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Thrombelastographic changes in OPCAB surgical patients

R L Quigley

Division of Cardiothoracic Surgery, Albert Einstein Medical Center, Jefferson Health System, Philadelphia, Pennsylvania, USA, quigleyr{at}einstein.edu

D W Fried

Division of Cardiothoracic Surgery, Albert Einstein Medical Center, Jefferson Health System, Philadelphia, Pennsylvania, USA

R Salenger

University of Massachusetts, Worchester, Massachusetts, USA

J Pym

Division of Cardiothoracic Surgery, Albert Einstein Medical Center, Jefferson Health System, Philadelphia, Pennsylvania, USA

R Y Highbloom

Division of Cardiothoracic Surgery, Albert Einstein Medical Center, Jefferson Health System, Philadelphia, Pennsylvania, USA

The purpose of this study was to determine whether thrombelastography could detect hypercoagulability in the off-pump coronary artery bypass (OPCAB) patient. Seventeen OPCAB and six cardiopulmonary bypass (CPB) patients were studied pre- and postprocedure, as well as on each of the first three postoperative days (POD). In the OPCAB patients, there was a small reduction in the postprocedure coagulation index (CI). This was followed by an increase in the CI on each of the next three POD, reaching a level exceeding the mean preprocedure CI by 2.32 units, indicative of a state of relative hyper- coagulability. The mean CI for the CPB patients decreased significantly in the postprocedure sample. Over the next 72 h, the CI increased to a level that nearly equaled the preprocedure ‘baseline’. We concluded that our study identified a state of relative hypercoagulability in the OPCAB patient 72 h after surgery. The mechanism of this hypercoagulation, as well as the clinical significance of this finding, is yet to be determined.

Perfusion, Vol. 17, No. 5, 363-367 (2002)
DOI: 10.1191/0267659102pf600oa
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