Coronary artery bypass surgery TEE

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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

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]

Intraoperative Transesophageal Echocardiography (DO NOT EDIT)[1]

Class I
"1. Intraoperative transesophageal echocardiography should be performed for evaluation of acute, persistent, and life-threatening hemodynamic disturbances that have not responded to treatment.[2][3] (Level of Evidence: B)"
"2. Intraoperative transesophageal echocardiography should be performed in patients undergoing concomitant valvular surgery.[2][4] (Level of Evidence: B)"
Class IIa
"1. Intraoperative transesophageal echocardiography is reasonable for monitoring of hemodynamic status, ventricular function, regional wall motion, and valvular function in patients undergoing CABG.[3][5][6][7][8][9][10] (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 Eltzschig HK, Rosenberger P, Löffler M, Fox JA, Aranki SF, Shernan SK (2008). "Impact of intraoperative transesophageal echocardiography on surgical decisions in 12,566 patients undergoing cardiac surgery". Ann Thorac Surg. 85 (3): 845–52. doi:10.1016/j.athoracsur.2007.11.015. PMID 18291154.
  3. 3.0 3.1 Savage RM, Lytle BW, Aronson S, Navia JL, Licina M, Stewart WJ; et al. (1997). "Intraoperative echocardiography is indicated in high-risk coronary artery bypass grafting". Ann Thorac Surg. 64 (2): 368–73, discussion 373-4. doi:10.1016/S0003-4975(97)00612-7. PMID 9262577.
  4. American Society of Anesthesiologists and Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography (2010). "Practice guidelines for perioperative transesophageal echocardiography. An updated report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography". Anesthesiology. 112 (5): 1084–96. doi:10.1097/ALN.0b013e3181c51e90. PMID 20418689.
  5. Bergquist BD, Bellows WH, Leung JM (1996). "Transesophageal echocardiography in myocardial revascularization: II. Influence on intraoperative decision making". Anesth Analg. 82 (6): 1139–45. PMID 8638781.
  6. Moisés VA, Mesquita CB, Campos O, Andrade JL, Bocanegra J, Andrade JC; et al. (1998). "Importance of intraoperative transesophageal echocardiography during coronary artery surgery without cardiopulmonary bypass". J Am Soc Echocardiogr. 11 (12): 1139–44. PMID 9923994.
  7. Qaddoura FE, Abel MD, Mecklenburg KL, Chandrasekaran K, Schaff HV, Zehr KJ; et al. (2004). "Role of intraoperative transesophageal echocardiography in patients having coronary artery bypass graft surgery". Ann Thorac Surg. 78 (5): 1586–90. doi:10.1016/j.athoracsur.2004.05.001. PMID 15511437.
  8. Swaminathan M, Morris RW, De Meyts DD, Podgoreanu MV, Jollis JG, Grocott HP; et al. (2007). "Deterioration of regional wall motion immediately after coronary artery bypass graft surgery is associated with long-term major adverse cardiac events". Anesthesiology. 107 (5): 739–45. doi:10.1097/01.anes.0000287008.70453.81. PMID 18073549.
  9. Wang J, Filipovic M, Rudzitis A, Michaux I, Skarvan K, Buser P; et al. (2004). "Transesophageal echocardiography for monitoring segmental wall motion during off-pump coronary artery bypass surgery". Anesth Analg. 99 (4): 965–73, table of contents. doi:10.1213/01.ANE.0000130614.45647.81. PMID 15385335.
  10. Zimarino M, Gallina S, Di Fulvio M, Di Mauro M, Di Giammarco G, De Caterina R; et al. (2004). "Intraoperative ischemia and long-term events after minimally invasive coronary surgery". Ann Thorac Surg. 78 (1): 135–41. doi:10.1016/j.athoracsur.2003.12.030. PMID 15223418.

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