Abstract
The increased use of transesophageal echocardiography (TEE) by anesthesiologists may lead to an increase in the intraoperative detection of previously undiagnosed patent foramen ovale (PFO). The impact of heart manipulation on interatrial shunting through a PFO during off-pump coronary artery bypass graft (CABG) has not been studied. We retrospectively studied 11 patients with PFOs who underwent off-pump CABG. TEE contrast studies and blood gas analyses were performed at baseline, during heart elevation for distal coronary arteries anastomoses, and at the end of the surgery. At baseline, 5 of 11 patients had left-to-right shunting and 2 of 11 had right-to-left shunting. Heart elevation did not result in oxygen desaturation in any patient; however, it caused the disappearance of a right-to-left shunt (n = 1), persistence of this shunt (n = 1), and the development of a new right-to-left shunt (n = 2). Return of the heart to its original position resulted in a return of TEE findings to the baseline state in all patients. This series suggests that off-pump CABG can be performed safely in the majority of patients with PFOs; however, additional investigation is needed to assure that adverse effects do not occur in a subset of patients undergoing off -pump CABG in the presence of a PFO.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1142-1146 |
| Number of pages | 5 |
| Journal | Anesthesia and Analgesia |
| Volume | 95 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 1 2002 |
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All Science Journal Classification (ASJC) codes
- Anesthesiology and Pain Medicine
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The impact of newly diagnosed patent foramen ovale in patients undergoing off-pump coronary artery bypass grafting : Case series of eleven patients. / Sukernik, M. R.; Mets, Berend; Kachulis, B.; Oz, M. C.; Bennett-Guerrero, E.
In: Anesthesia and Analgesia, Vol. 95, No. 5, 01.11.2002, p. 1142-1146.Research output: Contribution to journal › Article
TY - JOUR
T1 - The impact of newly diagnosed patent foramen ovale in patients undergoing off-pump coronary artery bypass grafting
T2 - Case series of eleven patients
AU - Sukernik, M. R.
AU - Mets, Berend
AU - Kachulis, B.
AU - Oz, M. C.
AU - Bennett-Guerrero, E.
PY - 2002/11/1
Y1 - 2002/11/1
N2 - The increased use of transesophageal echocardiography (TEE) by anesthesiologists may lead to an increase in the intraoperative detection of previously undiagnosed patent foramen ovale (PFO). The impact of heart manipulation on interatrial shunting through a PFO during off-pump coronary artery bypass graft (CABG) has not been studied. We retrospectively studied 11 patients with PFOs who underwent off-pump CABG. TEE contrast studies and blood gas analyses were performed at baseline, during heart elevation for distal coronary arteries anastomoses, and at the end of the surgery. At baseline, 5 of 11 patients had left-to-right shunting and 2 of 11 had right-to-left shunting. Heart elevation did not result in oxygen desaturation in any patient; however, it caused the disappearance of a right-to-left shunt (n = 1), persistence of this shunt (n = 1), and the development of a new right-to-left shunt (n = 2). Return of the heart to its original position resulted in a return of TEE findings to the baseline state in all patients. This series suggests that off-pump CABG can be performed safely in the majority of patients with PFOs; however, additional investigation is needed to assure that adverse effects do not occur in a subset of patients undergoing off -pump CABG in the presence of a PFO.
AB - The increased use of transesophageal echocardiography (TEE) by anesthesiologists may lead to an increase in the intraoperative detection of previously undiagnosed patent foramen ovale (PFO). The impact of heart manipulation on interatrial shunting through a PFO during off-pump coronary artery bypass graft (CABG) has not been studied. We retrospectively studied 11 patients with PFOs who underwent off-pump CABG. TEE contrast studies and blood gas analyses were performed at baseline, during heart elevation for distal coronary arteries anastomoses, and at the end of the surgery. At baseline, 5 of 11 patients had left-to-right shunting and 2 of 11 had right-to-left shunting. Heart elevation did not result in oxygen desaturation in any patient; however, it caused the disappearance of a right-to-left shunt (n = 1), persistence of this shunt (n = 1), and the development of a new right-to-left shunt (n = 2). Return of the heart to its original position resulted in a return of TEE findings to the baseline state in all patients. This series suggests that off-pump CABG can be performed safely in the majority of patients with PFOs; however, additional investigation is needed to assure that adverse effects do not occur in a subset of patients undergoing off -pump CABG in the presence of a PFO.
UR - http://www.scopus.com/inward/record.url?scp=0036829316&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036829316&partnerID=8YFLogxK
U2 - 10.1097/00000539-200211000-00003
DO - 10.1097/00000539-200211000-00003
M3 - Article
C2 - 12401581
AN - SCOPUS:0036829316
VL - 95
SP - 1142
EP - 1146
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 5
ER -