Coronary Artery Bypass Graft (CABG) Surgery

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Questions and Answers

Which procedure involves a standard median sternotomy incision but is performed without cardiopulmonary bypass?

  • Off-pump coronary artery bypass (OPCAB) (correct)
  • Using a myocardial stabilization device
  • Traditional Coronary Artery Bypass Graft (CABG)
  • Connecting the patient to the cardiopulmonary bypass (CPB) machine

What is the main purpose of connecting the patient to the cardiopulmonary bypass (CPB) machine during CABG procedures?

  • To bypass the obstruction in the coronary artery lesion
  • To achieve or maintain hemodynamic stability (correct)
  • To graft a blood vessel from another part of the patient's body
  • To reduce fear and anxiety in the patient

What is one of the complications associated with Coronary Artery Bypass Graft (CABG) procedures?

  • Myocardial stabilization device usage
  • Hemorrhage (correct)
  • Connecting to the cardiopulmonary bypass machine
  • Reducing fear and anxiety

What preoperative testing is typically done before a Coronary Artery Bypass Graft (CABG) procedure?

<p>Obtaining coagulation studies and blood typing (B)</p> Signup and view all the answers

What is the goal of postoperative nursing management following CABG procedures?

<p>Achieving or maintaining hemodynamic stability (C)</p> Signup and view all the answers

What is the primary purpose of a Coronary Artery Bypass Graft (CABG) procedure?

<p>To restore blood flow to the heart (B)</p> Signup and view all the answers

What are the major indications for Coronary Artery Bypass Graft (CABG)?

<p>To treat left main coronary artery stenosis or multi-vessel CAD (B)</p> Signup and view all the answers

What factors are considered when recommending a Coronary Artery Bypass Graft (CABG) procedure?

<p>The number of diseased coronary vessels (A)</p> Signup and view all the answers

In what condition should the internal mammary artery be used for a Coronary Artery Bypass Graft (CABG) according to current guidelines?

<p>If possible (B)</p> Signup and view all the answers

What percentage of occlusion is required in the left main coronary artery for a patient to be considered for a Coronary Artery Bypass Graft (CABG) procedure?

<p>&gt;50% (C)</p> Signup and view all the answers

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Study Notes

Coronary Artery Bypass Graft (CABG)

  • CABG is a surgical procedure that grafts a blood vessel to an occluded coronary artery, allowing blood to flow beyond the occlusion.
  • The procedure aims to restore blood flow to the heart, relieve chest pain and ischemia, and improve the patient's quality of life.

Indications for CABG

  • Alleviation of angina that cannot be controlled with medication or PCI
  • Treatment for left main coronary artery stenosis or multi-vessel CAD
  • Prevention of and treatment for MI, dysrhythmias, or heart failure
  • Treatment for complications from an unsuccessful PCI

Factors Determine CABG Recommendation

  • Number of diseased coronary vessels
  • Degree of left ventricular dysfunction
  • Presence of other health problems
  • Patient's symptoms
  • Previous treatment

Procedure

  • Coronary arteries to be bypassed must have at least a 70% occlusion, or at least a 50% occlusion if in the left main coronary artery
  • Internal mammary artery is recommended for CABG, if possible
  • Saphenous vein is a commonly used vein for CABG

Traditional CABG

  • Performed with the patient under general anesthesia
  • Median sternotomy and cardiopulmonary bypass (CPB) machine are used
  • Blood vessel from another part of the patient's body is grafted distal to the coronary artery lesion, bypassing the obstruction

Alternative CABG

  • Off-pump coronary artery bypass (OPCAB) involves a standard median sternotomy incision, but without CPB
  • Beta-adrenergic blocker may be used to slow the heart rate
  • Myocardial stabilization device is used to hold the site still for the anastomosis of the bypass graft into the coronary artery while the heart continues to beat

Complications of CABG

  • Hemorrhage
  • Dysrhythmias
  • MI
  • Thromboembolic events

Preoperative Nursing Management

  • Performing a history and physical examination
  • Preoperative testing includes chest x-ray, ECG, laboratory tests, and blood typing and cross-matching
  • Obtaining consent form
  • Reducing fear and anxiety
  • Providing patient education

Postoperative Nursing Management

  • Achieving or maintaining hemodynamic stability and recovery from general anesthesia

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