purpose of the Study:
- To compare cardiac function using intraoperative transesophageal echocardiography in patients undergoing on-pump versus off-pump cardiac revascularization.
- To evaluate differences in myocardial strain markers between the two surgical approaches.
Main Methods:
- Prospective analysis of 41 elective cardiac revascularization patients (21 on-pump, 20 off-pump), matched for key variables.
- Intraoperative transesophageal echocardiography assessed left and right ventricular function.
- Troponin I and C-reactive protein levels were measured postoperatively.
Main Results:
- No significant differences in echocardiographic parameters of left and right ventricular function were observed between on-pump and off-pump groups.
- Troponin I and C-reactive protein concentrations were significantly higher in the on-pump group compared to the off-pump group.
Conclusions:
- Intraoperative echocardiography reveals comparable cardiac performance between on-pump and off-pump cardiac revascularization in elective cases.
- The on-pump technique may be associated with greater myocardial strain, as indicated by elevated biomarkers.
Purpose:
To compare cardiac function assessed by intraoperative transesophageal echocardiography in patients undergoing cardiac revascularization with or without cardiopulmonary bypass.
Material And Methods:
Forty-one patients scheduled for elective, isolated cardiac revascularization (21 on-pump and 20 off-pump) were prospectively analyzed. Patients were matched for demographic (age and gender), anthropometric (BMI), clinical (co-morbidities, EuroScore) and laboratory variables (blood counts, renal function, left ventricular function). Transesophageal echocardiography was performed after induction of anesthesia, protamine sulfate administration, and chest closure. Left ventricular wall motion score index, end-diastolic area, fractional area change, right ventricular area change and end-diastolic area were assessed. Troponin I and C-reactive protein concentrations were measured.
Results:
Regarding echocardiographic parameters of left and right ventricular function no significant differences between on-pump and off-pump groups at any point-of-time measurements were found. Troponin I and C-reactive protein were higher in on-pump as compared to off-pump group (p=0.001 and p=0.002; p=0.003 and p=0.001, respectively).
Conclusions:
In elective patients scheduled for cardiac revascularization there were no difference in cardiac performance assessed by intraoperative echocardiography regardless of surgical method used.
