Coronary artery bypass surgery perioperative management of myocardial ischemia
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Coronary Artery Bypass Surgery Microchapters | |
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Pathophysiology | |
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Diagnosis | |
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Perioperative Monitoring | |
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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 Preconditioning/Management of Myocardial Ischemia[1]
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Class I1. 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 infarction.[2][3][4][5][6] (Level of Evidence: B) Class IIa1. Volatile-based anesthesia can be useful in reducing the risk of perioperative myocardial ischemia and infarction.[7][8][9][10] (Level of Evidence: A) Class IIb1. 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. (Level of Evidence: A) 2. Mechanical preconditioning might be considered to reduce the risk of perioperative myocardial ischemia and infarction in patients undergoing off-pump CABG. (Level of Evidence: B) 3. Remote ischemic preconditioning strategies using peripheral-extremity occlusion/reperfusion might be considered to attenuate the adverse consequences of myocardial reperfusion injury. (Level of Evidence: B) 4. The effectiveness of postconditioning strategies to attenuate the adverse consequences of myocardial reperfusion injury is uncertain. (Level of Evidence: C) |
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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
- ↑ 1.0 1.1 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.
- ↑ Slogoff S, Keats AS (1985). "Does perioperative myocardial ischemia lead to postoperative myocardial infarction?". Anesthesiology. 62 (2): 107–14. PMID 3970360.
- ↑ Dyub AM, Whitlock RP, Abouzahr LL, Cinà CS (2008). "Preoperative intra-aortic balloon pump in patients undergoing coronary bypass surgery: a systematic review and meta-analysis". J Card Surg. 23 (1): 79–86. doi:10.1111/j.1540-8191.2007.00499.x. PMID 18290898.
- ↑ Heusch G (2008). "Heart rate in the pathophysiology of coronary blood flow and myocardial ischaemia: benefit from selective bradycardic agents". Br J Pharmacol. 153 (8): 1589–601. doi:10.1038/sj.bjp.0707673. PMC 2438254. PMID 18223669.
- ↑ Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF; et al. (2002). "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)". J Am Coll Cardiol. 40 (8): 1531–40. PMID 12392846.
- ↑ Lavana JD, Fraser JF, Smith SE, Drake L, Tesar P, Mullany DV (2010). "Influence of timing of intraaortic balloon placement in cardiac surgical patients". J Thorac Cardiovasc Surg. 140 (1): 80–5. doi:10.1016/j.jtcvs.2009.09.033. PMID 19909993.
- ↑ Landoni G, Biondi-Zoccai GG, Zangrillo A, Bignami E, D'Avolio S, Marchetti C; et al. (2007). "Desflurane and sevoflurane in cardiac surgery: a meta-analysis of randomized clinical trials". J Cardiothorac Vasc Anesth. 21 (4): 502–11. doi:10.1053/j.jvca.2007.02.013. PMID 17678775.
- ↑ Lucchinetti E, Hofer C, Bestmann L, Hersberger M, Feng J, Zhu M; et al. (2007). "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". Anesthesiology. 106 (3): 444–57. PMID 17325502.
- ↑ Yao YT, Li LH (2009). "Sevoflurane versus propofol for myocardial protection in patients undergoing coronary artery bypass grafting surgery: a meta-analysis of randomized controlled trials". Chin Med Sci J. 24 (3): 133–41. PMID 19848312.
- ↑ Yu CH, Beattie WS (2006). "The effects of volatile anesthetics on cardiac ischemic complications and mortality in CABG: a meta-analysis". Can J Anaesth. 53 (9): 906–18. doi:10.1007/BF03022834. PMID 16960269.