The Annals of Thoracic Surgery, Vol 22, 343-346, Copyright © 1976 by The Society of Thoracic Surgeons
Comparison of patients with coronary artery or valve disease: intraoperative differences in blood volume and observations of vasomotor response
EL Hanson, PB Kane, J Askanazi, JF Neville Jr and WR Webb
A review of 296 patients undergoing cardiac operations has shown that those
with coronary artery disease have a blood volume deficit. The 148 patients
with valve disease had a normal blood volume of 78 ml/kg (normal range,
68--88 ml/kg), while the 148 coronary artery disease had a blood volume of
69 ml/kg (p less than 0.001). Infusion of plasma prior to cardiopulmonary
bypass as well as the total transfusion required afterward to maintain
blood pressure indicated an important clinical difference in these two
groups. Another finding was that the requirement for a drug to control
blood pressure prior to use of cardiopulmonary bypass was greater in the
coronary patients (p less than 0.01). Comparison of the requirement for a
hypotensive agent before and after bypass showed a greater predictability
in the valve group. This experience leads us to conclude that patients with
coronary artery disease and angina not only have a low blood volume, but
they also have a marked vasoactive lability which shows up in their
hemodynamic response to the conduct of an operation and to anesthesia.
