Monitoring and devices for hemodynamic assessment during OPCAB

Abstract

Monitoring is aimed to cope with the disturbances of the physiology of the patient during surgery and anesthesia in order to prevent harm to the patient. Patient monitoring is a key aspect of anesthesiology, and anesthesiologists should be able to interpret and evaluate the clinical relevance of changes and to react properly to a change in physiologic parameters. It is the challenging task of the anesthesiologist, as the primary perioperative care provider to identify patients with unstable or highrisk conditions and insure adequate care prior, during and following surgery. OPCAB surgery is basically different from other surgery. One can consider OPCAB as ‘repairing the engine of a car while driving on the highway’. Everyone feels that this might be not so easy and could lead to problems for the engine, car and/or mechanic. The same is true for OPCAB: clamping native coronary arteries might induce ischemia or cardiac fibrillation; cardiac dislocation might lead to an impaired systemic circulation; inadequate motion reduction of the epicardium might result in problems with the vascular anastomosis.