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Hemodynamic Changes and their Management during off Pump Coronary Artery bypass: An Observational study

Sambhunath Das, Krithika K.G.

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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

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Journal of Cardiovascular Medicine and Surgery 9(3-4):p 49-54, July-December 2023. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.93-423.2

How Cite This Article:

Krithika KG, Das S. Hemodynamic changes and their management during off pump coronary artery bypass: an observational study. J Cardiovasc Med Surg. 2023;9(3-4):49–54.

Timeline

Received : March 08, 2023         Accepted : March 15, 2023          Published : December 30, 2023

Abstract

Background: Coronary artery bypass grafting (CABG) without cardiopulmonary bypass is one of the alternative with an intention to avoid all the complications related to extracorporeal circulation. Off pump CABG (OPCABG) is associated with various hemodynamic alterations and its management is really challenging. Methodology: The objective of our case series is to study the hemodynamic changes during each artery grafting, its complications and its management. In this study we have studied 27 patients who underwent OPCABG. Heartrate, blood pressure and cardiac output were measured during each grafting and analyzed. The major complications that occurred and its management are discussed. Result: The heartrate and blood pressure significantly decreased during LAD, OM and RCA grafting compared to the baseline. The cardiac output decreased significantly during OM and RCA grafting. One patient had intra-operative myocardial ischemia. One patient had cardiac arrest in the ICU followed by LAD and LCX graft revision. Two patients had increased post-op bleeding and taken for re-exploration. Conclusion: Hemodynamic management of OPCABG is always challenging but feasible to manage. All the patients tolerated the hemodynamic changes well and had a good postoperative outcome.

References

  • 1.   Tempe DK, Gandhi A. Time for judicious application of off-pump CABG. Journal of Cardiothoracic and Vascular Anesthesia. 2023; 37(1): 6-7.
  • 2.   Couture P, Denault A, Limoges P, Sheridan P, Babin D, Cartier R. Mechanisms of hemodynamic changes during off-pump coronary artery bypass surgery. Canadian Journal of Anesthesia. 2002; 49(8): 835.
  • 3.   Shim JK, Kim KS, Couture P, Denault A, Kwak YL, Yoo KJ, Youn YN. Hemodynamic management during off-pump coronary artery bypass surgery: a narrative review of proper targets for a safe conduct and trouble shootings. Korean Journal of Anesthesiology. 2023; 76(4): 267-279.
  • 4.   Do QB, Goyer C, Chavanon O, Couture P, Denault A, Cartier R. Hemodynamic changes during offpump CABG surgery. European journal of cardiothoracic surgery. 2002; 21(3): 385-90.
  • 5.   Carvalho AR, Guizilini S, Murai GM, Begot I, Rocco IS, Hossne Jr NA, Chamlian EG, Santos JM, Macedo RA, Lisboa GC, Nasciutti AC. Hemodynamic changes during heart displacement in aorta notouch off-pump coronary artery bypass surgery: a pilot study. Brazilian Journal of Cardiovascular Surgery. 2018; 33: 469-75

Data Sharing Statement

There are no additional data available

Funding

This research received no funding

Author Contributions

All authors contributed significantly to the work and approve its publication

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval

Acknowledgements

Information Not Provided

Conflicts of Interest

No conflicts of interest in this work.

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Cite this article

Krithika KG, Das S. Hemodynamic changes and their management during off pump coronary artery bypass: an observational study. J Cardiovasc Med Surg. 2023;9(3-4):49–54.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator

Received Accepted Published
March 08, 2023 March 15, 2023 December 30, 2023
DOI: http://dx.doi.org/10.21088/jcms.2454.7123.93-423.2

Keywords

Hemodynamic changesOff pump coronary artery bypassCoronary artery diseaseCardiac stabilisersCell saverinotropes

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Timeline

Received March 08, 2023
Accepted March 15, 2023
Published December 30, 2023

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator


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