[Effects of carbon dioxide insufflation during endoscopic conduit harvesting in coronary artery bypass surgery].
BACKGROUND
Endoscopic vessel harvesting is becoming common for the patients undergoing coronary artery bypass grafting. Insufflation of carbon dioxide (CO2) during the procedures has been reported elsewhere to affect arterial carbon dioxide tension, but the occurrence of hypercapnia is still controversial.


METHODS
We investigated the effects of CO2 insufflation during endoscopic harvesting of the saphenous vein (SV, n = 34), radial artery (RA, n = 14), or internal mammary artery (IMA, n = 7) for coronary artery bypass surgery. The conduit harvesting was performed using Vasoview Dissecting Cannula with insufflation of CO2 maintaining a cavity pressure of 8-10 mmHg.


RESULTS
After insufflation of CO2, significant elevation of partial pressure of CO2 in arterial blood (PaCO2) was found during harvesting of SV (35.4 +/- 3.8 to 49.2 +/- 7.5 mmHg, P < 0.01) and of IMA (38.0 +/- 2.3 to 44.2 +/- 3.2 mmHg, P < 0.05), but no significant elevation of PaCO2 occurred during RA harvesting using a tourniquet. The extent of PaCO2 elevation in SV harvesting showed negative correlation with patient's body weight, body mass index, and body surface area.


CONCLUSIONS
Significant hypercarbia occurs during endoscopic harvesting of SV or IMA. It is recommended that PaCO2 should be carefully monitored during endoscopic conduit harvesting for coronary artery bypass surgery.
Suzuki
Tomofumi
T
Division of Anesthesia, Shonan Kamakura General Hospital, Kamakura 247-8533.
Oda
Toshiyuki
T
Takagi
Yoshito
Y
Fukuda
Minoru
M
Inoue
Satoshi
S
Mochizuki
Aguru
A
Fujita
Kaori
K
D000368:Aged; D017546:Angioscopy; D002245:Carbon Dioxide / Q000378:metabolism*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007327:Insufflation; D008297:Male; D008323:Mammary Arteries / Q000601:surgery; D008875:Middle Aged; D010313:Partial Pressure; D017534:Radial Artery / Q000601:surgery; D012501:Saphenous Vein / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods*
D002245:Carbon Dioxide