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INTRODUCTION

Reperfusion

RWMA usually improves within 15 seconds.

May not improve until graft is open, i.e., proximal graft completed.

Chest Closure

Appearance of new regional wall motion abnormalities should be a cause for concern.

  • Consider possibility of a kinked graft.
  • IMA or other arterial grafts spasm.
  • Flawed grafts may be OK until heparin reversed.
  • Reopen chest if RWMA persists.

Stabilizing devices have evolved into useful instruments to make beating heart surgery a reality for the majority of patients today. The future of beating heart surgery is upon us and to meet the challenge we need to share information and develop specific techniques to continue the evolution of anesthesia into the 21st century. A joint effort between the surgeon and the anesthesiologist during Beating Heart CAB is essential for continued successful outcomes.

 

* OPCAB is a trademark of Genzyme

** MIDCAB is a trademark of CardioThoracic Systems