Part of the book: Artery Bypass
Neurological complications are one of the most common complications after coronary artery bypass grafting. With the development of off-pump coronary artery bypass grafting (OPCABG), the incidence of postoperative neurological complications caused by aortic intubation decreased significantly; however, the continuous suture of the great saphenous vein-aortic anastomosis in the coronary artery bypass grafting requires the operation of surgical clamp and perforation on the ascending aorta, which may lead to potential plaque detachment. Calcification of ascending aorta is an independent risk factor for cerebrovascular events after OPCABG. Therefore, it is crucial to explore and operate on the ascending aorta. There are three main methods of proximal anastomosis in OPCABG: (1) partial blocking of ascending aorta with side wall clamp for anastomosis; (2) application of proximal anastomosis auxiliary device (Enclose, Heartstring, etc.) for proximal anastomosis; and (3) original auxiliary device (urethra catheter-water sac) or no-clamp surgical techniques for proximal anastomosis.
Part of the book: Cardiac Diseases
Coronary artery bypass grafting (CABG), as a gold standard treatment for coronary artery disease, has been widely adopted all around the world. Meanwhile, it’s also well known that diabetes is an independent risk factor for postoperative mortality. However, hyperglycemia often occurs perioperatively, regardless of whether the patient has diabetes or not. Perioperative stress hyperglycemia is harmful to patients undergoing cardiac surgery and has a clear correlation with increased inflammatory response, and clinical adverse events, especially for patients with diabetes. Thus, proper perioperative blood glycemic control can reduce the short-term and long-term mortality and the incidence of complications in patients undergoing CABG.
Part of the book: Coronary Artery Bypass Grafting