Coronary artery bypass surgery central nervous system monitoring

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Coronary Artery Bypass Surgery Microchapters

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Patient Information

Overview

Pathophysiology

Saphenous Vein Graft Disease
Other Non-Atherosclerotic Saphenous Vein Graft Diseases

Indications for CABG

Prognosis

Diagnosis

Imaging in the Patient Undergoing CABG

Chest X Ray

Angiography

CT Angiography
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Trans-Esophageal Echocardiography

Treatment

Goals of Treatment

Perioperative Management

Perioperative Monitoring

Electrocardiographic Monitoring
Pulmonary Artery Catheterization
Central Nervous System Monitoring

Surgical Procedure

Anesthetic Considerations
Intervention in left main coronary artery disease
The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)
Minimally Invasive CABG
Hybrid coronary revascularization
Conduits Used for Bypass
Videos on Spahenous Vein Graft Harvesting
Videos on Coronary Artery Bypass Surgery

Post-Operative Care and Complications

Pharmacotherapy in patients undergoing CABG CABG

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Anomalous Coronary Arteries
COPD/Respiratory Insufficiency
Existing Renal Disease
Concomitant Valvular Disease
Previous Cardiac Surgery
Menopause
Carotid Disease evaluation before surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

ACCF/AHA Guidelines for Central Nervous System Monitoring[1]

Class IIb

"1. The effectiveness of intraoperative monitoring of the processed electroencephalogram to reduce the possibility of adverse recall of clinical events or for detection of cerebral hypoperfusion in CABG patients is uncertain.[2][3][4] (Level of Evidence: B)"

"2. The effectiveness of routine use of intraoperative or early postoperative monitoring of cerebral oxygen saturation via near-infrared spectroscopy to detect cerebral hypoperfusion in patients undergoing CABG is uncertain.[5][6][7] (Level of Evidence: B)"

Guidelines Resources

  • 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[1]

References

  1. 1.0 1.1 Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0b013e31823c074e. PMID 22064599.
  2. Avidan MS, Zhang L, Burnside BA, Finkel KJ, Searleman AC, Selvidge JA, Saager L, Turner MS, Rao S, Bottros M, Hantler C, Jacobsohn E, Evers AS (2008). "Anesthesia awareness and the bispectral index". The New England Journal of Medicine. 358 (11): 1097–108. doi:10.1056/NEJMoa0707361. PMID 18337600. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  3. Hemmerling TM, Olivier JF, Basile F, Le N, Prieto I (2005). "Bispectral index as an indicator of cerebral hypoperfusion during off-pump coronary artery bypass grafting". Anesthesia and Analgesia. 100 (2): 354–6. doi:10.1213/01.ANE.0000140245.44494.12. PMID 15673855. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  4. Myles PS, Leslie K, McNeil J, Forbes A, Chan MT (2004). "Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial". Lancet. 363 (9423): 1757–63. doi:10.1016/S0140-6736(04)16300-9. PMID 15172773. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  5. Brady K, Joshi B, Zweifel C, Smielewski P, Czosnyka M, Easley RB, Hogue CW (2010). "Real-time continuous monitoring of cerebral blood flow autoregulation using near-infrared spectroscopy in patients undergoing cardiopulmonary bypass". Stroke; a Journal of Cerebral Circulation. 41 (9): 1951–6. doi:10.1161/STROKEAHA.109.575159. PMID 20651274. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  6. Murkin JM, Adams SJ, Novick RJ, Quantz M, Bainbridge D, Iglesias I, Cleland A, Schaefer B, Irwin B, Fox S (2007). "Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study". Anesthesia and Analgesia. 104 (1): 51–8. doi:10.1213/01.ane.0000246814.29362.f4. PMID 17179242. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  7. Slater JP, Guarino T, Stack J, Vinod K, Bustami RT, Brown JM, Rodriguez AL, Magovern CJ, Zaubler T, Freundlich K, Parr GV (2009). "Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery". The Annals of Thoracic Surgery. 87 (1): 36–44, discussion 44–5. doi:10.1016/j.athoracsur.2008.08.070. PMID 19101265. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)

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