Circulatory support after coronary artery surgery

An important change in the pattern of pharmacologic and mechanical circulatory support following coronary artery surgery has been noted in Newfoundland. The authors studied two groups of patients: group 1, 119 patients who underwent coronary artery bypass procedures from 1975 to 1978 and group 2, 344 similar patients studied from 1979 to 1982. Both groups of patients had similar left ventricular function and similar numbers of grafts per patient were inserted (group 1, 2.6; group 2, 2.8). There was a great reduction in the need for perioperative circulatory support (group 1, 34%; group 2, 6%), associated with a notable reduction in the rate of myocardial infarction perioperatively (group 1, 24%; group 2, 4.9%). This improvement resulted from the routine use of invasive hemodynamic monitoring and cold blood cardioplegia in group 2 patients.