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Coronary Artery Bypass Graft (CABG) Surgery


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    Overview and Recommendations

    • Background

    • Evaluation

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      • In patients with stable coronary artery disease

      • In patients with acute coronary syndromes (other than STEMI)

      • In patients with ST-elevation myocardial infarction (STEMI)

    • Management

  • Related Summaries

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    • General Description

    • Indications for CABG

    • Preoperative preparation

    • Perioperative medical management

    • Surgical technique

    • Postrevascularization management

    • Prognosis

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    Indications and Efficacy

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      CABG in acute coronary syndrome (ACS)

      • Indications for CABG in ACS

      • Indications for CABG in other acute situations

      • Efficacy of CABG for ACS

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      CABG in ST-elevation myocardial infarction (STEMI)

      • Indications for CABG in STEMI

      • Efficacy of CABG in STEMI

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      CABG in stable coronary artery disease (CAD)

      • Indications for CABG in stable coronary artery disease

      • Efficacy of CABG in stable coronary artery disease

    • CABG in other patient populations

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    Preoperative Preparation

    • Preoperative evaluation

    • Preoperative inspiratory muscle training

    • Preconditioning

    • Preoperative intra-aortic balloon pump (IABP)

    • Preprocedure waiting period

    • Additional preoperative considerations

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    Perioperative Management

    • Intraoperative epiaortic ultrasound

    • Antibiotic and antiseptic prophylaxis

    • Venous thromboembolism prophylaxis

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      Aspirin and other antiplatelet agents

      • Recommendations from professional organizations

      • Aspirin

      • Preoperative clopidogrel

      • Cangrelor

    • Beta blockers

    • Other antiarrhythmic agents

    • Atrial natriuretic peptides

    • Angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers

    • Fluid support

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      Glucose management

    • Hypertension management

    • Management of patients with prior myocardial infarction or left ventricular dysfunction

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      Perioperative blood transfusions

      • Recommendations

      • Transfusion threshold

      • Adverse effects

      • Additional considerations

    • Antifibrinolytic drugs

    • Statins

    • Medications for renal protection

    • Additional perioperative medications

    • Other perioperative treatments

    • Perioperative monitoring

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    Intraoperative Management

    • Bypass graft conduit

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      Additional cardiac reconstruction

      • Ventricular reconstruction

      • Valvular reconstruction

      • Carotid endarterectomy

      • Left atrial appendage closure

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      Off-pump CABG

      • Indications

      • Operative mortality

      • Long-term mortality

      • Cardiovascular morbidity

      • Renal morbidity

      • Specific populations

      • Operative approach

      • Additional considerations

    • Miniaturized extracorporeal circulation

    • Anesthesia and early extubation

    • Analgesia

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      Intraoperative monitoring

      • Transesophageal echocardiography

      • Central nervous system monitoring

    • Additional information

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    Postrevascularization Management

    • Postoperative complications

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      Postoperative medications

      • General information

      • Aspirin and other antiplatelet agents

      • Statins

      • Antihypertensive medications

      • Vitamin supplements

    • Smoking cessation

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      Resumption of normal activities

      • Driving and travel restrictions

      • Sexual activity

    • Psychosocial considerations

    • Additional postoperative considerations

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      Mortality after CABG

      • Risk factors for operative mortality after CABG

      • Risk factors for long-term mortality after CABG

      • Risk prediction models for mortality after CABG

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      Morbidity after CABG

      • Stroke

      • Other neurologic outcomes

      • Adverse renal outcomes

      • Postoperative atrial fibrillation

      • Other adverse outcomes

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    Quality Improvement

    • Physician Quality Reporting System Quality Measures

    • Choosing Wisely Australia

    • Choosing Wisely Italy

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    Guidelines and Resources

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      • International guidelines

      • United States guidelines

      • United Kingdom guidelines

      • Canadian guidelines

      • European guidelines

    • Review articles

  • Patient Information

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    ICD Codes

    • ICD-10 codes

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    • General references used

    • Recommendation grading systems used

    • Synthesized Recommendation Grading System for DynaMed

    • DynaMed Editorial Process

    • Special acknowledgements

    • How to cite

Topic Editor
Dale K. Mueller MD

Section Chief, Department of Surgery, University of Illinois; Illinois, United States; Cardiovascular and Thoracic Surgeon, HeartCare Midwest SC; Illinois, United States

Conflicts of Interest

Dr. Mueller declares no relevant financial conflicts of interest.

Recommendations Editor
Zbys Fedorowicz MSc, DPH, BDS, LDSRCS

Director of Bahrain Branch of the United Kingdom Cochrane Center, The Cochrane Collaboration; Awali, Bahrain

Conflicts of Interest

Dr. Fedorowicz declares no relevant financial conflicts of interest.

Deputy Editor
Peter Oettgen MD

Editor in Chief, DynaMed; Cardiologist, Beth Israel Deaconess Medical Center; Massachusetts, United States; Associate Professor of Medicine, Harvard Medical School; Massachusetts, United States

Conflicts of Interest

Dr. Oettgen declares no relevant financial conflicts of interest.

Produced in collaboration with American College of Physicians