Epidural Anesthesia in Cardical Surgery

The purpose of this study was to present our initial experience with the use of combined high epidural thoracic anesthesia (HTEA) with general anesthesia (GA) in unselected patients for open-heart surgery. Material and methods: From November 2005 to January 2006, 75 patients were subjected to open heart surgery using HTEA and GA. Unstable angina was present in 42 (56%). Forty eight (64%) were classified as New York Heart Association class III +-or IV. Preoperative ejection fraction was 39 13. Median sternotomy was performed in 70 (93%) patients, right antero-lateral thoracotomy in 4(5%) and median laparotomy in 1 patient. Aorto coronary bypass (ACB) was done in 45(60%) ofthe patientswith 5(7%) offpump cases,ventriculoplasty and valve reconstructive surgery in 8(11%) of the patients, valve replacement was done in 12(16%) of the patients, mitral valve reconstruction in 6 (8%) of the patients. Two patients required intra aortic balloon pump suppor