Coronary artery bypass surgery perioperative management of myocardial ischemia

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Coronary Artery Bypass Surgery Microchapters

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Patient Information

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

Recommendation for Duration of DAPT in Patients With ACS Treated With 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]

ACCF/AHA Guidelines for Perioperative Myocardial Dysfunction

Class I

1. In the absence of severe, symptomatic aorto-iliac occlusive disease or PAD, the insertion of an intraaortic balloon is reasonable to reduce mortality rate in CABG patients who are considered to be at high risk (eg, those who are undergoing reoperation or have LVEF <30% or left main CAD).1021–1026 (Level of Evidence: B)

2. Measurement of biomarkers of myonecrosis (eg, creatine kinase-MB, troponin) is reasonable in the first 24 hours after CABG.200 (Level of Evidence: B)

Guidelines Resources

  • 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. 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.

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