Coronary artery bypass grafts - Revision history

Michael: /* Gross */ rm '.'

2015-01-13T05:48:00Z

Gross: rm '.'

← Older revision		Revision as of 05:48, 13 January 2015
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	==Gross==		==Gross==
	[[Image:Heart_saphenous_coronary_grafts.jpg\|right\|thumb\|Heart with three bypass grafts. (WC)]].		[[Image:Heart_saphenous_coronary_grafts.jpg\|right\|thumb\|Heart with three bypass grafts. (WC)]]
	===Types of grafts===		===Types of grafts===
	*Arterial - usually ''internal thoracic artery''.		*Arterial - usually ''internal thoracic artery''.

Michael at 17:26, 18 June 2014

2014-06-18T17:26:59Z

← Older revision		Revision as of 17:26, 18 June 2014
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	Others:		Others:
	*Disease that cannot be treated with percutaneous coronary intervention (PCI).		*Disease that cannot be treated with percutaneous coronary intervention (PCI).

			==Complications==
			*[[Cholesterol embolism]] - may go anywhere.
			**Kidney -> [[renal failure]].
			**Cerebral vessels -> [[stroke]].
			*[[Aortic dissection]].
			*[[Myocardial infarction]].
			*Others.

	==Gross==		==Gross==

Michael: /* See also */

2014-06-13T21:00:18Z

Michael at 13:21, 10 January 2014

2014-01-10T13:21:46Z

← Older revision		Revision as of 13:21, 10 January 2014
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	*Triple vessel disease.		*Triple vessel disease.
	**Disease involving the left anterior descending (coronary artery), left circumflex coronary artery and right coronary artery.		**Disease involving the left anterior descending (coronary artery), left circumflex coronary artery and right coronary artery.

			Others:
			*Disease that cannot be treated with percutaneous coronary intervention (PCI).

	==Gross==		==Gross==

Michael: /* Gross */

2013-05-24T03:22:40Z

Gross

← Older revision		Revision as of 03:22, 24 May 2013
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	==Gross==		==Gross==
			[[Image:Heart_saphenous_coronary_grafts.jpg\|right\|thumb\|Heart with three bypass grafts. (WC)]].
	===Types of grafts===		===Types of grafts===
	*Arterial - usually ''internal thoracic artery''.		*Arterial - usually ''internal thoracic artery''.

Michael: expand

2012-09-03T14:25:06Z

expand

← Older revision		Revision as of 14:25, 3 September 2012
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	==Indications==		==Indications==
	Indications for CABG:<ref>{{Cite journal \| last1 = Serruys \| first1 = PW. \| last2 = Morice \| first2 = MC. \| last3 = Kappetein \| first3 = AP. \| last4 = Colombo \| first4 = A. \| last5 = Holmes \| first5 = DR. \| last6 = Mack \| first6 = MJ. \| last7 = Ståhle \| first7 = E. \| last8 = Feldman \| first8 = TE. \| last9 = van den Brand \| first9 = M. \| title = Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. \| journal = N Engl J Med \| volume = 360 \| issue = 10 \| pages = 961-72 \| month = Mar \| year = 2009 \| doi = 10.1056/NEJMoa0804626 \| PMID = 19228612 }}</ref>		Indications for CABG:<ref name=pmid19228612>{{Cite journal \| last1 = Serruys \| first1 = PW. \| last2 = Morice \| first2 = MC. \| last3 = Kappetein \| first3 = AP. \| last4 = Colombo \| first4 = A. \| last5 = Holmes \| first5 = DR. \| last6 = Mack \| first6 = MJ. \| last7 = Ståhle \| first7 = E. \| last8 = Feldman \| first8 = TE. \| last9 = van den Brand \| first9 = M. \| title = Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. \| journal = N Engl J Med \| volume = 360 \| issue = 10 \| pages = 961-72 \| month = Mar \| year = 2009 \| doi = 10.1056/NEJMoa0804626 \| PMID = 19228612 }}</ref>
	*Left main coronary artery disease.		*Left main coronary artery disease.
	*Triple vessel disease.		*Triple vessel disease.
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	Notes:		Notes:
	*Arterial grafts, generally, are much longer lived ~90% patency at 10 years verus ~57% for saphenous vein grafts.<ref name=pmid15680832>{{Cite journal \| last1 = Sabik \| first1 = JF. \| last2 = Lytle \| first2 = BW. \| last3 = Blackstone \| first3 = EH. \| last4 = Houghtaling \| first4 = PL. \| last5 = Cosgrove \| first5 = DM. \| title = Comparison of saphenous vein and internal thoracic artery graft patency by coronary system. \| journal = Ann Thorac Surg \| volume = 79 \| issue = 2 \| pages = 544-51; discussion 544-51 \| month = Feb \| year = 2005 \| doi = 10.1016/j.athoracsur.2004.07.047 \| PMID = 15680832 }}</ref>		*Arterial grafts, generally, are much longer lived ~90% patency at 10 years verus ~57% for saphenous vein grafts.<ref name=pmid15680832>{{Cite journal \| last1 = Sabik \| first1 = JF. \| last2 = Lytle \| first2 = BW. \| last3 = Blackstone \| first3 = EH. \| last4 = Houghtaling \| first4 = PL. \| last5 = Cosgrove \| first5 = DM. \| title = Comparison of saphenous vein and internal thoracic artery graft patency by coronary system. \| journal = Ann Thorac Surg \| volume = 79 \| issue = 2 \| pages = 544-51; discussion 544-51 \| month = Feb \| year = 2005 \| doi = 10.1016/j.athoracsur.2004.07.047 \| PMID = 15680832 }}</ref>

