Document Detail

Hemodynamic advantages of right heart decompression during off-pump surgery.
MedLine Citation:
PMID:  20124291     Owner:  NLM     Status:  MEDLINE    
Cardiac maneuvering during off-pump coronary artery bypass surgery can compress the right ventricle, causing temporary dysfunction and hemodynamic instability. The hemodynamic impact of a decompression technique comprising right pleurotomy and pericardial release was investigated during cardiac elevation. Intraoperative continuous real-time monitoring of cardiac index and stroke volume index was carried out using the PulseCO system in 12 consecutive patients with normal ventricular function who underwent off-pump coronary artery bypass by a single surgeon. A pulmonary artery catheter was used to monitor pulmonary artery pressure and systemic venous O(2) saturation. Hemodynamic changes during vertical displacement of the heart were measured before and after performing a right pleurotomy and pericardial release. Following right heart decompression, stroke volume index, cardiac index, mean arterial pressure, and systemic venous O(2) saturation were significantly better preserved during cardiac elevation. This demonstrates that right heart decompression via pleurotomy and pericardial release significantly improves hemodynamic stability during cardiac manipulation. We recommend the use of this procedure in off-pump coronary artery bypass when cardiac tilting is required.
Theodore Velissaris; Max M Jonas; Sunil K Ohri
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  18     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  17-21     Citation Subset:  IM    
Department of Cardiothoracic Surgery, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
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MeSH Terms
Blood Pressure*
Catheterization, Swan-Ganz
Coronary Artery Bypass, Off-Pump / methods*
Decompression, Surgical / methods*
Middle Aged
Monitoring, Intraoperative / methods
Oxygen / blood*
Pericardium / surgery
Pleura / surgery
Pulmonary Artery
Stroke Volume
Ventricular Dysfunction, Right / prevention & control*
Reg. No./Substance:

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