Off-pump coronary artery bypass grafting: a case report.
It is easy to take for granted the seemingly effortless way cardiovascular surgeons are able to bypass atherosclerotic coronary arteries. The process used today was developed over many years of rigorous study, experimentation, success, and failure. Early cardiac surgery was performed blindly, through small incisions, on a beating heart. Advances in medicine allowed surgery to be performed on hearts stilled by cardioplegic arrest, while the circulation was continued through the use of a cardiopulmonary bypass (CPB) machine. The development of the CPB machine allowed surgeons to perform the delicate work of coronary artery bypass grafting (CABG), first attempted on dogs, and then humans. This article briefly outlines the historical evolution of cardiac surgery that led to the development of the technology necessary to perform off-pump coronary artery bypass grafting (OPCAB). A case report of a 72-year-old female who underwent OPCAB is outlined. Included is a discussion of some of the benefits and potential complications of CABG and OPCAB. Anesthetic considerations for OPCAB procedures also are presented.
Woodlawn Hospital, Rochester, Ind, USA. lbehny@earthlink.net
Leanne R
LR
Behny
D000368:Aged; D000769:Anesthesia, Inhalation / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D000818:Animals; D016292:Procedural Sedation / Q000379:methods; D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D004285:Dogs; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000627:therapeutic use; D008874:Midazolam / Q000627:therapeutic use; D016343:Monitoring, Intraoperative / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use; D010197:Pancuronium / Q000627:therapeutic use; D019990:Perioperative Care / Q000379:methods; D017409:Sufentanil / Q000627:therapeutic use; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D017409:Sufentanil; D007530:Isoflurane; D010197:Pancuronium; D008874:Midazolam