Coronary artery bypass surgery in patients with COPD/respiratory insufficiency

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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]

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

Chronic Obstructive Pulmonary Disease/Respiratory Insufficiency (DO NOT EDIT)[1]

Class IIa
"1. Preoperative intensive inspiratory muscle training is reasonable to reduce the incidence of pulmonary complications in patients at high risk for respiratory complications after CABG.[2] (Level of Evidence: B)"
Class IIb
"1. After CABG, noninvasive positive pressure ventilation may be reasonable to improve pulmonary mechanics and to reduce the need for reintubation.[3][4] (Level of Evidence: B)"
"2. High thoracic epidural analgesia may be considered to improve lung function after CABG.[5][6] (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. Hulzebos EH, Helders PJ, Favié NJ, De Bie RA, Brutel de la Riviere A, Van Meeteren NL (2006). "Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial". JAMA : the Journal of the American Medical Association. 296 (15): 1851–7. doi:10.1001/jama.296.15.1851. PMID 17047215. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  3. Haeffener MP, Ferreira GM, Barreto SS, Arena R, Dall'Ago P (2008). "Incentive spirometry with expiratory positive airway pressure reduces pulmonary complications, improves pulmonary function and 6-minute walk distance in patients undergoing coronary artery bypass graft surgery". American Heart Journal. 156 (5): 900.e1–900.e8. doi:10.1016/j.ahj.2008.08.006. PMID 19061704. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  4. Zarbock A, Mueller E, Netzer S, Gabriel A, Feindt P, Kindgen-Milles D (2009). "Prophylactic nasal continuous positive airway pressure following cardiac surgery protects from postoperative pulmonary complications: a prospective, randomized, controlled trial in 500 patients". Chest. 135 (5): 1252–9. doi:10.1378/chest.08-1602. PMID 19017864. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  5. Liu SS, Block BM, Wu CL (2004). "Effects of perioperative central neuraxial analgesia on outcome after coronary artery bypass surgery: a meta-analysis". Anesthesiology. 101 (1): 153–61. PMID 15220785. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  6. Kofidis T, Baraki H, Singh H, Kamiya H, Winterhalter M, Didilis V, Emmert M, Woitek F, Haverich A, Klima U (2008). "The minimized extracorporeal circulation system causes less inflammation and organ damage". Perfusion. 23 (3): 147–51. doi:10.1177/0267659108097880. PMID 19029264. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)