Effect of Intraoperative Iloprost Inhalant on Hemodynamic Stability in Patients Undergoing Off-pump Coronary Artery Bypass Graft Surgery

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    Yonsei University
Updated on 26 January 2021


Considering that the cause of hemodynamic instability during OPCAB is closely related to right ventricular dysfunction with pulmonary artery hypertension, the use of inhaled iloprost (a selective pulmonary vasodilator) in patients undergoing OPCAB maybe beneficial for hemodynamic management. Previous research has showed that inhaled iloprost reduce pulmonary arterial pressure and pulmonary vascular resistance. Therefore, by administering inhaled iloprost before the graft anastomosis might improve cardiac output, mixed venous blood oxygen saturation, and pulmonary oxygenation during the surgery especially during the graft anastomosis.

The objective of our study is to evaluate the effect of inhaled Iloprost on hemodynamic stability in patients undergoing off-pump coronary artery bypass graft surgery.

Condition Coronary Artery Occlusive Disease
Treatment iloprost, Control (Normal saline)
Clinical Study IdentifierNCT04598191
SponsorYonsei University
Last Modified on26 January 2021


Yes No Not Sure

Inclusion Criteria

Patients older than 20 years and undergoing off-pump coronary artery bypass graft surgery with any of the following condition
High risk of hemodynamically unstable (patient in NYHA functional class III-IV, or mean pulmonary-artery pressure 25 mm Hg or right ventricular systolic pressure 50mmHg in preoperative echo findings, preoperative left ventricular ejection fraction < 50%, acute myocardial infarction within 1 month of surgery, ventricular fibrillation)
History of previous cardiac operation (redo)
Left main coronary artery disease
Lesion at all three major coronary arteries

Exclusion Criteria

Emergency operation
Patients undergoing minimally Invasive Direct Coronary Artery Bypass
Patients with cardiogenic shock or ventricular-assist device (eg. ECMO, IABP)
Patients with pre-existing infections prior to surgery (eg. sepsis)
Patients with liver cirrhosis
Patients with hemorrhagic disease / bleeding risk (history of active peptic ulcer, intracranial hemorrhage, congenital hemorrhagic disease etc.)
Patients with cerebrovascular event (TIA, stroke) within 3 months
Patients with symptomatic asthma/chronic obstructive pulmonary disease who are receiving treatment such as inhaler or steroid
Patient with severe chronic kidney disease (GFR(CKD-EPI) <30ml/min/1.73m2)
Patient with acute kidney injury
Patients who have participated in other clinical studies that may affect prognosis
Patients who cannot understand the informed consent (eg. Foreigner)
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