Context : Patients with COPD are at increased risk of coronary artery disease (CAD) and, conversely, CAD is associated with the diagnosis and severity of COPD . Due to secondary pulmonary hypertension, right ventricular hypertrophy and ischaemia are known to occur in COPD. The purpose of our study is to compare two preoperative echocardiographic parameters; TAPSE and Transpulmonary Pressure Gradient (TPG), to quantify RV dysfunction to predict post cardiopulmonary bypass decreased venous oxygen saturation in COPD patients undergoing CABG. Aims : To find out the correlation of TAPSE and TPG with the changes of venous oxygen saturation after release of cross clamp. Settings and design: After obtaining institutional ethics committee clearance and informed consent from each patient 60 COPD patients undergoing on-pump CABG for CAD, were included in this study over a period of one and half year. Material and methods:After institution of general anaesthesia TAPSE and TPG were measured before any incision. SvO2 was measured before going on bypass and one hour after release of cross clamp. Statistical analysis used: Data were analyzed using standard statistical software Epi Info (TM) 7.2.2.2. Result and conclusion: TPG has better predictive accuracy in comparison to TAPSE (91.67% vs 61.67%) to predict low SvO2 after coming out of bypass, following CABG.

An Intra-operative Transesophageal Echocardiographic Study to Compare The Effect of Sevourane and Isourane on Left Ventricular Dysfunction In Patients With Ischemic Heart Disease Undergoing Coronary Artery Bypass Grafting Using Cardiopulmonary Bypass Context : Diastolic dysfunction has been increasingly recognized as an important cause of congestive heart failure (CHF) and resultant morbidity. About 50% patients with CHF have 'diastolic heart failure' in spite of a normal systolic function with preserved ejection fraction. The widely used volatile anesthetic agents, Isourane and Sevourane, are considered important components of balanced anesthesia technique. However their effects on left ventricular (LV) systolic and diastolic function have not been precisely dened. This study was designed to quantify and compare their effects on left ventricular function by TEE before start of CPB. Aims : To compare the effects of Isourane and Sevourane on echocardiographic LVsystolic and diastolic parameters. Settings and design : After obtaining institutional ethics committee clearance and informed consent from 60 patients operated within my study period was included . Data were collected after induction and just before going on bypass. Materials and Methods : After inducing the patients with institutional protocol one group was given isourane(Group I) and another group was given sevourane(Group S), both at 1MAC. TEE parameters measuring LVsystolic and diastolic functions were done. Statistical analysis : Data were analysed by Epi Info (TM) 7.2.2.2. Result and conclusion :Isourane was better than sevourane in comparism of systolic and diastolic dysfunction.