Atrial stimulation during OPCAB

A simple maneuver to maintain stable hemodynamics during OPCAB
  • V. Gulielmos
  • U. Kappert
  • M. Eller
  • H. Sahre


Off-pump surgery is proposed to avoid inflammatory response, renal and pulmonary, but above all thromboembolic episodes [1, 6–8]. Even if most cardiac surgeons acknowledge the advantages of a cardiac procedure avoiding cardiopulmonary bypass, very few have changed their surgical concept to OPCAB. The main reason for that is the hemodynamic instability occurring while tilting the heart, mostly for exposure of the back wall vessels of the left ventricle.


Left Ventricle Wall Stress Atrial Pace Atrial Stimulation Left Ventricular Wall Stress 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ascione R, Lloyd CT, Underwood MJ, Gomes WJ, Angelini GD (1999) On-pump versus off-pump coronary revascularization: evaluation of renal function. Ann Thorac Surg 68:493–498PubMedCrossRefGoogle Scholar
  2. 2.
    Benetti FJ, Ballester C, Sani G, Boonstra P, Grandjean J (1995) Video assisted coronary bypass surgery. J Card Surg 10:620–625PubMedCrossRefGoogle Scholar
  3. 3.
    Gruendemann PF, Borst C, Verlaan CWJ, Meijburg H, Mouës, Jansen EWL (1999) Exposure of circumflex branches in the tilted, beating porcine heart: echocardiographic evidence of right ventricular deformation and the effect of right or left heart bypass. J Thorac Cardiov Sur 118:316–323CrossRefGoogle Scholar
  4. 4.
    Gulielmos V, Kappert U, Eller M, Sahre H, Alexiou K, Georgi C, Nicolai J, Hartmann N (2003) Improving hemodynamics during off-pump bypass surgery by atrial pacing. Heart Surg Forum (in press)Google Scholar
  5. 5.
    Sowton E (1964) Hemodynamic studies in patients with artificial pacemakers. Brit Heart J 26:737–746PubMedCrossRefGoogle Scholar
  6. 6.
    Strüber M, Cremer JT, Gohrbandt B, Hagl C, Jankowski M, VÖlker B, Rückoldt H, Martin M, Haverich A (1999) Humane cytokine responses to coronary artery bypass grafting with and without cardiopulmonary bypass. Ann Thorac Surg 68:1330–1335PubMedCrossRefGoogle Scholar
  7. 7.
    Trehan N, Mishra M, Sharma OP, Mishra A, Kasliwal RR (2001) Further reduction in stroke after off-pump coronary artery bypass grafting: a 10-year experience. Ann Thorac Surg 72:1026–1032CrossRefGoogle Scholar
  8. 8.
    Wan S, Izzat MB, Lee TW, Wan IYP, Tang NLS, Yim APC (1999) Avoiding cardiopulmonary bypass in multivessel CABG reduces cytokine response and myocardial injury. Ann Thorac Surg 68:52–57PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • V. Gulielmos
  • U. Kappert
  • M. Eller
  • H. Sahre

There are no affiliations available

Personalised recommendations