Hemodynamic collapse during off-pump coronary artery bypass grafting.
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.
Vassiliades
Thomas A
TA
Pensacola Heart Institute, Florida, USA.
Nielsen
James L
JL
Lonquist
James L
JL
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*