Continuous Procedural Full-Lung Ventilation During Minimally Invasive Coronary Bypass Grafting.

Area of Science:

• Cardiothoracic Surgery
• Minimally Invasive Procedures
• Respiratory Physiology

Background:

• Minimally invasive cardiac surgery-coronary artery bypass graft (MICS-CABG) offers reduced invasiveness and excellent outcomes.
• Patients with reduced lung function pose challenges for MICS-CABG due to single-lung ventilation requirements.

Purpose of the Study:

• To introduce and evaluate the feasibility of the "fan technique" for continuous full-lung ventilation during MICS-CABG.
• To assess the impact of the fan technique on respiratory parameters in MICS-CABG patients.

Main Methods:

• A novel "fan technique" was developed to allow continuous full-lung ventilation.
• Intraoperative ventilation measurements were analyzed in 22 consecutive MICS-CABG patients using the fan technique.

Main Results:

• The fan technique demonstrated significant improvements in ventilation pressure, respiratory rate, minute volume, and Pao2 compared to conventional single-lung ventilation.
• Specifically, ventilation pressure decreased (21.4 vs 26.6 mbar), minute volume increased (7.4 vs 6.2 L/min), and Pao2 significantly improved (294.9 vs 153.2 mm Hg).

Conclusions:

• The fan technique facilitates MICS-CABG in patients with compromised pulmonary function, previously unsuitable for single-lung ventilation.
• This technique holds potential as a standard procedure for MICS-CABG, particularly for complex multivessel revascularizations.
• Further research is needed to determine the impact on postoperative pulmonary complications and clinical outcomes.