Intermittent, partial occlusion of inferior vena cava for hemodynamic stabilization during OPCAB procedures with left...

Off-pump coronary artery bypass (OPCAB) grafting has gained popularity as a technique for coronary bypass. Technical challenges exist for patients with left ventricular (LV) dysfunction while grafting the lateral wall vessels. This group of patients commonly present with varying mitral regurgitation which worsens with positioning of the heart for graft construction. High doses of inotropes, fluid challenges, or intra-aortic balloon pump (IABP) are needed to maintain hemodynamic stability during the procedure. We present a novel technique of intermittent, partial occlusion of inferior vena cava (IVC) to achieve hemodynamic stability during graft construction without high dose of inotropes or IABP.