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Complications of Coronary Artery Bypass Grafting Surgery

PanVascular Medicine

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Abstract

More than 800,000 patients undergo coronary artery bypass grafting (CABG) each year worldwide (Nalysnyk et al. Heart 89:767–772, 2003). In the recent years, there have been major advances in techniques used in CABG surgery in order to assure better success rates and reduce complication rates. Thus, there has been a move toward arterial graft revascularization as compared to venous grafts in order to allow longer patency rates. In addition, newer methods such as minimal access and off cardiopulmonary bypass (CPB) surgery are now in routine practice in many centers around the world with an aim to reduce the rates of postoperative morbidity and length of hospital stay. Despite such advances, patients that present for CABG are older and increasingly frail with multiple cardiac and other comorbidities compared to those patients operated on in the last century. Hence, the risk of significant postoperative morbidity and mortality still exists and is even expected to increase in the coming years (Nalysnyk et al. Heart 89:767–772, 2003). In this chapter we will be discussing the complications of CABG surgery.

Her Majesty the Queen in Right of United Kingdom

####Daniela Graf on 2013-11-19 17:09:50####

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Abbreviations

Intra-aortic balloon pump (IABP):

This is a device that is positioned in the descending aorta. It inflates in diastole thereby reducing the work of the heart/impedance by reducing the afterload and improves coronary circulation (Bojar 2011; Chikwe et al. 2006).

Cardiopulmonary bypass (CPB):

This machine is used to perfuse organs during cardioplegic cardiac arrest during cardiac surgery. It includes heparinized circuit of a venous pipe and an arterial pipe, a mechanical pump, a blood reservoir, and an oxygenator. The venous pipe takes blood from the right heart. The blood is oxygenated and pumped back into the body via the arterial pipe (Bojar 2011).

Deep hypothermic circulatory arrest:

In cardiac surgery patients who undergo major aortic procedures, e.g., arch surgery, and run the risk of cerebral hypoperfusion/injury undergo circulatory arrest with cooling to as low as 18°. With every 10° C of temperature reduction, there is 50 % reduction in cellular metabolism, thereby reducing the risk of ischemic injury to the brain (Bojar 2011).

Cardioplegia:

A cold (4° C), high potassium content solution given at the time of cardiopulmonary bypass surgery to cause a diastolic cardiac arrest. The fluid leads to significant reduction in myocardial cellular metabolism and thereby reducing cardiac ischemia during the operation. The fluid also contains nutrition necessary for the myocardial cell survival (Bojar 2011; Chikwe et al. 2006).

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Authors and Affiliations

  1. Department of Cardio-Thoracic Surgery, University Hospital of South Manchester (Wythenshawe Hospital), Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK

    Maziar Khorsandi M.B.Ch.B., M.R.C.S., M.Sc. (Surg. Sci)., B.M.Sc. (Core Surgical Trainee (CT2)

  2. Department of Cardio-Thoracic surgery, Royal Infirmary of Edinburgh, Edinburgh, UK

    Kasra Shaikhrezai M.D., M.Sc. (Surg. Sci)., M.R.C.S. (Specialist Registrar in Cardio-Thoracic Surgery)

  3. Department of Cardio-Thoracic surgery, Royal Infirmary of Edinburgh, Edinburgh, UK

    Vipin Zamvar M.B.B.S., M.S. D.N.B. (C.Th.)., F.R.C.S. (C.Th.) (Consultant Cardio-Thoracic Surgeon)

Authors
  1. Maziar Khorsandi M.B.Ch.B., M.R.C.S., M.Sc. (Surg. Sci)., B.M.Sc.
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  2. Kasra Shaikhrezai M.D., M.Sc. (Surg. Sci)., M.R.C.S.
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  3. Vipin Zamvar M.B.B.S., M.S. D.N.B. (C.Th.)., F.R.C.S. (C.Th.)
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Correspondence to Maziar Khorsandi M.B.Ch.B., M.R.C.S., M.Sc. (Surg. Sci)., B.M.Sc. .

Editor information

Editors and Affiliations

  1. Akademisches Lehrkrankenhaus MLU, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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© 2014 Her Majesty the Queen in Right of United Kingdom

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Khorsandi, M., Shaikhrezai, K., Zamvar, V. (2014). Complications of Coronary Artery Bypass Grafting Surgery. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_233-1

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  • DOI: https://doi.org/10.1007/978-3-642-37393-0_233-1

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  1. Latest

    Complications of Coronary Artery Bypass Grafting Surgery
    Published:
    08 July 2014

    DOI: https://doi.org/10.1007/978-3-642-37393-0_233-2

  2. Original

    Complications of Coronary Artery Bypass Grafting Surgery
    Published:
    08 April 2014

    DOI: https://doi.org/10.1007/978-3-642-37393-0_233-1

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