Haemodynamic Stability During Off-Pump Coronary Bypass Grafting: Apical Suction Vs. Deep Pericardial Suture

Off-pump coronary surgery is an established entity. Safe exposure of inferior and lateral wall vessels remains a challenge for complete revascularization. We compared deep pericardial stitches with apical suction to overcome this challenge. There were 16 patients in each group. Patients with only anterior wall disease were excluded. Heart rate, arterial blood pressure, central venous pressure, end tidal CO2 and standard base excess were recorded. The observed parameters in both groups showed that heart in apical suction group performed better during inferior and lateral wall exposure. Requirement of noradrenaline was less. However both groups showed similar pattern of recovery once shifted to ICU. Apical suction is a better option for the exposure of inferior and lateral walls as compared to deep pericardial stitch, in order to achieve complete revascularisation on beating heart.