Gestione anestesiologica e outcome di 100 bypass aortocoronarici a cuore battente

Aim. The aim of this paper is to describe the anesthesiological management and the outcome of beating heart revascularization. Methods. A prospective study has been performed in a tertiary teaching hospital on 100 consecutive patients undergoing off-pump coronary artery revascularization. The main features of anesthetic technique are the maintenance hemodynamic stability and atrial kick. Results. Mechanical stabilisers shunts have improved the management of these patients. In hospital mortality was 1%, acute myocardial infarction 3%, low output syndrome 2%, atrial fibrillation 16%. Only 2% of patients had acute renal failure, but no patient needed renal replacement treatment. No neurologic event was noted. Only 19% of patients received blood transfusion. Ninety-seven % of patients were extubated within 12 h. Conclusions. The application of this anesthetic strategy combined with surgical skilful and new devices makes off-pump surgery safe also in high risk patients.