HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ramachandra C. Reddy Peter J. Molinaro Israel J. Jacobowitz Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vitali, R. M. Articles by Jacobowitz, I. J. Search for Related Content PubMed PubMed Citation Articles by Vitali, R. M. Articles by Jacobowitz, I. J.

Ann Thorac Surg 2000;70:1098-1099
© 2000 The Society of Thoracic Surgeons

---

Supplement: cardiothoracic techniques & technologies

Hemodynamic effects of carbon dioxide insufflation during endoscopic vein harvesting

^a Maimonides Medical Center and State University of New York, Downstate Medical Center, Brooklyn, New York, USA

Address reprint requests to Dr Reddy, Department of Cardiovascular and Thoracic Surgery, State University of New York, Downstate Medical Center, 450 Clarkson Ave, Box 40, Brooklyn, NY 11203-2098
e-mail: ramreddy{at}aol.com

Presented at the Sixth Annual Cardiothoracic Techniques and Technologies Meeting 2000, Ft Lauderdale, FL, Jan 27–29, 2000.

Background. A prospective study was performed assessing the hemodynamic effects of carbon dioxide (CO₂) insufflation during endoscopic vein harvesting (EVH) using the Guidant Vasoview Uniport system.

Methods. Five hemodynamic and respiratory parameters (end-tidal carbon dioxide, arterial partial pressure of carbon dioxide, mean arterial pressure, mean pulmonary arterial pressure, and cardiac output), were measured in 100 consecutive patients undergoing EVH with CO₂ insufflation. Data were obtained prior to commencement of EVH, 15 minutes after commencement, and 5 minutes after completion of the vein harvesting.

Results. No adverse hemodynamic effects were observed during CO₂ insufflation. Specifically, average mean arterial pressure went from 88.77 ± 9.64 to 89.13 ± 8.60 to 88.24 ± 8.71 mm Hg before, during, and after endoscopic vein harvesting (p = 0.291). Likewise, average mean pulmonary artery pressures were 19.76 ± 4.75, 20.05 ± 4.48, and 20.05 ± 4.62 mm Hg (p = 0.547); and average cardiac output was 4.25 ± 0.74, 4.22 ± 0.73, and 4.23 ± 0.69 L/min (p = 0.109) at those three intervals. Additionally, there was no evidence of significant systemic absorption of CO₂ as reflected in average arterial PCO₂, which remained steady at 37.42 ± 5.19, 37.51 ± 4.59, and 38.10 ± 4.80 mm Hg (p = 0.217); and average end-tidal CO₂, which was 32.10 ± 3.66, 32.50 ± 3.47, and 32.38 ± 3.33 mm Hg (p = 0.335). In a subset of 20 patients with elevated pulmonary arterial pressure (more than 32 mm Hg), there was also no significant change in any of the parameters.

Conclusions. Carbon dioxide insufflation during EVH leads to no adverse hemodynamic consequences or systemic CO₂ absorption. The technique appears to be safe and well tolerated.

This article has been cited by other articles:

				S.-M. Lin, W.-K. Chang, C.-M. Tsao, C.-H. Ou, K.-H. Chan, and S.-K. Tsai Carbon Dioxide Embolism Diagnosed by Transesophageal Echocardiography During Endoscopic Vein Harvesting for Coronary Artery Bypass Grafting Anesth. Analg., March 1, 2003; 96(3): 683 - 685. [Abstract] [Full Text] [PDF]

				J. M. Bitondo, W. M. Daggett, D. F. Torchiana, C. W. Akins, A. D. Hilgenberg, G. J. Vlahakes, J. C. Madsen, T. E. MacGillivray, and A. K. Agnihotri Endoscopic versus open saphenous vein harvest: a comparison of postoperative wound complications Ann. Thorac. Surg., February 1, 2002; 73(2): 523 - 528. [Abstract] [Full Text] [PDF]