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Hemodynamic comparison between minimally invasive and conventional approaches in off-pump coronary artery bypass grafting: A randomized controlled trial

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Original Article

Author Details : B Ranjith Karthekeyan, Kamalakkannan Ganapathy Sambandam*, Shruthi Shree, Saranya Nagalingam, Kiran Muthu Rajah, Ashok Gnanachandran

Volume : 11, Issue : 2, Year : 2024

Article Page : 174-180

https://doi.org/10.18231/j.ijca.2024.035

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Abstract

Background: This study aimed to investigate the hypothesis that minimally invasive coronary artery bypass grafting (CABG) induces fewer hemodynamic alterations compared to conventional approaches, attributing this to reduced heart rotation during grafting. Given the critical role of hemodynamic stability in patient outcomes and the growing popularity of minimally invasive CABG, we sought to assess and compare the hemodynamic responses during left anterior descending artery grafting.
Materials and Methods: This randomized controlled trial was conducted at a tertiary center, enrolling a total of 60 patients, with 30 in each group. Parameters such as heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), and perfusion index (PI) were measured at baseline, after octopus stabilization prior to grafting, at 3 minutes during grafting, and at the end of grafting. Additionally, serum lactate levels were assessed at baseline and upon completion of grafting.
Results: The baseline HR was comparable between the groups. However, the trends in HR revealed a significant increase in the conventional group after octopus stabilization (P value = 0.0038), at 3 minutes post-initiation of grafting (p < 0 xss=removed> Conclusion: Despite no significant differences in MAP, CVP, and lactate levels, our findings highlight significant disparities in HR and PI between the two groups. We conclude that the observed variations in heart rate may be attributed to minimal positional changes in the minimally invasive approach compared to the conventional approach.
 

Keywords: Coronary artery bypass, Heart rate, Central venous pressure, Mean arterial pressure, Perfusion index.

How to cite : Karthekeyan B R, Sambandam K G, Shree S, Nagalingam S, Rajah K M, Gnanachandran A, Hemodynamic comparison between minimally invasive and conventional approaches in off-pump coronary artery bypass grafting: A randomized controlled trial. Indian J Clin Anaesth 2024;11(2):174-180

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