Coronary artery bypass surgery in association with other cardiac procedures
Coronary Artery Bypass Surgery Microchapters
Coronary artery bypass surgery in association with other cardiac procedures On the Web
Multiple factors should be considered when planning to add CABG to another planned cardiac surgery in patients with significant coronary heart disease. The presence of any comorbidities, availability of a conduit, and left ventricular ejection fraction are some of the factors that must be evaluated before making a decision. According to numerous studies, similar long-term survival and health-related quality of life have been observed in patients who underwent aortic valve replacement with concomitant CABG compared to those without coronary heart disease.
Coronary Artery Bypass Surgery in Association with Other Cardiac Procedures
- Multiple factors should be considered when planning to add CABG to another planned cardiac surgery in patients with significant coronary heart disease. Considerations include but are not limited to the following factors:
- Studies that were done on patients between the ages of 75 and 84 years show that age is not a prohibitive risk factor for adding CABG to other cardiac surgeries. Although risk increases in patients older than 85 years of age.
- Numerous observational studies and meta-analyses demonstrated similar long-term survival and health-related quality of life in patients who underwent aortic valve replacement with concomitant CABG compared to those without coronary heart disease. However, concomitant CABG is associated to a higher rate of perioperative morbidity and mortality in comparison to isolated aortic valve replacement.
2021 ACA Revascularization Guideline
|Class 1 Recommendation, Level of Evidence:C-LD|
|In a patient with significant coronary heart disease who is undergoing another cardiac surgery, such as valve surgery and aortic surgery, CABG is recommended with a goal of reducing ischemic events.|
|Class 2b Recommendation, Level of Evidence:C-LD|
|In a patient with intermediate coronary heart disease who is undergoing another cardiac surgery, such as valve surgery and aortic surgery, CABG may be reasonable with a goal of reducing ischemic events.|
2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery (DO NOT EDIT)
|"1. CABG is recommended in patients undergoing noncoronary cardiac surgery with greater than or equal to 50% luminal diameter narrowing of the left main coronary artery or greater than or equal to 70% luminal diameter narrowing of other major coronary arteries. (Level of Evidence: C)"|
|"1. The use of the LIMA is reasonable to bypass a significantly narrowed LAD artery in patients undergoing noncoronary cardiac surgery. (Level of Evidence: C)"|
|"2. CABG of moderately diseased coronary arteries (>50% luminal diameter narrowing) is reasonable in patients undergoing noncoronary cardiac surgery. (Level of Evidence: C)"|
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