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Ann Thorac Surg 2002;73:1874-1879
© 2002 The Society of Thoracic Surgeons
a Pensacola Heart Institute, Pensacola, Florida, USA
* Address reprint requests to Dr Vassiliades, Jr, 5151 North Ninth Avenue, Suite 200, Pensacola, FL 32504, USA
Presented at the Forty-eighth Annual Meeting of the Southern Thoracic Surgical Association, San Antonio, TX, Nov 8–10, 2001.
Background. The causes of hemodynamic collapse during off-pump coronary artery bypass (OPCAB) remain scarcely defined. We present an analysis of 23 cases of sustained hemodynamic collapse during elective off- pump CABG.
Methods. During a 54-month period, we performed 1420 elective OPCAB procedures through a sternotomy, constituting 71.2% of the total CABG procedures performed. Twenty-three patients (1.6%) experienced hemodynamic collapse intra-operatively requiring immediate cardiopulmonary bypass. Preoperative characteristics, intraoperative data, and postoperative outcome were retrospectively reviewed in each patient.
Results. In all cases, improvements in intra-operative technique and/or judgment could be made retrospectively. Twenty (20/23) of these patients had an uneventful postoperative course and three (3/23) patients had an unstable course with two deaths.
Conclusions. The causes of hemodynamic collapse during elective OPCAB were ischemic, mechanical, or a combination of both. A detailed review of our five and a half year experience has revealed a number of suggestions for improving the conduct of the operation.
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