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| | __NOTOC__ |
| {{Coronary artery bypass surgery}} | | {{Coronary artery bypass surgery}} |
| {{CMG}}; {{AOEIC}} {{VK}} | | {{CMG}}; {{AOEIC}} {{VK}} |
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| ==ACCF/AHA Guidelines for Preconditioning/Management of Myocardial Ischemia<ref name="pmid22064599">{{cite journal| author=Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG et al.| title=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. | journal=Circulation | year= 2011 | volume= | issue= | pages= | pmid=22064599 | doi=10.1161/CIR.0b013e31823c074e | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22064599 }} </ref>== | | ==ACCF/AHA Guidelines for Perioperative Myocardial Dysfunction== |
| {{cquote| | | {{cquote| |
| ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]=== | | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]=== |
| '''1.''' Management targeted at optimizing the determinants of coronary arterial perfusion (eg, [[heart rate]], diastolic or [[mean arterial pressure]], and right ventricular or LV end-diastolic pressure) is recommended to reduce the risk of perioperative [[myocardial ischemia]] and [[MI|infarction]].<ref name="pmid3970360">{{cite journal| author=Slogoff S, Keats AS| title=Does perioperative myocardial ischemia lead to postoperative myocardial infarction? | journal=Anesthesiology | year= 1985 | volume= 62 | issue= 2 | pages= 107-14 | pmid=3970360 | doi= | pmc= | url= }} </ref><ref name="pmid18290898">{{cite journal| author=Dyub AM, Whitlock RP, Abouzahr LL, Cinà CS| title=Preoperative intra-aortic balloon pump in patients undergoing coronary bypass surgery: a systematic review and meta-analysis. | journal=J Card Surg | year= 2008 | volume= 23 | issue= 1 | pages= 79-86 | pmid=18290898 | doi=10.1111/j.1540-8191.2007.00499.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18290898 }} </ref><ref name="pmid18223669">{{cite journal| author=Heusch G| title=Heart rate in the pathophysiology of coronary blood flow and myocardial ischaemia: benefit from selective bradycardic agents. | journal=Br J Pharmacol | year= 2008 | volume= 153 | issue= 8 | pages= 1589-601 | pmid=18223669 | doi=10.1038/sj.bjp.0707673 | pmc=PMC2438254 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18223669 }} </ref><ref name="pmid12392846">{{cite journal| author=Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF et al.| title=ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). | journal=J Am Coll Cardiol | year= 2002 | volume= 40 | issue= 8 | pages= 1531-40 | pmid=12392846 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12392846 }} </ref><ref name="pmid19909993">{{cite journal| author=Lavana JD, Fraser JF, Smith SE, Drake L, Tesar P, Mullany DV| title=Influence of timing of intraaortic balloon placement in cardiac surgical patients. | journal=J Thorac Cardiovasc Surg | year= 2010 | volume= 140 | issue= 1 | pages= 80-5 | pmid=19909993 | doi=10.1016/j.jtcvs.2009.09.033 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19909993 }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' | | '''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) |
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| ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]===
| | '''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)}} |
| '''1.''' Volatile-based anesthesia can be useful in reducing the risk of perioperative myocardial ischemia and infarction.<ref name="pmid17678775">{{cite journal| author=Landoni G, Biondi-Zoccai GG, Zangrillo A, Bignami E, D'Avolio S, Marchetti C et al.| title=Desflurane and sevoflurane in cardiac surgery: a meta-analysis of randomized clinical trials. | journal=J Cardiothorac Vasc Anesth | year= 2007 | volume= 21 | issue= 4 | pages= 502-11 | pmid=17678775 | doi=10.1053/j.jvca.2007.02.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17678775 }} </ref><ref name="pmid17325502">{{cite journal| author=Lucchinetti E, Hofer C, Bestmann L, Hersberger M, Feng J, Zhu M et al.| title=Gene regulatory control of myocardial energy metabolism predicts postoperative cardiac function in patients undergoing off-pump coronary artery bypass graft surgery: inhalational versus intravenous anesthetics. | journal=Anesthesiology | year= 2007 | volume= 106 | issue= 3 | pages= 444-57 | pmid=17325502 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17325502 }} </ref><ref name="pmid19848312">{{cite journal| author=Yao YT, Li LH| title=Sevoflurane versus propofol for myocardial protection in patients undergoing coronary artery bypass grafting surgery: a meta-analysis of randomized controlled trials. | journal=Chin Med Sci J | year= 2009 | volume= 24 | issue= 3 | pages= 133-41 | pmid=19848312 | doi= | pmc= | url= }} </ref><ref name="pmid16960269">{{cite journal| author=Yu CH, Beattie WS| title=The effects of volatile anesthetics on cardiac ischemic complications and mortality in CABG: a meta-analysis. | journal=Can J Anaesth | year= 2006 | volume= 53 | issue= 9 | pages= 906-18 | pmid=16960269 | doi=10.1007/BF03022834 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16960269 }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' | |
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| ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]===
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| '''1.''' The effectiveness of prophylactic pharmacological therapies or controlled reperfusion strategies aimed at inducing preconditioning or attenuating the adverse consequences of myocardial reperfusion injury or surgically induced systemic inflammation is uncertain. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''
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| '''2.''' Mechanical preconditioning might be considered to reduce the risk of perioperative myocardial ischemia and infarction in patients undergoing off-pump CABG. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''
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| '''3.''' Remote ischemic preconditioning strategies using peripheral-extremity occlusion/reperfusion might be considered to attenuate the adverse consequences of myocardial reperfusion injury. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''
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| '''4.''' The effectiveness of postconditioning strategies to attenuate the adverse consequences of myocardial reperfusion injury is uncertain. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''}}
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| ==Guidelines Resources== | | ==Guidelines Resources== |
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| {{reflist|2}} | | {{reflist|2}} |
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| {{WH}}
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| {{WS}}
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| [[Category:Cardiac surgery]] | | [[Category:Cardiac surgery]] |
| [[Category:Cardiology]] | | [[Category:Cardiology]] |
| [[Category:mature chapter]]
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| [[Category:Surgery]] | | [[Category:Surgery]] |
| [[Category:Surgical procedures]] | | [[Category:Surgical procedures]] |
| | [[Category:Up-To-Date]] |
| | [[Category:Up-To-Date cardiology]] |