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Change in right ventricular function during off-pump coronary artery bypass graft surgery

Authors
 Y.L. Kwak  ;  Y.J. Oh  ;  Y.W. Hong  ;  J.H. Lee  ;  K.J. Yoo  ;  S.M. Jung 
Citation
 EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol.25(4) : 572-577, 2004 
Journal Title
 EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY 
ISSN
 1010-7940 
Issue Date
2004
MeSH
Aged ; Cardiopulmonary Bypass ; Coronary Artery Bypass/methods* ; Female ; Hemodynamics ; Humans ; Intraoperative Period ; Male ; Middle Aged ; Monitoring, Intraoperative/methods ; Prospective Studies ; Stroke Volume ; Thermodilution ; Ventricular Function, Right/physiology*
Keywords
Off-pump coronary artery bypass grafting ; Right ventricular ejection fraction ; Thermodilution pulmonary artery catheter ; Right heart function
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.
Full Text
http://ejcts.oxfordjournals.org/content/25/4/572.long
DOI
10.1016/j.ejcts.2004.01.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Lee, Jong Wha(이종화)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111175
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