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Change in right ventricular function during off-pump coronary artery bypass graft surgery
- Source :
- European Journal of Cardio-Thoracic Surgery. 25:572-577
- Publication Year :
- 2004
- Publisher :
- Oxford University Press (OUP), 2004.
-
Abstract
- Objectives: Hemodynamic derangement during displacement of beating heart in off-pump coronary artery bypass graft (OPCAB) surgery might be related with right ventricular (RV) dysfunction. We evaluated RV function and hemodynamic alterations using a thermodilution pulmonary artery catheter. Methods: The study included 30 patients undergoing OPCAB, using single pericardial suture and tissue stabilizer. A thermodilution pulmonary artery catheter for continuous monitoring of the cardiac output (CO), right ventricular ejection fraction (RVEF) and RV volume was inserted before anesthesia. The hemodynamic variables were measured after the induction of anesthesia, 5 min after the heart was positioned for each coronary anastomosis and after the sternum was closed. Results: There was no significant change in the RVEF and cardiac index during anastomosis of the left anterior descending artery and right coronary artery. However, the significantly reduced RVEF accompanied by an increase in RV afterload and decrease in the CO was observed during anastomosis of the obtuse marginal (OM) artery. RV volumes did not significantly change during anastomoses, though the right atrial pressure increased during anastomoses of all coronary arteries. Conclusions: The displacement of beating heart for positioning during anastomosis of the graft to OM artery caused significant derangement of RV function and decrease in CO. A thermodilution catheter continuously measuring the CO and RVEF was useful to monitor the change in RV function and volume during OPCAB. q 2004 Elsevier B.V. All rights reserved.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Cardiac output
medicine.medical_treatment
Thermodilution
Intraoperative Period
Surgical anastomosis
Monitoring, Intraoperative
medicine.artery
Internal medicine
Humans
Medicine
Prospective Studies
Coronary Artery Bypass
Aged
Off-pump coronary artery bypass
Cardiopulmonary Bypass
business.industry
Hemodynamics
Pulmonary artery catheter
Central venous pressure
Stroke Volume
General Medicine
Middle Aged
Surgery
Coronary arteries
medicine.anatomical_structure
Right coronary artery
Anesthesia
Pulmonary artery
Ventricular Function, Right
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 10107940
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- European Journal of Cardio-Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....6020155a641fe150a00c10df91b2a06f