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Questions and Answers
Which procedure involves a standard median sternotomy incision but is performed without cardiopulmonary bypass?
What is the main purpose of connecting the patient to the cardiopulmonary bypass (CPB) machine during CABG procedures?
What is one of the complications associated with Coronary Artery Bypass Graft (CABG) procedures?
What preoperative testing is typically done before a Coronary Artery Bypass Graft (CABG) procedure?
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What is the goal of postoperative nursing management following CABG procedures?
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What is the primary purpose of a Coronary Artery Bypass Graft (CABG) procedure?
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What are the major indications for Coronary Artery Bypass Graft (CABG)?
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What factors are considered when recommending a Coronary Artery Bypass Graft (CABG) procedure?
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In what condition should the internal mammary artery be used for a Coronary Artery Bypass Graft (CABG) according to current guidelines?
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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?
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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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Description
Learn about the surgical procedure of Coronary Artery Bypass Graft (CABG), where a blood vessel is grafted to a blocked coronary artery to restore blood flow to the heart. Understand the purposes of CABG, which include relieving chest pain, improving quality of life, and reducing the risk of a heart attack.
