Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Comparative StudyA prospective evaluation of hemodynamic instability during off-pump coronary artery bypass surgery.
Despite recognized hemodynamic derangements during cardiac displacement, most patients appear to tolerate the off-pump procedure well. However, some patients unpredictably become hemodynamically unstable requiring emergency cardiopulmonary bypass or intra-aortic balloon pump support. After an experience of 5306 multivessel off-pump coronary artery bypasses (OPCABs), this study was undertaken to determine the factors that would identify the patients who were at a higher risk for the procedure. ⋯ Patients with low left ventricular ejection fraction <25%, myocardial infarction of <1-month duration, congestive heart failure, or preoperative hemodynamic instability constitute the high-risk group for OPCAB.
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Comparative StudyA comparison of bleeding and transfusion in patients who undergo coronary artery bypass grafting via sternotomy with and without cardiopulmonary bypass.
To determine whether there is a difference between on-pump cardiopulmonary bypass (CABG) and off-pump coronary artery bypass grafting (OPCAB) without heparin reversal with regard to bleeding, transfusion requirements, and incidence of surgical re-exploration of the mediastinum. ⋯ Despite not reversing the heparin at the end of the OPCAB surgery, OPCAB surgery was associated with an overall reduction in allogeneic transfusion requirements.
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialArrhythmias in off-pump coronary artery bypass grafting and the antiarrhythmic effect of regional ischemic preconditioning.
The authors sought to establish whether regional ischemic preconditioning (IP) reduces ischemic reperfusion arrhythmias in patients who undergo off-pump coronary artery bypass grafting (OPCAB). ⋯ Arrhythmia was a common phenomenon during and after an OPCAB procedure. The present IP protocol significantly suppressed HR elevation, the episodes of SVT, and the incidence of VT after surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialFenoldopam for renal protection in patients undergoing cardiopulmonary bypass.
To evaluate the possible protective effects of fenoldopam on renal function in patients undergoing cardiopulmonary bypass. ⋯ In this study, fenoldopam was an effective agent in the prevention of renal dysfunction after cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Comparative StudyThe in vitro effects of remifentanil and fentanyl on isolated human right atria and saphenous veins.
To determine the myocardial and vascular effects of remifentanil and fentanyl in human atria and saphenous veins. ⋯ Remifentanil has no direct effect on the contraction of myocardium. Fentanyl inhibits the electrical stimulation-induced contraction in human right atrial muscles in vitro. Remifentanil and fentanyl produce "concentration-dependent" relaxation in human saphenous vein strips independent from the endothelium.