Skip Navigation

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Longer version of article
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (16)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Chassot, P.-G.
Right arrow Articles by Spahn, D. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chassot, P.-G.
Right arrow Articles by Spahn, D. R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

British Journal of Anaesthesia, 2004, Vol. 92, No. 3 400-413
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Review Article

Off-pump coronary artery bypass surgery: physiology and anaesthetic management{dagger}

P.-G. Chassot1, P. van der Linden3, M. Zaugg4, X. M. Mueller2,5 and D. R. Spahn*,1

Departments of 1 Anaesthesiology and 2 Cardiovascular Surgery, University Hospital Lausanne (CHUV), CH-1011 Lausanne, Switzerland. 3 Department of Cardiac Anaesthesiology, CHU Brugmann, B–1020 Brussels, Belgium. 4 Institute of Anaesthesiology, University Hospital Zürich (USZ), CH-8091 Zürich, Switzerland 5 Present address: Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec J1H 5N4, Canada

*Corresponding author. E-mail: donat.spahn@chuv.hospvd.ch

Increasing interest is being shown in beating heart (off-pump) coronary artery surgery (OPCAB) because, compared with operations performed with cardiopulmonary bypass, OPCAB surgery may be associated with decreased postoperative morbidity and reduced total costs. Its appears to produce better results than conventional surgery in high-risk patient populations, elderly patients, and those with compromised cardiac function or coagulation disorders. Recent improvements in the technique have resulted in the possibility of multiple-vessel grafting in all coronary territories, with a graft patency comparable with conventional surgery. During beating-heart surgery, anaesthetists face two problems: first, the maintenance of haemodynamic stability during heart enucleation necessary for accessing each coronary artery; and second, the management of intraoperative myocardial ischaemia when coronary flow must be interrupted during grafting. The anaesthetic technique is less important than adequate management of these two major constraints. However, experimental and recent clinical data suggest that volatile anaesthetics have a marked cardioprotective effect against ischaemia, and might be specifically indicated. OPCAB surgery requires team work between anaesthetists and surgeons, who must be aware of each other’s constraints. Some surgical aspects of the operation are reviewed along with physiological and anaesthetic data.

Br J Anaesth 2004; 92: 400–13


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
S. Romagnoli, S. Bevilacqua, S. Gelsomino, S. Pradella, L. Ghilli, C. Rostagno, G. F. Gensini, and C. Sorbara
Small-Dose Recombinant Activated Factor VII (NovoSeven(R)) in Cardiac Surgery.
Anesth. Analg., May 1, 2006; 102(5): 1320 - 1326.
[Abstract] [Full Text] [PDF]

Home page
 Contin Educ Anaesth Crit Care PainHome page
D. A Hett
Anaesthesia for off-pump coronary artery surgery
CEACCP, April 1, 2006; 6(2): 60 - 62.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Jegger, P.-G. Chassot, M.-A. Bernath, J. Horisberger, P. Gersbach, P. Tozzi, D. Delay, and L. K. von Segesser
A novel technique using echocardiography to evaluate venous cannula performance perioperatively in CPB cardiac surgery.
Eur. J. Cardiothorac. Surg., April 1, 2006; 29(4): 525 - 529.
[Abstract] [Full Text] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
J. G. Bovill
Intravenous Anesthesia for the Patient with Left Ventricular Dysfunction
Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2006; 10(1): 43 - 48.
[Abstract] [PDF]

Home page
 Anesth. Analg.Home page
S. Rex, S. Brose, S. Metzelder, L. de Rossi, S. Schroth, R. Autschbach, R. Rossaint, and W. Buhre
Normothermic Beating Heart Surgery with Assistance of Miniaturized Bypass Systems: The Effects on Intraoperative Hemodynamics and Inflammatory Response
Anesth. Analg., February 1, 2006; 102(2): 352 - 362.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
W. Hassanein, A. A. Albert, B. Arnrich, J. Walter, I. C. Ennker, U. Rosendahl, S. Bauer, and J. Ennker
Intraoperative Transit Time Flow Measurement: Off-Pump Versus On-Pump Coronary Artery Bypass
Ann. Thorac. Surg., December 1, 2005; 80(6): 2155 - 2161.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
A. Kelleher and J. Gothard
Editorial II: Anaesthesia for off-pump coronary artery surgery
Br. J. Anaesth., March 1, 2004; 92(3): 324 - 326.
[Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.