Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2021; 18 (3): 181-256 ➤ Центральная гемодинамика при операциях реваскуляризации коронарных артерий без искусственного кровообращения

Central hemodynamics in coronary artery revascularization operations without cardiopulmonary bypass

Authors: Khinchagov D.Ya., Rybka M.M.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2021-18-3-201-211

UDC: 616.127-089.168:616.12-005.4-052

Link: Clinical Physiology of Blood Circulaiton. 2021; 3 (18): 201-211

Quote as: Khinchagov D.Ya., Rybka M.M. Central hemodynamics in coronary artery revascularization operations without cardiopulmonary bypass. Clinical Physiology of Circulation. 2021; 18 (3): 201–11 (in Russ.). DOI: 10.24022/1814-6910-2021-18-3-201-211

Keywords:  off-pump coronary artery bypass anesthetic management hemodynamics

Received / Accepted:  03.09.2021 / 21.09.2021

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Abstract

In off-pump coronary artery bypass (OPCAB) for the implementation of complete revascularization of the affected coronary arteries without connecting the cardiopulmonary bypass, the anesthetic risk increases and the degree of difficulty in providing anesthesia increases. OPCAB impose new requirements for anesthetic management, which is associated with impaired myocardial function and hemodynamic disorders due to cardiac positioning and coronary artery clamping, which necessitates careful monitoring, adequate inotropic support and infusion therapy. This article highlights the current understanding of central hemodynamics during the main stage and recommendations for performing complete myocardial revascularization, reducing the risk of conversion to cardiopulmonary bypass. An overview of the main scientific works in the field of anesthetic management and stable hemodynamics during OPCAB is given.

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****
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  25. Patel N.C., Patel N.U., Loulmet D.F., McCabe J.C., Subramanian V.A. Emergency conversion to cardiopulmonary bypass during attempted off-pump revascularization results in increased morbidity and mortality. J. Thorac. Cardiovasc. Surg. 2004; 128: 655–61. DOI: 10.1016/j.jtcvs.2004.04.043
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  27. Chakravarthy M.R., Prabhakumar D. Anaesthesia for off pump coronary artery bypass grafting – the current concepts. Indian J. Anaesth. 2007; 51 (4): 334–43.
  28. Michelsen L.G., Horswell J. Anesthesia for off-pump coronary artery bypass grafting. Semin. Thorac. Cardiovasc. Surg. 2003; 15: 71–82. DOI: 10.1016/S1043-0679(03)70044-6
  29. Lee E.H., Lee H.M., Chung C.H., Chin J.H., Choi D.K., Chung H.J. et al. Impact of intravenous lidocaine on myocardial injury after off-pump coronary artery surgery. Br. J. Anaesth. 2011; 106: 487–93. DOI: 10.1093/bja/aeq416
  30. Hett D.A. Anaesthesia for off-pump coronary artery surgery. CEACCP. 2006; 6 (2): 60–2. DOI: 10.1093/bjaceaccp/mkl005
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  32. Zangrillo A., Landoni G., Sparicio D., Pappalardo F., Bove T., Cerchierini E. et al. Perioperative magnesium supplementation to prevent atrial fibrillation after offpump coronary artery surgery: a randomized controlled study. J. Cardiothorac. Vasc. Anesth. 2005; 19: 723–8. DOI: 10.1053/j.jvca.2005.02.015
  33. Tempe D., Virmani S. Anaesthesia for off-pump coronary artery surgery. Ann. Card. Anaesth. 2007; 10 (1): 65–71. DOI: 10.4103/0971-9784.37931
  34. Fellahi J.L., Godier A., Benchetrit D., Berthier F., Besch G., Bochaton T. et al. Perioperative management of patients with coronary artery disease undergoing non-cardiac surgery: summary from the French Society of Anaesthesia and Intensive Care Medicine 2017 convention. Anaesth. Crit. Care Pain Med. 2018; 37 (4): 367–74. DOI: 10.1016/j.accpm.2018.02.021
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About Authors

  • Dzhumber Ya. Khinchagov, Cand. Med. Sci., Anesthesiologist-Intensivist; ORCID
  • Mikhail M. Rybka, Dr. Med. Sci., Head of Department of Anesthesiology and Resuscitation; ORCID

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