			====Common configurations====
			Arterial:
			*Left internal thoracic artery (LITA) - almost always to the distal LAD.
			Venous:
			*Aorta to posterior interventricular branch of RCA.
			**Typically pass around the right side of the heart.
			*Aorta to left circumflex coronary artery.
			**Typically pass around the left side of the heart.
			*Aorta to first or second diagonal branch of the LAD.

	===Identification===		===Identification===
			*Know the common configurations.
			*Get the OR note - '''important'''.
			**Clinical notes are notoriously unreliable.
			*Trace the grafts from proximal to distal ''or'' distal to proximal.
			*Look for the sutures... where there is a suture there is often a graft.
			**The aorta usu. has one extra suture for the (arterial) cannulation site -- where the bypass machine returns the blood to the body.
			**The right atrium usu. has a suture for the (venous) cannulation site -- where the bypass machine receives the blood from the body.

	All grafts should be identified:		All grafts should be identified:
	*Proximal anastomosis - if applicable.		*Proximal anastomosis - if applicable.
			**Usu. non-existent in ITA grafts.
			**Generally, found several centimetres above the coronary ostia.
	*Distal anastomosis.		*Distal anastomosis.
			**Classic site of failure, esp. in arterial grafts.
	~~Common configurations:~~
	*~~Arterial - left internal thoracic artery (LITA) - usu. to the distal LAD.~~
	*~~Venous - RCA~~, ~~LCx~~.

	==See also==		==See also==
Line 31:		Line 48:

	==References==		==References==
	{{Reflist\|1}}		{{Reflist\|2}}

	[[Category:Clinical]]		[[Category:Clinical]]

Michael: /* Gross */

2012-09-03T14:04:57Z

Gross

← Older revision		Revision as of 14:04, 3 September 2012
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	*Arterial grafts, generally, are much longer lived ~90% patency at 10 years verus ~57% for saphenous vein grafts.<ref name=pmid15680832>{{Cite journal \| last1 = Sabik \| first1 = JF. \| last2 = Lytle \| first2 = BW. \| last3 = Blackstone \| first3 = EH. \| last4 = Houghtaling \| first4 = PL. \| last5 = Cosgrove \| first5 = DM. \| title = Comparison of saphenous vein and internal thoracic artery graft patency by coronary system. \| journal = Ann Thorac Surg \| volume = 79 \| issue = 2 \| pages = 544-51; discussion 544-51 \| month = Feb \| year = 2005 \| doi = 10.1016/j.athoracsur.2004.07.047 \| PMID = 15680832 }}</ref>		*Arterial grafts, generally, are much longer lived ~90% patency at 10 years verus ~57% for saphenous vein grafts.<ref name=pmid15680832>{{Cite journal \| last1 = Sabik \| first1 = JF. \| last2 = Lytle \| first2 = BW. \| last3 = Blackstone \| first3 = EH. \| last4 = Houghtaling \| first4 = PL. \| last5 = Cosgrove \| first5 = DM. \| title = Comparison of saphenous vein and internal thoracic artery graft patency by coronary system. \| journal = Ann Thorac Surg \| volume = 79 \| issue = 2 \| pages = 544-51; discussion 544-51 \| month = Feb \| year = 2005 \| doi = 10.1016/j.athoracsur.2004.07.047 \| PMID = 15680832 }}</ref>

