title: Hemodynamic collapse during off-pump coronary artery bypass grafting.
abstract: 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.
authors.affiliation: Pensacola Heart Institute, Florida, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Vassiliades
authors.forename: James L
authors.initials: JL
authors.lastname: Nielsen
authors.forename: James L
authors.initials: JL
authors.lastname: Lonquist
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012769:Shock / Q000209:etiology*