Coronary artery bypass surgery goals of treatment
|
Coronary Artery Bypass Surgery Microchapters | |
|
Pathophysiology | |
|---|---|
|
Diagnosis | |
|
Treatment | |
|
Perioperative Monitoring | |
|
Surgical Procedure | |
|
Special Scenarios | |
|
Coronary artery bypass surgery goals of treatment On the Web | |
|
Coronary artery bypass surgery goals of treatment in the news | |
|
Blogs on Coronary artery bypass surgery goals of treatment|- |
|
|
Directions to Hospitals Performing Coronary artery bypass surgery goals of treatment | |
|
Risk calculators for Coronary artery bypass surgery goals of treatment | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2],Mohammed A. Sbeih, M.D. [3]
Goals of treatment
The main goal of this procedure is treat Ischemic heart disease where the main problems are narrowing of the coronary arteries from fatty deposits in these vessels which then obstruct blood flow to the heart muscle. This causes the heart muscle to starve of oxygen, thus causing anginal pain. A complete blockage may causes a myocardial infarction (MI), where the heart muscle starts to die and is irreversible. It is therefore vital to correct any partial blockage before a complete obstruction occurs.
Coronary Artery By-pass Grafting (CAGB) involves removing veins from other parts of the patients body, most commonly from legs or the chest wall and inserting them by microsurgery around the blocked heart vessel so that blood flows through these new channels instead. A number of blood vessels can be replaced at the same time. For example, a triple heart by-pass replaces 3 coronary arteries. The latest techniques involve doing this through a keyhole (laparoscopic) incision while the heart is still pumping as this aids greatly in recover times. Tradtionally, a large incision through the centre of the chest, over and through the breast bone (sternum) was made, the heart stopped and the patient but onto a by-pass machine, but recovery took longer due to the extent of the trauma to the chest wall. This procedure is particularly useful when other methods such as angioplasty are not suitable or have failed.
Primarily, the goal should be to detect and treat a SVG stenosis early in the development of ischemia while the SVG is still patent. Although intervention on a chronic total occlusion of a SVG may seem like an effective treatment strategy, it is best avoided. As long as the SVG is not completely occluded, intervention can be performed.
Two additional overall goals of treating SVG stenosis include the resolution of symptomatic ischemia and the prevention/treatment of distal embolization.