Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 1999
Effects of a bolus injection of adenosine triphosphate on atrioventricular conduction and hemodynamics in patients undergoing coronary artery bypass grafting.
To investigate the effects of adenosine triphosphate (ATP) on atrioventricular (A-V) conduction and hemodynamics in patients undergoing coronary artery surgery. ⋯ A bolus injection of 10 mg of ATP successfully induced a transient A-V block in 83% of the 12 patients. The countermeasures, including ventricular pacing, are indispensable to cope with the subsequent hypotension that may lead to myocardial ischemia, especially in patients with ischemic heart disease.
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J. Cardiothorac. Vasc. Anesth. · Apr 1999
Comparative StudyEmbracing the heart: perioperative management of patients undergoing off-pump coronary artery bypass grafting using the octopus tissue stabilizer.
To describe hemodynamic alterations during coronary artery bypass grafting (CABG) without extracorporeal circulation using the Octopus Tissue Stabilizer, and to describe the two anesthetic management protocols based on either general anesthesia with opioids (34 patients) or general anesthesia with high thoracic epidural anesthesia (TEA; 66 patients). ⋯ Both anesthetic protocols are safe and effective in handling these patients. Off-pump CABG surgery requires anesthetic interventions because hemodynamic alterations are caused by the presentation of the heart to the surgeon. The complication rate is low but needs to be evaluated, compared with conventional CABG, in a prospective randomized study. High thoracic epidural anesthesia allows early recovery, but improved outcome could not be proved in this patient group.