Coronary artery bypass surgery electrocardiographic monitoring

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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]

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

Electrocardiographic Monitoring (DO NOT EDIT)[1]

Class I
"1. Continuous monitoring of the electrocardiogram for arrhythmias should be performed for at least 48 hours in all patients after CABG.[2][3][4] (Level of Evidence: B)"
Class IIa
"1. Continuous ST-segment monitoring for detection of ischemia is reasonable in the intraoperative period for patients undergoing CABG.[5][6][7][8] (Level of Evidence: B)"
Class IIb
"1. Continuous ST-segment monitoring for detection of ischemia may be considered in the early postoperative period after CABG.[9][3][10][11][12][13] (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. 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)
  3. 3.0 3.1 Drew BJ, Califf RM, Funk M, Kaufman ES, Krucoff MW, Laks MM, Macfarlane PW, Sommargren C, Swiryn S, Van Hare GF (2004). "Practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association scientific statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young: endorsed by the International Society of Computerized Electrocardiology and the American Association of Critical-Care Nurses". Circulation. 110 (17): 2721–46. doi:10.1161/01.CIR.0000145144.56673.59. PMID 15505110. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  4. Echahidi N, Pibarot P, O'Hara G, Mathieu P (2008). "Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery". Journal of the American College of Cardiology. 51 (8): 793–801. doi:10.1016/j.jacc.2007.10.043. PMID 18294562. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  5. Slogoff S, Keats AS (1985). "Does perioperative myocardial ischemia lead to postoperative myocardial infarction?". Anesthesiology. 62 (2): 107–14. PMID 3970360. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  6. Gordon MA, Urban MK, O'Connor T, Barash PG (1991). "Is the pressure rate quotient a predictor or indicator of myocardial ischemia as measured by ST-segment changes in patients undergoing coronary artery bypass surgery?". Anesthesiology. 74 (5): 848–53. PMID 2021200. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  7. Knight AA, Hollenberg M, London MJ, Tubau J, Verrier E, Browner W, Mangano DT (1988). "Perioperative myocardial ischemia: importance of the preoperative ischemic pattern". Anesthesiology. 68 (5): 681–8. PMID 3259409. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  8. Jain U, Laflamme CJ, Aggarwal A, Ramsay JG, Comunale ME, Ghoshal S, Ngo L, Ziola K, Hollenberg M, Mangano DT (1997). "Electrocardiographic and hemodynamic changes and their association with myocardial infarction during coronary artery bypass surgery. A multicenter study. Multicenter Study of Perioperative Ischemia (McSPI) Research Group". Anesthesiology. 86 (3): 576–91. PMID 9066323. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  9. Podesser BK, Schwarzacher S, Zwoelfer W, Binder TM, Wolner E, Seitelberger R (1995). "Comparison of perioperative myocardial protection with nifedipine versus nifedipine and metoprolol in patients undergoing elective coronary artery bypass grafting". The Journal of Thoracic and Cardiovascular Surgery. 110 (5): 1461–9. PMID 7475198. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  10. Mangano DT, Siliciano D, Hollenberg M, Leung JM, Browner WS, Goehner P, Merrick S, Verrier E (1992). "Postoperative myocardial ischemia. Therapeutic trials using intensive analgesia following surgery. The Study of Perioperative Ischemia (SPI) Research Group". Anesthesiology. 76 (3): 342–53. PMID 1531742. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  11. Zvara DA, Groban L, Rogers AT, Prielipp RC, Murphy B, Hines M, Hammon JW, Kon ND, Royster RL (2000). "Prophylactic nitroglycerin did not reduce myocardial ischemia during accelerated recovery management of coronary artery bypass graft surgery patients". Journal of Cardiothoracic and Vascular Anesthesia. 14 (5): 571–5. doi:10.1053/jcan.2000.9445. PMID 11052441. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  12. Berry PD, Thomas SD, Mahon SP, Jackson M, Fox MA, Fabri B, Weir WI, Russell GN (1998). "Myocardial ischaemia after coronary artery bypass grafting: early vs late extubation". British Journal of Anaesthesia. 80 (1): 20–5. PMID 9505772. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  13. Cheng DC, Karski J, Peniston C, Asokumar B, Raveendran G, Carroll J, Nierenberg H, Roger S, Mickle D, Tong J, Zelovitsky J, David T, Sandler A (1996). "Morbidity outcome in early versus conventional tracheal extubation after coronary artery bypass grafting: a prospective randomized controlled trial". The Journal of Thoracic and Cardiovascular Surgery. 112 (3): 755–64. PMID 8800165. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)

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