logging in or signing up Coronary Artery Bypass Graft draswinikumars Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 2300 Category: Education License: All Rights Reserved Like it (0) Dislike it (1) Added: September 05, 2009 This Presentation is Public Favorites: 3 Presentation Description Postgraduate Lecture Comments Posting comment... By: azd12 (16 month(s) ago) i would be very grateful if you allow me to get this presentation Saving..... Post Reply Close Saving..... Edit Comment Close By: 19411563 (26 month(s) ago) excelent Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript History : 2 History Introduction : 3 Introduction Technical considerations : 4 Technical considerations cabg : 5 cabg Port-access cabg : 6 Port-access cabg Minimally invasive direct cabg : 7 Minimally invasive direct cabg MIDCAB Limited left thorocotomy Beating heart (off pump) Most commonly LIMA to LAD 98% angiographic patency Full sternotomy needed-5% Less access to LCA and RCA Need for repeat RVN - 6% Risk of MI – 3% Mortality – 2.5% Combined with PCI OFF pump cabg : 8 OFF pump cabg Standard median sternotomy Small skin incisions Stabilization devices to reduces the motion of target vessels while anastomoses are being performed No cardioplegia Beating heart surgery Reduction in blood loss Reduction in transfusions Cardioplegia : 9 Cardioplegia procedure : procedure 10 Venous conduits : 11 Venous conduits Occlusion of venous graft : 12 Occlusion of venous graft Careful harvesting – avoidance of over distension – use of modified storage solutions – inclusion of surrounding tissues – minimizing manipulation of graft Internal mammary artery graft : 13 Internal mammary artery graft OTHER CONDUITS : OTHER CONDUITS 14 14 Radial Gastroepiploic Inferior epigastric Subscapular Intercostal Splenic Left gastric Gastroduodenal Indicated in Young Diabetic Hyperlipidemic Saphenous unsuitable Saphenous un available Radial grafts Initial enthusiasm Blunted later Preferable to RIMA Peri-operative complications : 15 Peri-operative complications Peri-operative complications : Peri-operative complications 16 Peri-operative complications : Peri-operative complications 17 Peri-operative complications : Peri-operative complications 18 Complications : 19 Complications Operative mortality : 20 Operative mortality VENOUS GRAFT PATENCY : 21 VENOUS GRAFT PATENCY Occlusion rate 8-12% at I year Occlusion rate 8-12% at I year Occlusion rate 2% after I year Occlusion rate 4% after 6 years At 10 years 50% of grafts will be occluded Predictors of graft occlusion Small target vessel diameter High LDL and low HLD Symptomatic results : 22 Symptomatic results ARTERIAL GRAFT PATENCY : 23 ARTERIAL GRAFT PATENCY PROGRESSION OF DISEASE IN NON-GRAFTED : 24 PROGRESSION OF DISEASE IN NON-GRAFTED CONTINUING THERAPY WITH DRUGS : 25 CONTINUING THERAPY WITH DRUGS CONTINUING THERAPY WITH DRUGS : 26 CONTINUING THERAPY WITH DRUGS SUMMARY OF INDICATIONS FOR CABG : 27 SUMMARY OF INDICATIONS FOR CABG OTHER INDICATIONS : 28 OTHER INDICATIONS Long term survival after cabg : 29 Long term survival after cabg Slide 30: 30 Thank You for the patient listening You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Coronary Artery Bypass Graft draswinikumars Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 2300 Category: Education License: All Rights Reserved Like it (0) Dislike it (1) Added: September 05, 2009 This Presentation is Public Favorites: 3 Presentation Description Postgraduate Lecture Comments Posting comment... By: azd12 (16 month(s) ago) i would be very grateful if you allow me to get this presentation Saving..... Post Reply Close Saving..... Edit Comment Close By: 19411563 (26 month(s) ago) excelent Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript History : 2 History Introduction : 3 Introduction Technical considerations : 4 Technical considerations cabg : 5 cabg Port-access cabg : 6 Port-access cabg Minimally invasive direct cabg : 7 Minimally invasive direct cabg MIDCAB Limited left thorocotomy Beating heart (off pump) Most commonly LIMA to LAD 98% angiographic patency Full sternotomy needed-5% Less access to LCA and RCA Need for repeat RVN - 6% Risk of MI – 3% Mortality – 2.5% Combined with PCI OFF pump cabg : 8 OFF pump cabg Standard median sternotomy Small skin incisions Stabilization devices to reduces the motion of target vessels while anastomoses are being performed No cardioplegia Beating heart surgery Reduction in blood loss Reduction in transfusions Cardioplegia : 9 Cardioplegia procedure : procedure 10 Venous conduits : 11 Venous conduits Occlusion of venous graft : 12 Occlusion of venous graft Careful harvesting – avoidance of over distension – use of modified storage solutions – inclusion of surrounding tissues – minimizing manipulation of graft Internal mammary artery graft : 13 Internal mammary artery graft OTHER CONDUITS : OTHER CONDUITS 14 14 Radial Gastroepiploic Inferior epigastric Subscapular Intercostal Splenic Left gastric Gastroduodenal Indicated in Young Diabetic Hyperlipidemic Saphenous unsuitable Saphenous un available Radial grafts Initial enthusiasm Blunted later Preferable to RIMA Peri-operative complications : 15 Peri-operative complications Peri-operative complications : Peri-operative complications 16 Peri-operative complications : Peri-operative complications 17 Peri-operative complications : Peri-operative complications 18 Complications : 19 Complications Operative mortality : 20 Operative mortality VENOUS GRAFT PATENCY : 21 VENOUS GRAFT PATENCY Occlusion rate 8-12% at I year Occlusion rate 8-12% at I year Occlusion rate 2% after I year Occlusion rate 4% after 6 years At 10 years 50% of grafts will be occluded Predictors of graft occlusion Small target vessel diameter High LDL and low HLD Symptomatic results : 22 Symptomatic results ARTERIAL GRAFT PATENCY : 23 ARTERIAL GRAFT PATENCY PROGRESSION OF DISEASE IN NON-GRAFTED : 24 PROGRESSION OF DISEASE IN NON-GRAFTED CONTINUING THERAPY WITH DRUGS : 25 CONTINUING THERAPY WITH DRUGS CONTINUING THERAPY WITH DRUGS : 26 CONTINUING THERAPY WITH DRUGS SUMMARY OF INDICATIONS FOR CABG : 27 SUMMARY OF INDICATIONS FOR CABG OTHER INDICATIONS : 28 OTHER INDICATIONS Long term survival after cabg : 29 Long term survival after cabg Slide 30: 30 Thank You for the patient listening