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How to avoid problems in redo coronary artery bypass surgery.

Abstract

The objective of my presentation is to discuss the various intra- and perioperative problems related to redo coronary artery bypass surgery so that we can minimize complications during surgery and improve the final outcomes. When a patient accepts redo cardiac surgery in spite of known higher morbidity and mortality, the patient strongly believes that he will come out of this operation successfully and enjoy several more years of life. Weintraub reported that redo cardiac surgery has higher mortality and morbidity; 5% in elective cases, 11% in urgent cases, and 16.4% in emergency cases. He and associates described that the female gender, a low ejection fraction (EF), and preoperative arrhythmias are significant risk factors. Lemmer and associates described poor postoperative functional results with the majority of patients having emergency repeat coronary artery revascularization developing recurrent ischemic syndrome within a short period of time. I am outlining the problems from our experience of 543 patients in the last five years.

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BibTeXRIS

V R Machiraju. How to avoid problems in redo coronary artery bypass surgery.. https://doi.org/10.1111/j.0886-0440.2004.4051_11.x

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Coronary Artery Bypass↗

Current trends in coronary artery disease in women.

PURPOSE OF REVIEW: There are some striking sex differences regarding presentation, symptoms and sign, diagnosis, and treatment of coronary artery disease. Historically, healthcare delivery to women has been plagued with treatment bias favoring men. This review will present relevant cardiovascular physiologic sex differences, current treatment options for coronary artery disease both surgical and medical, and clinical outcomes of such treatments. RECENT FINDINGS: In the past, pharmacologic and interventional studies generally excluded women from their subjects. As a result, women have been traditionally treated based on the findings in their male counterparts. Recent studies examining sex differences in the treatment of coronary artery disease have given new insight into the hormonal and behavioral influences associated with coronary artery disease. Finally, these studies have drawn attention to possibly inadvertent discrepancies in the way men and women are treated for coronary artery disease. SUMMARY: Despite significant advances in medical and surgical approaches to treat coronary artery disease, it remains and will continue to be the most important healthcare challenge of the 21st century. Whereas efforts are underway to encourage inclusion of more women in therapeutic trials, the educational process, particularly in medical school, needs to broadly address sex specific pathophysiology and treatment, rather than relying on sub-subspecialty training for optimizing healthcare delivery in women.

Coronary Artery Bypass↗