Clinical significance of a new Q wave after cardiac surgery

Abstract

The association of a new Q wave and high levels of myocardial necrosis biomarkers is strongly associated with postoperative cardiac events. On the contrary, the isolated appearance of a new Q wave has no impact on the postoperative cardiac outcome.

Myocardial injury after off-pump coronary artery bypass grafting operation

“…Our study confirms that ECG changes observed in the immediate postoperative period do not possess a clinical relevance and the ability to predict postoperative outcome [2]; unfortunately we are not able to document further evolution of the ECG in the following months.…”

“…While postoperative electrocardiogram (ECG) variations have a limited clinical value [2], several studies demonstrated the power of cardiac troponin I (cTnI) [3][4][5][6] and creatine kinase-MB (CK-MB) [7][8][9] to predict hospital mortality, major complications and graft failure after standard on-pump coronary artery bypass grafting (CABG). It is still debated whether perioperative myocardial ischemia may influence survival in the mid-term: postoperative cTnI release provided conflicting results on this regard [5,10], while there is consensus about the prognostic role of postoperative CK-MB release on mid-term survival after on-pump CABG [7][8][9].…”

Detecting myocardial ischaemia using miniature ultrasonic transducers — a feasibility study in a porcine model☆

“…Detection of ischaemia in this setting still represents a challenge, and there is no optimal technique for making the diagnosis. Electrocardiography (ECG) provides continuous real-time monitoring of the myocardium, but its sensitivity in case of ischaemia varies [1,2]. Echocardiography, however, is a more sensitive tool [3,4], and combining automated ECG ST-segment analysis and echocardiographic monitoring by two-dimensional (2D) wall motion scoring is superior to either method alone [5].…”

The influence of propofol or desflurane on postoperative cognitive dysfunction in patients undergoing coronary artery bypass surgery*

“…Details of the duration of mechanical ventilation and intensive care unit and hospital length of stay (from the operative day) were collected. Postoperative morbidity was collected including death, myocardial infarction (at least two of the following criteria: cardiac enzyme level elevation with either troponin I > 20 lg.l )1 or CK-MB > 30 lg.l )1 , serial ECG with new Q waves in two or more leads, or new wall motion abnormality on echocardiography [22,23]), ventricular or supraventricular arrhythmia, inotrope use to support low cardiac output, mechanical cardiac support; a bleeding rate of > 200 ml.h .............................................................................................................................................................................................................. oedema, respiratory failure requiring re-intubation of the patient's trachea; superficial wound or skin requiring treatment, deep sternal, chest, urinary or abdominal infection requiring treatment; stroke, transient ischaemic attack, coma, agitation or delirium; serum creatinine increase > 1.5 times baseline value, haemofiltration; and homologous blood product transfusion. Finally, depression was assessed using the cardiac depression index score [24].…”