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Department of Anesthesiology

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Diagnostic dilemma of perioperative myocardial infarction after coronary artery bypass grafting: A review.

TitleDiagnostic dilemma of perioperative myocardial infarction after coronary artery bypass grafting: A review.
Publication TypeJournal Article
Year of Publication2020
AuthorsWeidenmann V, N Robinson B, Rong LQ, Hameed I, Naik A, Morsi M, Grieshaber P, Böning A, Girardi LN, Gaudino M
JournalInt J Surg
Volume79
Pagination76-83
Date Published2020 Jul
ISSN1743-9159
Abstract

Coronary artery bypass grafting (CABG) is one of the most commonly performed cardiac procedures in the United States (US) and Europe. In the US, perioperative morbidity and mortality related to CABG are below 5%. One of the most significant complications following CABG, however, is perioperative myocardial infarction (PMI). Cardiac biomarkers, intra- and post-operative echocardiography, and electrocardiography are routinely used to monitor for evidence of PMI. In this review, we seek to summarize how each of these modalities is used in the clinical setting to differentiate PMI from expected procedure-related changes, and how these findings impact patients' outcomes. We conclude that while no perfect diagnostic test for the detection of clinically meaningful PMI exists, using a combination of existing modalities with knowledge of expected post-procedure changes allows for early and reliable detection. Future development is needed to create more sensitive and specific modalities for the detection of PMI in patients undergoing CABG.

DOI10.1016/j.ijsu.2020.05.036
Alternate JournalInt J Surg
PubMed ID32442689