Coronary artery bypass surgery management of dysrhythmias

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Overview

Pathophysiology

Saphenous Vein Graft Disease
Other Non-Atherosclerotic Saphenous Vein Graft Diseases

Indications for CABG

Prognosis

Diagnosis

Imaging in the Patient Undergoing CABG

Chest X Ray

Angiography

CT Angiography
MRI Angiography

Trans-Esophageal Echocardiography

Treatment

Goals of Treatment

Perioperative Management

Perioperative Monitoring

Electrocardiographic Monitoring
Pulmonary Artery Catheterization
Central Nervous System Monitoring

Surgical Procedure

Anesthetic Considerations
Intervention in left main coronary artery disease
The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)
Minimally Invasive CABG
Hybrid coronary revascularization
Conduits Used for Bypass
Videos on Spahenous Vein Graft Harvesting
Videos on Coronary Artery Bypass Surgery

Post-Operative Care and Complications

Pharmacotherapy in patients undergoing CABG CABG

Special Scenarios

Anomalous Coronary Arteries
COPD/Respiratory Insufficiency
Existing Renal Disease
Concomitant Valvular Disease
Previous Cardiac Surgery
Menopause
Carotid Disease evaluation before surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery (DO NOT EDIT)[1]

Perioperative Dysrhythmias (DO NOT EDIT)[1]

Class I
"1. Beta blockers should be administered for at least 24 hours before CABG to all patients without contraindications to reduce the incidence or clinical sequelae of postoperative AF.[2][3][4][5][6][7][8][9] (Level of Evidence: B)"
"2. Beta blockers should be reinstituted as soon as possible after CABG in all patients without contraindications to reduce the incidence or clinical sequelae of AF.[2][3][4][5][6][7][8][9] (Level of Evidence: B)"
Class IIa
"1. Preoperative administration of amiodarone to reduce the incidence of postoperative AF is reasonable for patients at high risk for postoperative AF who have contraindications to beta blockers.[10] (Level of Evidence: B)"
"2. Digoxin and non-dihydropyridine calcium channel blockers can be useful to control the ventricular rate in the setting of AF but are not indicated for prophylaxis.[4][11][12][13][14][15] (Level of Evidence: B)"

Sources

  • 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[1]

References

  1. 1.0 1.1 1.2 Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0b013e31823c074e. PMID 22064599.
  2. 2.0 2.1 Crystal E, Garfinkle MS, Connolly SS, Ginger TT, Sleik K, Yusuf SS (2004). "Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery". Cochrane Database of Systematic Reviews (Online) (4): CD003611. doi:10.1002/14651858.CD003611.pub2. PMID 15495059. Retrieved 2011-12-19.
  3. 3.0 3.1 Connolly SJ, Cybulsky I, Lamy A, Roberts RS, O'brien B, Carroll S, Crystal E, Thorpe KE, Gent M (2003). "Double-blind, placebo-controlled, randomized trial of prophylactic metoprolol for reduction of hospital length of stay after heart surgery: the beta-Blocker Length Of Stay (BLOS) study". American Heart Journal. 145 (2): 226–32. doi:10.1067/mhj.2003.147. PMID 12595838. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  4. 4.0 4.1 4.2 Andrews TC, Reimold SC, Berlin JA, Antman EM (1991). "Prevention of supraventricular arrhythmias after coronary artery bypass surgery. A meta-analysis of randomized control trials". Circulation. 84 (5 Suppl): III236–44. PMID 1682069. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  5. 5.0 5.1 Mariscalco G, Klersy C, Zanobini M, Banach M, Ferrarese S, Borsani P, Cantore C, Biglioli P, Sala A (2008). "Atrial fibrillation after isolated coronary surgery affects late survival". Circulation. 118 (16): 1612–8. doi:10.1161/CIRCULATIONAHA.108.777789. PMID 18824644. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  6. 6.0 6.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Kay GN, Le Huezey JY, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann LS, Smith SC, Priori SG, Estes NA, Ezekowitz MD, Jackman WM, January CT, Lowe JE, Page RL, Slotwiner DJ, Stevenson WG, Tracy CM, Jacobs AK, Anderson JL, Albert N, Buller CE, Creager MA, Ettinger SM, Guyton RA, Halperin JL, Hochman JS, Kushner FG, Ohman EM, Stevenson WG, Tarkington LG, Yancy CW (2011). "2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines". Circulation. 123 (10): e269–367. doi:10.1161/CIR.0b013e318214876d. PMID 21382897. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  7. 7.0 7.1 Al-Khatib SM, Hafley G, Harrington RA, Mack MJ, Ferguson TB, Peterson ED, Califf RM, Kouchoukos NT, Alexander JH (2009). "Patterns of management of atrial fibrillation complicating coronary artery bypass grafting: Results from the PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT-IV) Trial". American Heart Journal. 158 (5): 792–8. doi:10.1016/j.ahj.2009.09.003. PMID 19853700. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  8. 8.0 8.1 Silverman NA, Wright R, Levitsky S (1982). "Efficacy of low-dose propranolol in preventing postoperative supraventricular tachyarrhythmias: a prospective, randomized study". Annals of Surgery. 196 (2): 194–7. PMC 1352475. PMID 6979982. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  9. 9.0 9.1 Ali IM, Sanalla AA, Clark V (1997). "Beta-blocker effects on postoperative atrial fibrillation". European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery. 11 (6): 1154–7. PMID 9237602. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  10. Daoud EG, Strickberger SA, Man KC, Goyal R, Deeb GM, Bolling SF, Pagani FD, Bitar C, Meissner MD, Morady F (1997). "Preoperative amiodarone as prophylaxis against atrial fibrillation after heart surgery". The New England Journal of Medicine. 337 (25): 1785–91. doi:10.1056/NEJM199712183372501. PMID 9400034. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  11. Williams DB, Misbach GA, Kruse AP, Ivey TD (1985). "Oral verapamil for prophylaxis of supraventricular tachycardia after myocardial revascularization. A randomized trial". The Journal of Thoracic and Cardiovascular Surgery. 90 (4): 592–6. PMID 3900590. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  12. Davison R, Hartz R, Kaplan K, Parker M, Feiereisel P, Michaelis L (1985). "Prophylaxis of supraventricular tachyarrhythmia after coronary bypass surgery with oral verapamil: a randomized, double-blind trial". The Annals of Thoracic Surgery. 39 (4): 336–9. PMID 3885884. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  13. Tyras DH, Stothert JC, Kaiser GC, Barner HB, Codd JE, Willman VL (1979). "Supraventricular tachyarrhythmias after myocardial revascularization: a randomized trial of prophylactic digitalization". The Journal of Thoracic and Cardiovascular Surgery. 77 (2): 310–4. PMID 310917. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  14. Weiner B, Rheinlander HF, Decker EL, Cleveland RJ (1986). "Digoxin prophylaxis following coronary artery bypass surgery". Clinical Pharmacy. 5 (1): 55–8. PMID 3485028. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  15. Johnson LW, Dickstein RA, Fruehan CT, Kane P, Potts JL, Smulyan H, Webb WR, Eich RH (1976). "Prophylactic digitalization for coronary artery bypass surgery". Circulation. 53 (5): 819–22. PMID 1083313. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)

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