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Asian Cardiovasc Thorac Ann 2003;11:203-207
© 2003 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTION

Deep Pericardial Stitch Enables Hemodynamically Stable Exposure of Beating Heart

Bartlomiej Perek, MD, Marek Jemielity, MD, Jadwiga Tomczyk, MD1, Estilita Camacho, MD1, Wojciech Dyszkiewicz, MD

Department of Cardiac Surgery, Institute of Cardiology
1 Department of Anesthesiology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland

For reprint information contact: Bartlomiej Perek, MD Tel: 48 61 8549085 Fax: 48 61 8549085 email: bperek{at}yahoo.com Department of Cardiac Surgery, Institute of Cardiology, ul. Dluga 1/2, 61-848 Poznan, Poland.

The use of a deep pericardial stitch to obtain optimal exposure for precise distal anastomoses was assessed in 51 patients (mean age, 56.5 ± 9.1 years) undergoing off-pump coronary artery bypass grafting. Hemodynamic data were recorded after sternotomy, before, and after each of the 120 distal anastomosis. Most hemodynamic parameters did not change throughout the procedures. During exposure of the circumflex artery, there were significant decreases in systolic arterial pressure from 106.0 ± 15.5 to 87.7 ± 13.6 mm Hg, mean systemic arterial pressure from 83.9 ± 11.7 to 68.5 ± 17.0 mm Hg, stroke volume from 68.5 ± 23.3 to 50.5 ± 18.3 mL, and stroke index from 34.4 ± 11.5 to 24.3 ± 8.7 mL•m-2. Cardiac function was not affected when other coronary arteries were bypassed. On completion of all anastomoses, hemodynamics returned to baseline status. It was concluded that the deep pericardial stitch enabled stable and safe exposure of the heart for off-pump coronary artery grafting.






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