The techniques and reproducibility of surgical coronary revascularization rely on over forty-year experience. However, surgery for ischemic heart disease with associated left ventricular dysfunction carried high if not prohibitive operative risk during the pioneering and early era of coronary surgery. Although the benefits of revascularization in this context have been well documented, the propensity to operate on patients with heart failure still often relies on concurrent anginal symptoms. Similarly, many surgeons are reluctant to offer surgery aimed to reverse low cardiac output during acute or evolving myocardial infarction. The purpose of this chapter is to depict up-to-date strategies and attitudes toward coronary operations in chronic or acute heart failure, focusing on personal experience with ischemic cardiomyopathy and acute coronary syndromes complicated by pump dysfunction or shock. Emphasis will be given to the selection of patients, evolving technology, technical strategies, and ultimately to the limitations of isolated coronary revascularization and the increasing role of associated surgical procedures in ischemic cardiomyopathy.

Coronary artery bypass grafting for chronic and acute heart failure / M. Pocar, A. Moneta, D. Passolunghi, A. Di Mauro, A. Bregasi, R. Mattioli, F. Donatelli (CARDIOLOGY RESEARCH AND CLINICAL DEVELOPMENTS). - In: Coronary artery bypasses / [a cura di] R.T. Hammond, J.B. Alton. - Hauppauge : Nova Science Publishers, 2009. - ISBN 9781607410645. - pp. 111-122

Coronary artery bypass grafting for chronic and acute heart failure

M. Pocar
Primo
;
D. Passolunghi;A. Di Mauro;A. Bregasi;F. Donatelli
Ultimo
2009

Abstract

The techniques and reproducibility of surgical coronary revascularization rely on over forty-year experience. However, surgery for ischemic heart disease with associated left ventricular dysfunction carried high if not prohibitive operative risk during the pioneering and early era of coronary surgery. Although the benefits of revascularization in this context have been well documented, the propensity to operate on patients with heart failure still often relies on concurrent anginal symptoms. Similarly, many surgeons are reluctant to offer surgery aimed to reverse low cardiac output during acute or evolving myocardial infarction. The purpose of this chapter is to depict up-to-date strategies and attitudes toward coronary operations in chronic or acute heart failure, focusing on personal experience with ischemic cardiomyopathy and acute coronary syndromes complicated by pump dysfunction or shock. Emphasis will be given to the selection of patients, evolving technology, technical strategies, and ultimately to the limitations of isolated coronary revascularization and the increasing role of associated surgical procedures in ischemic cardiomyopathy.
acute myocardial-infarction; ischemic mitral regurgitation; saphenous vein graft; surgical-treatment; cardiogenic-shock; valve repair; on-pump; revascularization; cardiomyopathy; viability
Settore MED/23 - Chirurgia Cardiaca
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
2009
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/69691
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