Fatores preditores de infarto do miocárdio no período perioperatório de cirurgia de revascularização miocárdica

Objective: To present the complications that prolong the stay in the Intensive Care Unit (ICU) of the patients undergoing cardiac surgery.Methods: We retrospectively analyzed records of 85 patients undergoing cardiac surgery during the period of March to May 2009, at the Santa Casa de Misericordia de Juiz de Fora (MG), and, of these patients we studied 14 (16.47%) who stayed for more than five days in ICU. Amongst the 85 patients, there were three deaths, being two patients operated on an emergency basis, which increases morbidity, and one patient who remained in the hospital and under mechanical ventilation (MV) for 21 days.Results: The study showed that complications that increased the length of stay in ICU were respiratory and metabolic disorders, according to the literature. Conclusion:The complications that increase length of stay in ICU are related to respiratory function, chronic obstructive pulmonary disease, smoking, lung congestion, prolonged switch-off from MV, diabetes, infections, kidney failure, stroke and hemodynamic instability. 167LAIZO, A ET AL -Complications that increase the time of Hospitalization at ICU of patients submitted to cardiac surgery Bras Cir Cardiovasc 2010; 25(2): 166-171 Rev

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Complicações que aumentam o tempo de permanência na unidade de terapia intensiva na cirurgia cardíaca

Laizo¹,

Delgado²,

Rocha³

2010

“…Its value in diagnosis of myocardial infarction is well known in clinical patients, but it is still under study in patients already grafted, [1,[3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Among them, it emphasizes the myocardial infarction (AMI) due to its high incidence, which varies from 5% to 15%, according to the literature. [1][2][3][4][5] The consequences of peri-operative AMI can vary from minor enzyme elevations without clinical relevance to presentations of low cardiac output or malignant tachyarrhythmias, followed by death or reduced long-term survival, which explains the efforts made in trying to avoid such complication [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Importância da troponina I no diagnóstico do infarto do miocárdio no pós-operatório de cirurgia de revascularização

Oliveira¹,

Botelho²,

Brandi³

et al. 2009

Importância da troponina I no diagnóstico do infarto do miocárdio no pós-operatório de cirurgia de revascularizaçãoThe importance of troponin I in the diagnosis of myocardial infarction in the postoperative of coronary artery bypass graft surgery Abstract Objective: The aim of this study is to establish a cut-off value for troponin I by correlating it to occurrence of postoperative myocardial infarction.Methods: 180 consecutive patients with coronary disease referred for surgery were included. The mean age of the patients were 60.6 (±9.3) years, with 119 (66.1%) males and 61 (33.9%) females. The patients were divided into two groups: group without myocardial infarction (A) -170 patients -and with myocardial infarction (B) -10 patients.The troponin I was collected from each patient at the beginning of anesthesia and on the second postoperative day by correlating it to presence or not of postoperative myocardial infarction. StatsDirect 1.6.0 for Windows was used for statistical analysis.Results: Preoperative troponin I was 1.0 (±6) ng/ml as mean. Univariate logistic regression showed correlation of troponin I of the second postoperative day with myocardial infarction (P=0.0005). ROC curve was used to define the cut-off value, and 6.1 ng/ml (sensitivity=90.0%, specificity=82.1%, OR=49.8 with CI=95% 6.1-410.4, P<0.0001) were found.Conclusion: The chance of a patient with postoperative myocardial infarction to present troponin I equal to or higher than 6.1 ng/ml is 49.8-fold higher than the chance of a patient without infarction to present troponin I higher than this value. Resultados: A troponina I pré-operatória apresentou uma

Resultados imediatos da artéria torácica interna direita e artéria radial como segundo enxerto arterial em revascularização do miocárdio

Miana¹,

Lima²,

Whitaker³

et al. 2007

Resultados imediatos da artéria torácica interna direita e artéria radial como segundo enxerto arterial em revascularização do miocárdioImmediate results of right internal thoracic artery and radial artery as the second arterial graft in myocardial revascularization Abstract Objective: We sought to compare early clinical outcomes in patients receiving a right internal thoracic artery or a radial artery as the second arterial graft in myocardial revascularization.Methods: We retrospectively studied 58 consecutive patients who underwent coronary artery bypass surgery and received both a left internal thoracic artery graft and either a right internal thoracic artery (n=20) or a radial artery graft (n=38), between January 2004 and March 2006. Hospital mortality, pleural drainage, operative time and postoperative complications were analyzed.Results: There were no significant preoperative differences between groups. There was only one (1.7%) in-hospital death which occurred in the Radial Group. Operative times was significantly higher in the Right Internal Thoracic Group (p-value = 0.0018), but were not associated with increased Intensive Care Unit stays, mechanical ventilation or other postoperative complications. We were able to perform significantly more distal anastomosis using the radial artery than the right internal thoracic artery (1.57 versus 1.05: pvalue =0.003).Conclusion: In our group of patients, the use of a right internal thoracic artery as a second arterial graft was associated with a prolonged operative time, but had no interference with the immediate clinical outcomes. 61MIANA, LA ET AL -Immediate results of right internal thoracic artery and radial artery as the second arterial graft in myocardial revascularization Braz J Cardiovasc Surg 2007; 22(1): 60-67