Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2
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Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2
Chapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 25772/61404AbstractSurgical treatment of coronary artery disease should increase regional coronary How reserve and not increase any early or late morbidity and mortality mone than the other treatment modalities. Ill tile past 50 years, surgical treatment of coronary artery disease lias been adapted r Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2apidly worldwide and several tvclutiqucs have been developed to decrease total surgical risks and to improve early and late results with the lúgliestEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
level of quality ol life. In spile ol th? last guidelines that oiler stents lor single or multiple vessels disease, the tact is that surgical revasculChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2e effects of extracorporeal circulation and cardioplegia {off-pump), and general anesthesia (awake coronary bypass). Ihe prime goal of surgical revascularization is to obtain complete revascularization by bypassing all severe stenotic coronary arteries having a diameter larger than I mm. Surgical re Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2vascularization with cardiopulmonary bypass tltrough a full sternotomy remains the most widely used surgical technique. With tile development of stabiEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
lization devices, off-pump procedures can be safely performed in most patients with single or mullivessel disease. Minimal invasive and/or robotic surChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2ally the left internal mammary artery to the left anterior descending artery. Tile early cumulative mortality rate is below 3%, but lower tluui 1% in lower-risk patients. There are some variables most predictive of early mortality: older age, female, reoperalion, non-elecfive surgery, left ventricul Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2ar dysfunction, accelerated atherosclerosis. The survival rate is higher than 65% for 15 years, late mortality is dependent not only on non-use of intEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
ernal mammalian artery, closure of grafts, progression of native arterial disease but also on comorbidities. Satisfactory quality of life after surgerChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2capacity. Return of angina during the first 6 months depends on incomplete revascularization or graft failure, whereas progression of native-vessel disease and grafts are serious risk factors for tile late recurrence of angina. Venous graft occlusion is tile most common reason for reintervention, an Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2d native vessel disease is the second.Keywords: Coronary artery bypass, arterial graft, revascularization, off-pump, awake14S Coronary Artery DiseaseEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
• Assessment Surgery, Prevention1introductionCoronary artery disease (CAD) is the most common pathology which prepossesses cardiologists and cardiac sChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2on of mortality in the world as reported by the World I lealth Organization in 2012 (2j. Coronary artery disease is caused by an atherosclerotic plaque which narrows the internal lumen of the coronary artery. This lesion decreases coronary’ arterial blood flow and oxygen supply to the myocardium, an Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2d causes several symptoms such as chest pain, dyspnea, syncope, sometimes pulmonary edema The low blood flow through the coronary artery territory canEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
not increase and support the increasing daily-life effort capacity, and the increased demand of oxygenated blood supply starts angina pectoris. There Chapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2d standard for diagnosis. An improved understanding of the pathophysiology’ of CAI) has forwarded efforts to increase myocardial blood supply. According to the result of angiography, patients should be treated either medically or with invasive treatment modalities. Because myocardial revascularizati Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2on prolongs survival, relieves angina, and improves quality of life, percutaneous coronary intervention and coronary artery bypass surgery (CABG) canEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
be the only treatment strategies to perform this revascularization. The general condition of patients is I ho decisive factor lo soled I ho best accepChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2artery lesions, lesion type, and lesion localion. The potential aim of Iho minimally invasive techniques is to reduce postoperative patient discomfort, to decrease bleeding and wound infection, and to shorten recovery times2HistoryThe first method to establish blood supply to the ischemic myocardium Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2 is to place the pedided pectoralis muscle flap on the pericardium performed by Beck in 1935 [31- Tire folio wing 10 years passed with the developmentEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
s such as chemical pericarditis and revascularization through I he coronary sinus. Bock I operation (abrasion of the pericardium and epicardium + applChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2 the coronary sinus + brachial artery bypass between the descending aorta and the coronary’ sinus) was introduced in 1947. Vineberg described the direct implantation of internal mammalian artery (IMA) into the myocardium in 1950 [4). A modification of the Vmeberg procedure (anastomosis of a long sap Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2henous vein between the aorta and the apex of the heart) was performed by Smith in 1955. The first successful coronary endarterectomy was performed byEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
Bailey in 1956 [5]. Goetz performed the first successful planned CABG operation in 1960 [6]. The first patch graft technique to enlarge the obstructeChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2escribed by Sabiston in 1962 (8). Favalaro placed a saphenous vein between the ascendingCoronary Artery Bypass Surgery 149 http://dx.doi org/10 5772/61404aorta (side-to-end) and the right coronary artery (RCA) (end-to-end) in 1960s. [9] The official start of CABG surgery happened at the end of 1960s Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2 and saphenous vein grafts were used in all major branches with the same technique as we use nowadays [10]. Kolessov performed the first successful leEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
ft internal mammary artery (LIMA) to the left anterior descending (LAD) coronary artery anastomosis on the beating heart through a left thoracotomy inChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2cy became known 112].After all of the developments in cardiac surgery, the cornerstone is the development of the cardiopulmonary bypass machine. This staged development has brought CABG surgery as a standard treatment modality after 1960s. The first stage was the discovery of heparin in 1915, which Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2opened the door for open heart surgery. The second stage was the development of a heart-lung machine, rhe first successful open heart procedures on aEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
human utilizing the heartlung machine were total left-sided heart bypass procedures, where the patient's own lungs were used IO oxygenate the blood, rChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2rocedure using a heart lung machine was performed by Gibbon to close an atrial septal defect in 1953 [14]. The third stage was the development of membrane oxygenators in the 1960s The first successful usage of a membrane oxygenator for extracorporeal circulation was performed by Hill itnd colleagues Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2 in 1972 [15] The fourth stage was using a potassium-based cardioplegia solution to protect myocardium during open heart surgery. Melrose and colleaguEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
es presented the first expenmental study with blood cardioplegia in 1955, but toxicity of this solution prevented usage of this cardioplegia for severChapter 6Coronary Artery Bypass SurgeryKaan Kirali and Hakan Sa<;liAdditional information is available at the end of the chapterhttp://dx.doi.Org/10.5 Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2ion of myocardium during potassium-induced cardiac arrest was demonstrated in 1973 [17j. l ollcueand colleagues reintroduced the technique of blood cardioplegia in 1978 [18].Aller all of the developments in the conventional CABG surgery’, the next slop has been IO minimize the standard surgical reva Ebook Coronary artery disease - Assessment, surgery, prevention: Part 2scularization procedure using different techniques. Coronary bypass surgery is performed without opening a cardiac chamber and it is not necessary toEbook Coronary artery disease - Assessment, surgery, prevention: Part 2
use extracorporeal circulation Continuing ventilation of the lungs eliminates the use of any oxygenator and keeping a beating heart eliminates any pumGọi ngay
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