Anesthesia management of patients undergoing off-pump coronary artery bypass grafting: A retrospective study of single center

Yong Lin; Tao Sun; Ning-Ning Cheng; Jing-Jing Liu; Li-Xian He; Li-Hong Wang; Xian-Wen Liu; Mei-Fang Chen; Liang-Wan Chen; Yun-Tai Yao; Evidence in Cardiovascular Anesthesia (EICA) Group

doi:10.3389/fsurg.2022.1067750

Anesthesia management of patients undergoing off-pump coronary artery bypass grafting: A retrospective study of single center

Front Surg. 2023 Jan 30:9:1067750. doi: 10.3389/fsurg.2022.1067750. eCollection 2022.

Authors

Affiliations

¹ Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
² Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
³ Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China.
⁴ Department of Anesthesiology, Binzhou People's Hospital, Binzhou, China.
⁵ Department of Anesthesiology, The First Affiliated Hospital of Xinxiang Medical College, Xinxiang, China.
⁶ Department of Anesthesiology, Chuiyangliu Hospital of Tsinghua University, Beijing, China.
⁷ Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, China.

Abstract

Background: To summarize the current practice of anesthesia management for Chinese patients undergoing off-pump coronary artery bypass (OPCAB) surgery at a large-volume cardiovascular center.

Materials and methods: The clinical data of consecutive patients undergoing isolated, primary OPCAB surgery during the period from September 2019 to December 2019 were retrospectively analyzed. Patient characteristics, intraoperative data, and short-term outcomes were extracted from the Hospital Information System and the Anesthesia Information Management System.

Results: A total of 255 patients who underwent OPCAB surgery were enrolled in the current study. High-dose opioids and short-acting sedatives were the most commonly administrated anesthetics intraoperatively. Pulmonary arterial catheter insertion is frequently performed in patients with serious coronary heart disease. Goal-directed fluid therapy, a restricted transfusion strategy, and perioperative blood management were routinely used. Rational usages of inotropic and vasoactive agents facilitate hemodynamic stability during the coronary anastomosis procedure. Four patients underwent re-exploration for bleeding, but no death was observed.

Conclusions: The study introduced the current practice of anesthesia management at the large-volume cardiovascular center, and the short-term outcomes indicated the efficacy and safety of the practice in OPCAB surgery.

Keywords: anesthesia management; coronary artery bypass; hemodynamics; retrospective; single center.

Grants and funding

This work was supported by the Natural Science Foundation of Fujian Province (grant nos. 2021 J01769 and 2019 J05082), Joint Funds for the innovation of science and Technology, Fujian province (grant nos. 2018Y9022 and 2020Y9019), and CAMS Innovation Fund for Medical Sciences (CIFMS) (2021-I2M-C&T-B-038).