Segmental wall motion abnormalities during telerobotic totally endoscopic coronary artery bypass grafting

Anesthesia and Analgesia
Stephan MierdlK Westphal

Abstract

In addition to single-lung ventilation (SLV), intrathoracic CO2 insufflation is mandatory for adequate exposure during totally endoscopic coronary artery bypass grafting. With transesophageal echocardiography, we investigated biventricular myocardial wall motion in 25 patients with isolated disease of the left anterior descending coronary artery who underwent totally endoscopic coronary artery bypass grafting with the "Da Vinci" robotic surgical system. At distinct time points during the operation, a cine loop of both ventricles was registered from a transgastric mid-short-axis view. Myocardial wall motion analysis was performed according to an established segmentation model of the left ventricle and to an established five-point scale for wall motion (1, normal; 5, dyskinesia). Significant alterations from preoperative baseline wall motion were visible in the septal, inferior, and anterior segments of the left ventricle at some time during the prebypass period, combined with a markedly decreased PaO2 under SLV and increased intrathoracic pressure. The same findings applied to the right ventricle; however, wall motion abnormalities were more pronounced here. After myocardial revascularization, weaning from cardiopulmonary bypass...Continue Reading

References

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Citations

Dec 3, 2005·Seminars in Cardiothoracic and Vascular Anesthesia·Carol L Lake
Jul 1, 2004·Expert Review of Cardiovascular Therapy·Roberto CasulaRodney Foale
May 24, 2007·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·R CasulaA Darzi
Jul 1, 2010·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Gang WangTingting Chen

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