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Abstract Surgical treatment for angina pectoris was first proposed in Figure 1. Open in new tab Download slide. Figure 2. Figure 3. Figure 4. Table 1 Incidence and predictors of early clinical outcomes after coronary artery bypass surgery, with a focus on perioperative considerations to prevent complications. Specific predictors. These are generally factors that are associated with how well the patient tolerates the procedure, the progression of disease, the procedural complexity, and the postoperative recovery.

Postoperative stroke has been found to increase the risk of day mortality by five- to six-fold. Other predictors are: urgency of procedure, recent MI, number of distal anastomoses, incomplete revascularization, longer cardiopulmonary bypass time. Operative graft flow measurement may identify grafts that need revision. Re-exploration for bleeding increases the risk of stroke, MI, pneumonia, and deep sternal wound infection, but also significantly increases the use of blood products and prolongs postoperative hospital stay by about 2 days.

Antifibrinolytic agents may reduce blood loss. The reduction in operative time should be weighed against increased rates of re-exploration. Delirium is associated with increased morbidity and mortality, as well as prolonged hospital stay and increased hospitalization costs. A multicomponent intervention for the management of cognitive impairment, sleep deprivation, immobility, visual and hearing impairment, and dehydration reduces number and duration of delirium episodes.

Renal failure is a significant predictor of short- and long-term mortality, even in patients with preoperative normal renal functions.

Easy preventive strategies consist of: preoperative hydration, prevention and correction of hypotension, abandon the use of nephrotoxic drugs, and use of nonionic contrast during angiography. Postoperative sternal wound infections increase the postoperative process, stay are associated with incremental costs, and lead to a drastic increase in early or delayed mortality. Prevention of mediastinitis through preoperative antiseptic showers, hair removal, and administration of perioperative antibiotics has been instated.

Limiting the need for re-exploration for bleeding will furthermore reduce its rate. Often of transient nature due to early postoperative inflammatory responses and oxidative stress that are reduced over subsequent days post-surgery. Atrial fibrillation is a predictor of stroke and was found to significantly reduce long-term survival in a number of studies.

Open in new tab. Figure 5. De-epicardialization: a simple, effective surgical treatment for angina pectoris. Google Scholar Crossref. Search ADS. Augmentation of the extracardiac anastomoses of the coronary arteries through pericardial adhesions. Surgical therapy of coronary arterial disease with special reference to myocardial revascularization. Communications between the coronary arteries produced by the application of inflammatory agents to the surface of the heart.

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