Coronary artery bypass grafting in left ventricular dysfunction: when and how.
Journal
Current opinion in cardiology
ISSN: 1531-7080
Titre abrégé: Curr Opin Cardiol
Pays: United States
ID NLM: 8608087
Informations de publication
Date de publication:
01 11 2023
01 11 2023
Historique:
medline:
5
10
2023
pubmed:
26
9
2023
entrez:
26
9
2023
Statut:
ppublish
Résumé
The surgical management of patients undergoing coronary artery bypass grafting (CABG) with low ejection fraction presents unique challenges that require meticulous attention to details and good surgical technique and judgement. This review details the latest evidence and best practices in the care of such patients. CABG in patients with low ejection fraction carries a significant risk of perioperative mortality and morbidity related to the development of postcardiotomy shock. Preoperative optimization with pharmacological or mechanical support is required, especially in patients with cardiogenic shock. Rapid and complete revascularization is what CABG surgeons aim to achieve. Multiple arterial revascularization should be reserved to selected patients. Off-pump CABG, on-pump breathing heart CABG, and new cardioplegic solutions remain of uncertain benefit compared with traditional CABG. Tremendous advancements in CABG allowed surgeons to offer revascularization to patients with severe left ventricular dysfunction and multivessel disease with acceptable risk. Despite that, there is a lack of comprehensive and robust studies particularly on long-term outcomes. Individualized patient assessment and a heart team approach should be used to determine the optimal surgical strategy for each patient.
Identifiants
pubmed: 37751395
doi: 10.1097/HCO.0000000000001090
pii: 00001573-990000000-00103
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
464-470Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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