	All grafts should be identified.		===Identification===
			All grafts should be identified:
	*Proximal anastomosis - if applicable.		*Proximal anastomosis - if applicable.
	*Distal anastomosis.		*Distal anastomosis.

			Common configurations:
			*Arterial - left internal thoracic artery (LITA) - usu. to the distal LAD.
			*Venous - RCA, LCx.

	==See also==		==See also==

Michael: +patency

2012-09-03T14:02:32Z

+patency

← Older revision		Revision as of 14:02, 3 September 2012
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	==Gross==		==Gross==
			===Types of grafts===
			*Arterial - usually ''internal thoracic artery''.
			*Venous - saphenous vein.

			Notes:
			*Arterial grafts, generally, are much longer lived ~90% patency at 10 years verus ~57% for saphenous vein grafts.<ref name=pmid15680832>{{Cite journal \| last1 = Sabik \| first1 = JF. \| last2 = Lytle \| first2 = BW. \| last3 = Blackstone \| first3 = EH. \| last4 = Houghtaling \| first4 = PL. \| last5 = Cosgrove \| first5 = DM. \| title = Comparison of saphenous vein and internal thoracic artery graft patency by coronary system. \| journal = Ann Thorac Surg \| volume = 79 \| issue = 2 \| pages = 544-51; discussion 544-51 \| month = Feb \| year = 2005 \| doi = 10.1016/j.athoracsur.2004.07.047 \| PMID = 15680832 }}</ref>

	All grafts should be identified.		All grafts should be identified.
	*Proximal anastomosis - if applicable.		*Proximal anastomosis - if applicable.

Michael: create

2012-09-03T13:24:41Z

create

← Older revision		Revision as of 13:24, 3 September 2012
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	'''Coronary artery bypass surgery''', also '''coronary artery bypass grafting''' (abbreviated '''CABG'''~~), is a procedure to treatment [[atherosclerotic coronary artery disease]] (ACAD)~~. ~~It is~~ encountered by [[pathologist]]s at [[autopsy]].		'''Coronary artery bypass grafts''' are a treatment for [[atherosclerotic heart disease]] (ASHD). They are created in a procedure called '''coronary artery bypass surgery''', also '''coronary artery bypass grafting''', abbreviated '''CABG'''. CABGs are encountered by [[pathologist]]s at [[autopsy]].

	The other treatments for ~~ACAD~~ are medical management, and percutaneous coronary intervention (PCI).		The other treatments for ASHD are medical management, and percutaneous coronary intervention (PCI).

	==Indications==		==Indications==
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	==Gross==		==Gross==
	#All grafts should be identified.		All grafts should be identified.
	#*Proximal anastomosis.		*Proximal anastomosis - if applicable.
	#*Distal anastomosis.		*Distal anastomosis.

	==See also==		==See also==

Michael: Haribo moved page Coronary artery bypass surgery to Coronary artery bypass grafts: make it unapologetically for pathologists

2012-09-03T13:19:47Z

Haribo moved page Coronary artery bypass surgery to Coronary artery bypass grafts: make it unapologetically for pathologists

← Older revision	Revision as of 13:19, 3 September 2012
(No difference)

← Older revision		Revision as of 21:00, 13 June 2014
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	*[[Autopsy]].		*[[Autopsy]].
	*[[Heart]].		*[[Heart]].
			*[[Heart anatomy]].

	==References==		==References==