Euvolemic off pump coronary surgery further improves early postoperative outcomes.

BACKGROUND: Fluid resuscitation during Off-Pump Coronary Surgery (OPCABG) is still not protocolized and depends on multiple variables. We are exploring in this study whether a restrictive or euvolemic approach has any impact on short term surgical outcomes following OPCABG. METHODS: It is a retrospective study of 300 patients analyzed based on the intraoperative fluid requirement with 150 patients in each group (Group I: Fluid <2 Litres, Group II: Fluid >2 Litres). RESULTS: Multivariable analysis showed echocardiography variables such as E/e ratio, LA volume index, and atrial fibrillation (AF). LA volume index is related to the higher fluid requirement. Group II had significantly higher ventilation time (P < 0.05), drain output (P = 0.05), drain removal time (<0.05), inotropic requirement, and diuretic use. CONCLUSION: The requirement of the intraoperative fluid was associated with various factors including diastolic dysfunction (left atrial volume index, left ventricle mass index, E/e ratio) and preoperative dual antiplatelet use. Group II patients had longer ventilation time, diuretics use, high drain output, and required drains for a longer period of time. Although there was no statistical difference among two groups as far as postoperative AF concerned, a reversal of AF to sinus rhythm was delayed in group II patients.

Left Atrial Anastomosing Hemangioma Causing Recurrent Pericardial Effusion.

We report an extremely rare tumor in an adult patient who presented with recurrent pericardial effusion. The mass was an extracardiac tumor on the left atrial roof, which was excised by open heart surgery. Histologic examination confirmed a cardiac anastomosing hemangioma.