Effectiveness of Coronary Bypass Surgery

EFFECTIVENESS OF CORONARY BYPASS SURGERY

Cardiovascular disease accounts for approximately one million death annually in the United States [8:73]. Coronary artery bypass grafting (CABG) is one medical procedure used in an effort to reduce the level of deaths attributable to cardiovascular disease [9:24]. Both the incidence and severity of cardiovascular disease increase with age, and similarly the frequency of CABG increases with age, with approximately 400,000 CABGs being performed annually in the United States [3:195].

CABG creates an alternate route for the flow of blood through the heart through the removal of a healthy blood vessel from another part of the body and the grafting of that blood vessel at points above and below the constricted or blocked segment of the damaged artery in the heart. Risks are involved in CABG, as death occurs in the range of two-to-three percent of patients. Again, the probability of death increases with age. Death is not the only risk involved in CABG, as from three-to-five percent of CABG patients suffer heart attacks during the procedure. Post-surgical stroke, memory loss, and confusion occurs in approximately six-percent of CABG patients [3:197; 9:25].

CABG requires the opening of the chest cavity. To reduce stress on the heart during CABG, the heart is stopped during the procedure and drained of blood, with the function of the patient's heart transferred to a cardiopulmonary bypass machine during the pr

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mplexes, a biphasic activation of complement was observed. Maximum levels of CRP on the second postoperative day were explained for the most part by C4b/c levels following protamine administration and correlated with the occurrence of arryhthmia on the same day. The researchers concluded that CABG causes a biphasic complement activation, in which the first phase occurs during the CABG, resulting from the interaction of blood with the extracorporeal circuit. The conclusions was that the second phase, occurring during the first five postoperative days, involves CRP as a second mechanism and is related to arryhthmia [2:3547]. Evidence of a wide spectrum of mechanisms that can lead to reperfusion injury during CABG has led to the development or proposal of an equally wide spectrum of therapeutic interventions [3:44]. These interventions include the adding of agents to prevent oxygen free radical damage during CABG, inhibit white blood cell function, reduce calcium influx, improve microvascular blood flow, inhibit sympathetic stimulation, and improve energy storage. Androsine was one agent tested for these purposes. Results of the investigation indicated that the adding of androsine during CABG is beneficial in mechanisms design

Category: Medical - E