cardiac surgery (heart surgery)
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Indications
- heart disease, including valvular heart disease not amenable to medical treatment
Adverse effects
- risk of cognitive impairment after CABG, PCI or cardiac valve replacement is uncertain[3]
Complications
- acute renal failure
- chronic renal failure is strongest nonmodificable risk factor[4]
- low cardiac output syndrome[6]
- postoperative cardiac arrhythmias after cardiac surgery[7]
Management
- perioperative colchicine[1]
- reduces postpericardiotomy syndrome
- does not reduce postoperative atrial fibrillation
- does not reduce pericardial effusions
- does not reduce pleural effusions
- increases gastrointestinal adverse events
- postoperative potassium in the absence of hypokalemia does not reduce risk of postoperative atrial fibrillation[12]
- perioperative rosuvastatin (20 mg/day) begun 8 days priorto surgery & continued for 5 days after surgery does not reduce postoperative complications in patients undergoing elective cardiac surgery[5]
- preoperative chlorhexidine mouthwash reduces risk of postoperative pneumonia in patients undergoing cardiac surgery[11]
- effect in other surgery unknown
- blood transfusion threshold: hemoglobin < 9 g/dL[2]
- lower 3-month mortality than hemoglobin < 7 g/dL
- levosimendan of no benefit in preventing low cardiac output after cardiac bypass surgery in the elderly[6]
- perioperative beta-blockade of benefit in reducing incidence of cardiac arrhythmias[7]
- left atrial appendage occlusion during cardiac surgery to prevent stroke[10]
- cardiac rehabilitation beneficial after cardiac valve surgery[9]
Notes
- see surgery
More general terms
More specific terms
- aortic valve surgery
- arterial switch operation
- Blalock-Taussig procedure; Blalock-Thomas-Taussig shunt
- cardiac massage
- cardiac valve repair
- cardiac valve replacement
- cardiac valvuloplasty
- cardiectomy
- cardiomyoplasty
- cardiomyotomy (Heller's cardiomyotomy)
- cardiotomy
- coronary artery bypass grafting (CABG)
- coronary stent/coronary stenting
- left atrial appendage closure (Watchman device, Lariat device)
- left ventricular reduction surgery (Batista procedure)
- maze procedure
- mitral valve surgery
- myocardial resection
- Norwood procedure
- open heart surgery
- pericardial window
- pericardiectomy
- pericardiocentesis
- pericardiotomy
- repair of cardiac septal defect
- repair of cardiac wound
- repair of congenital heart disease
- repair of patent ductus arteriosus
- Ross procedure
- septal reduction therapy
- valvotomy
References
- ↑ 1.0 1.1 Imazio M et al Colchicine for Prevention of Postpericardiotomy Syndrome and Postoperative Atrial FibrillationThe COPPS-2 Randomized Clinical Trial. JAMA. Published online August 30, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25172965 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1900482
- ↑ 2.0 2.1 Murphy GJ et al. Liberal or restrictive transfusion after cardiac surgery. N Engl J Med 2015 Mar 12; 372:997. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25760354 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1403612
Spertus J. "TITRe"ing the approach to transfusions after cardiac surgery. N Engl J Med 2015 Mar 12; 372:1069. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25760360 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1415394 - ↑ 3.0 3.1 Fink HA, Hemmy LS, MacDonald R et al Intermediate- and Long-Term Cognitive Outcomes After Cardiovascular Procedures in Older Adults: A Systematic Review. Ann Intern Med. 2015;163(2):107-117 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26192563 <Internet> http://annals.org/article.aspx?articleid=2397694
- ↑ 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
- ↑ 5.0 5.1 Zheng Z, Jayaram R, Jiang J et al Perioperative Rosuvastatin in Cardiac Surgery. N Engl J Med 2016; 374:1744-1753. May 5, 2016 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27144849
- ↑ 6.0 6.1 6.2 Mehta RH, Leimberger JD, van Diepen S et al. Levosimendan in patients with left ventricular dysfunction undergoing cardiac surgery. N Engl J Med 2017 Mar 19 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28316276 Free Article <Internet> http://www.nejm.org/doi/10.1056/NEJMoa1616218
- ↑ 7.0 7.1 7.2 Blessberger H, Kammler J, Domanovits H et al. Perioperative beta-blockers for preventing surgery-related mortality and morbidity. Cochrane Database Syst Rev. 2014;(9):CD004476 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25233038
- ↑ Boer C, Meesters MI, Milojevic M, et al. 2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery. J Cardiothorac Vasc Anesth. 2018 Feb;32(1):88-120. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29029990 Free Article <Internet> http://www.jcvaonline.com/article/S1053-0770(17)30552-9/fulltext
- ↑ 9.0 9.1 Patel DK, Duncan MS, Shah AS et al Association of Cardiac Rehabilitation With Decreased Hospitalization and Mortality Risk After Cardiac Valve Surgery. JAMA Cardiol. Published online October 23, 2019. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31642866 https://jamanetwork.com/journals/jamacardiology/article-abstract/2753611
- ↑ 10.0 10.1 Whitlock RP, Belley-Cote EP, Paparella D et al Left atrial appendage occlusion during cardiac surgery to prevent stroke. N Engl J Med 2021 May 15; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/33999547 https://www.nejm.org/doi/10.1056/NEJMoa2101897
- ↑ 11.0 11.1 Odor PM, Bampoe S, Gilhooly D, Creagh-Brown B, Moonesinghe SR. Perioperative interventions for prevention of postoperative pulmonary complications: systematic review and meta-analysis. BMJ. 2020 Mar 11;368:m540 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32161042 PMCID: PMC7190038 Free PMC article
- ↑ 12.0 12.1 Bosworth T Skip Potassium After Cardiac Surgery Medscape. September 03, 2024 https://www.medscape.com/viewarticle/skip-potassium-after-cardiac-surgery-2024a1000fxa