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The Annals of Thoracic Surgery, Vol 27, 376-389, Copyright © 1979 by The Society of Thoracic Surgeons

ARTICLES

Anesthetic considerations for aortocoronary bypass graft surgery

S Tarhan, RD White and HS Raimundo

Between 1964 and 1978, aortocoronary bypass graft procedures were performed in more than 300,000 patients, and the number seems to increase every year. Nevertheless, the procedure itself can result in perioperative myocardial infarction leading to death. Greater understanding of and constant attention to the myocardial oxygen (O2) supply and demand may reduce the incidence of perioperative myocardial infarction. Some of the factors influencing supply and demand can be controlled pharmacologically. Drugs such as nitroglycerin, nitroprusside, and propranolol can reduce the myocardial O2 demand. Unfortunately, there are few data to elucidate the relationship between myocardial O2 demand and supply as influenced by anesthetic drugs, especially in patients with myocardial ischemia. However, enthusiasm for aortocoronary bypass graft operations has given enormous impetus to laboratory and clinical studies of this subject. Recent developments in anesthetic management afford better means for protection of the ischemic myocardium during and after operation.