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Thromboelastography in off-pump coronary artery bypass grafting
Sushil Kumar Singh1, Vijayant Devenraj2, Vivek Tewarson2
1Department of Cardiothoracic and Vascular Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India doctorsushil@hotmail.com.
Asian Cardiovascular & Thoracic Annals
|November 14, 2014
Summary
Thromboelastography (TE) reliably predicts blood loss after off-pump coronary artery bypass surgery. Higher maximum amplitude values on TE correlate with reduced blood loss, aiding in patient risk assessment.
Area of Science:
- Cardiovascular Surgery
- Hemostasis and Thrombosis
- Point-of-Care Diagnostics
Background:
- Thromboelastography (TE) offers comprehensive clot analysis.
- Limited guidelines exist for TE use in off-pump coronary artery bypass (OPCAB).
- Previous studies focused on TE in on-pump cardiac surgery.
Purpose of the Study:
- To evaluate the utility and relevance of TE post-OPCAB.
- To assess TE's predictive value for blood loss in OPCAB patients.
Main Methods:
- Prospective study of 55 patients undergoing OPCAB.
- Bedside TE investigations performed in the ICU.
- Analysis of TE parameters in relation to postoperative blood loss.
Main Results:
- Significant association between maximum amplitude and total blood loss (p < 0.001).
- Increasing maximum amplitude correlated with decreased blood loss.
- A maximum amplitude cutoff of <49.63 mm predicted >500 mL blood loss with 100% sensitivity and 89.3% specificity.
Conclusions:
- TE parameters reliably correlate with increased blood loss in OPCAB.
- TE can predict patients needing blood transfusion.
- TE may identify patients at risk of hypercoagulable states.
