Cerebral arterial hemodynamics of patients undergoing off-pump coronary artery bypass grafting
Xiao Wei
Zhang Jianqun
Kong Qingyu
Chi Liqun
Wang Rong
Zhu Junming
Abstract：Objective To analyze changes of blood pressure and cerebral hemodynamics during off-pump coronary artery bypass grafting(OPCABG).Methods Totally 94 patients undergoing OPCABG from January 2015 to January 2017 in Beijing Anzhen Hospital,Capital Medical University were enrolled.Middle cerebral artery hemodynamic parameters[mean velocity(Vm),peak systolic velocity (Vp),end disatolic velocity(EDV) and internal diameter of middle cerebral artery(DM)] were monitored by transcranial Doppler sonography;systolic blood pressure (SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),bispectral index(BIS) and heart rate(HR) were recorded before operation (T0),at the time of intubation (T1),thoracic opening (T2),anterior descending anastomosis(T3),at the end of anastomosis(T4) and at the end of operation(T5).The correlation between blood pressure and hemodynamic parameters was analyzed.Results SBP,DBP,MAP,HR,Vm,Vp at T1-T5,BIS at T1-T2 and EDV at T1-T4 significantly decreased compared to those at T0 [(119 ± 10),(121 ± 12),(107 ± 12),(100±10),(117 ±12)mmHg vs (139±11)mmHg;(59 ±5),(62 ±7),(60 ±6),(59 ±6),(62 ±8)mmHg vs (76 ±6)mmHg;(78 ±8),(80 ±7),(75 ±5),(72 ±7),(82±7)mmHg vs (96 ±8)mmHg;(46 ±8),(42 ±4),(51 ± 5),(48 ± 5),(56 ± 6) times/min vs (67 ± 6) times/min;(44.2 ± 4.6),(45.4 ± 4.4),(42.7 ± 3.1),(50.4 ±2.5),(54.3 ±4.0)cm/s vs (58.1 ±3.3) cm/s;(76 ±5),(77 ±4),(69 ±4),(86 ±5),(88 ±4)cm/s vs (92 ±5)cm/s;(60 ±3),(63 ±5) vs (68 ±4);(29 ±5),(28 ±3),(25 ±4),(33 ±4)cm/s vs (35 ±3)cm/s](P ＜ 0.05).There were positive correlations among Vm,Vp,EDV with DM (r =0.74,0.68,0.51;P ＜ 0.01).There were negative correlations among △SBP,△DBP,△MAP with △Vm(r =-0.38,-0.40,-0.48),△Vp(r =-0.39,-0.42,-0.51) and △EDV(r=-0.35,-0.39,-0.46)(P＜0.05).Conclusion MAP shows high sensitivity in estimating cerebral blood flow;Vm may be a valuable indicator of cerebral arterial hemodynamics.
Keywords：Coronary artery bypass grafting,off-pumpMiddle cerebral artery
Publication Date：2017-11-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 1628-1631 )