| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2003;24:770-776
© 2003 Elsevier Science NL
a Department of Anesthesiology, Seoul City Boramae Hospital, Shindaebang-Dong, Dongjak-gu, Seoul 156-707, South Korea
b Department of Anesthesiology, Seoul National University Hospital, 28 Yongon-Dong, Chongno-gu, Seoul 110-744, South Korea
c Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea
Received 17 March 2003; received in revised form 9 June 2003; accepted 15 June 2003.
* Corresponding author. Tel.: +82-2-760-2465; fax: +82-2-745-1525
e-mail: anesingle{at}yahoo.co.kr
Objective: To determine whether a phosphodiesterase type 3 inhibitor can improve hemodynamics during off-pump coronary artery bypass grafting (OPCAB) of posterior vessels in patients on ß1-adrenoreceptor blockers. Methods: Thirty patients scheduled for OPCAB of the obtuse marginal artery (OM), and taking atenolol 100 mg a day were randomized in a double-blind manner to receive either milrinone or placebo. Hemodynamic data were obtained after induction, before pericardial incision, during left anterior descending artery grafting, during OM grafting, and after removal of the stabilizer. During the OM grafting, dopamine was infused when the cardiac index (CI) decreased below 2.0 L/min/m2, and phenylephrine was infused to maintain the arterial pressure with a CI above 2.0 L/min/m2. Results: During OM anastomosis, there were significant differences in CI (milrinone [M] = +7.7%, control [C] = -13.7%, p=0.01), SVI (M=-21.5%, C=-35.8%, p=0.03), SvO2 (M=-2.6%, C=-8.9%, p=0.02), and SVR (M=-28.1%, C=+1.1%, p=0.01) between the two groups, in terms of percentage change from baseline value. Dopamine was required more frequently and at a higher dose in the control group (M=13%, 5.0 µg/kg/min; C=67%, 10.1 µg/kg/min, p<0.05). Phenylephrine was infused in 33% of the patients in the milrinone group compared to 13% in the control group (p>0.05). Conclusions: Prophylactic milrinone improves CI, SVI and SvO2 reducing the need for high doses of dopamine during OM anastomosis in patients taking atenolol. Therefore, it can be used as an alternative to dopamine improving hemodynamics and organ perfusion during OPCAB of posterior vessels in patients on ß1-blockers.
Key Words: Atenolol • Cardiac index • Milrinone • Off-pump coronary artery bypass graft • Obtuse marginal artery
This article has been cited by other articles:
|
|
 |
|
  A. Y. Denault, Y. Lamarche, P. Couture, F. Haddad, J. Lambert, J.-C. Tardif, and L. P. Perrault Inhaled milrinone: a new alternative in cardiac surgery? Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2006; 10(4): 346 - 360. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Sidi, J. D. Muehlschlegel, D. S. Kirby, and E. B. Lobato Treatment of ischaemic left ventricular dysfunction with milrinone or dobutamine administered during coronary artery stenosis in the presence of beta blockade in pigs Br. J. Anaesth., December 1, 2006; 97(6): 799 - 807. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Jeon, J. H. Ryu, Y. J. Lim, C. S. Kim, J.-H. Bahk, S. Z. Yoon, and J. Y. Choi Comparative hemodynamic effects of vasopressin and norepinephrine after milrinone-induced hypotension in off-pump coronary artery bypass surgical patients. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 952 - 956. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
