ObjectiveTo evaluate the feasibility to use ultrasonic cardiac output monitoring (USCOM) for patients after coronary artery bypass grafting. MethodsClinical data of 32 patients undergoing off-pump coronary artery bypass grafting in General Hospital of Shenyang Military Region between April and June 2013 were retrospectively analyzed. There were 17 male and 15 female patients with their age of 46-76 (63.2±7.6) years. USCOM and pulmonary artery catheterization (PAC) were used to measure cardiac output (CO) synchronously,and the results were compared between USCOM and PAC. ResultsSixty-four pairs of data were collected from those 32 patients. No adverse event was observed with either USCOM or PAC. Mean CO was 4.27±0.92 L/min with USCOM and 4.49±0.75 L/min with PAC respectively,which were not statistically different (P=0.12) but significantly correlated (r=0.84,P<0.001). ConclusionThere is close correlation between USCOM and PAC for CO measurement. USCOM can not only measure CO accurately,but also has the advantages of being noninvasive,easy to perform and low cost.
ObjectiveTo investigate short-term outcomes and surgical techniques of endoscopic saphenous vein harvesting (ESVH) for coronary artery bypass grafting (CABG). MethodsClinical data of 554 patients undergoing CABG with ESVH in General Hospital of Shenyang Military between July 2009 and August 2013 were retrospectively analyzed. There were 372 male and 182 female patients with their age of 38-84(61.3±9.0) years. Clinical outcomes, postoperative lower extremity pain and edema, wound infection and healing were analyzed. ResultsDuring ESVH, 13 patients with very little subcutaneous fat received transition to skin bridge technology or partially open incision. Average number of harvested vein grafts was 1-4 (2.0±0.6), and the quality of the vein grafts was satisfactory. Postoperative lower extremity pain and edema were significantly reduced, and there was no delayed wound healing or infection. Seven patients died postoperatively, including 2 patients with perioperative myocardial infarction, 2 patients with pneumonia, 1 patient with ventricular fibrillation, 1 patient with massive cerebral infarction, and 1 patient with multiple organ dysfunction syndrome. A total of 452 patients were followed up for 120-1 460 (742.6±188.5) days. There was no late death or reintervention during follow-up. ConclusionESVH is a safe and efficacious procedure with less postoperative lower extremity pain and edema, satisfactory vein graft quality, better postoperative recovery and cosmetic results, compared with traditional fully or intermittently open wound for saphenous vein harvesting.