High thoracic epidural anesthesia for coronary artery bypass graft surgery in a patient with severe obstructive lung disease

Abstract

CHRONIC OBSTRUCTIVE zpulmonary disease (COPD) is well recognized as a major risk factor for perioperative morbidity and mortality in patients undergoing coronary artery bypass graft (CABG) surgery. Perioperative mortality may be 50% for elderly patients with severe COPD taking steroids who undergo CABG surgery. 1 Samuels LE Kaufman MS Morris RJ et al. Coronary artery bypass grafting in patients with COPD. Chest. 1998; 113: 878-882 Crossref PubMed Scopus (91) Google Scholar Nonsurgical therapy is recommended for this cohort. 1 Samuels LE Kaufman MS Morris RJ et al. Coronary artery bypass grafting in patients with COPD. Chest. 1998; 113: 878-882 Crossref PubMed Scopus (91) Google Scholar CABG surgery without cardiopulmonary bypass may have potential benefits for COPD patients. High thoracic epidural anesthesia (TEA) may further reduce postoperative complications. 2 Liem TH Hasenbos MAWM Booij LHDJ Gielen MJM Coronary artery bypass grafting using two different anesthestic techniques: Part 2. Postoperative outcome. J Cardiothorac Vasc Anesth. 1992; 6: 156-161 Abstract Full Text PDF PubMed Scopus (150) Google Scholar A case of a 77-year-old patient with severe COPD who successfully underwent off-pump CABG surgery, using high TEA, is presented.