Coronary artery bypass surgery goals of treatment

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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 Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Mohammed A. Sbeih, M.D.[3]

Goals of treatment

The main goal of this procedure is treat Ischemic heart disease where the main problems are narrowing of the coronary arteries from fatty deposits in these vessels which then obstruct blood flow to the heart muscle. This causes the heart muscle to starve of oxygen, thus causing anginal pain. A complete blockage may causes a myocardial infarction (MI), where the heart muscle starts to die and is irreversible. It is therefore vital to correct any partial blockage before a complete obstruction occurs.

Coronary artery bypass grafting (CAGB) involves removing veins from other parts of the patients body, most commonly from legs or the chest wall (the Internal mammary artery) and inserting them around the blocked heart vessel so that blood flows through these new vessels instead. A number of blood vessels can be replaced at the same time. For example, a triple heart bypass replaces 3 coronary arteries in the same operation.

Recently CABG started to be done through a keyhole (laparoscopic) incision while the heart is still pumping, this new technique decreases the recovery time. Tradtionally, a large incision through the centre of the chest (sternum) was made, the heart stopped and the patient put onto a bypass machine, but recovery took longer due to the trauma to the chest wall. This procedure is particularly useful when other methods such as angioplasty are not suitable or have failed.



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