Elevated arterial lactate concentrations early after coronary artery bypass grafting are associated with increased anaerobic metabolism in skeletal muscle.

Objective: To assess the effect of coronary artery bypass grafting with cardiopulmonary bypass on muscle perfusion, oxygen extraction, and lactate release during postoperative rest and exercise.

Design: Prospective observational study.

Setting: University hospital.

Bleeding following coronary surgery after preoperative low-molecular-weight heparin.

Low-molecular-weight heparin and acetyl salicylic acid have become an established treatment for unstable angina. A retrospective study on our database of one year was carried out to see what impact preoperative low-molecular-weight heparin versus none had on the postoperative course of 473 patients having coronary surgery exclusively. Apart from the fact that the low-molecular-weight heparin patients had a higher New York Heart Association classification and marginally more grafts, longer bypass and cross-clamp time, the preoperative characteristics and surgery of the two groups were similar.