Intra-operative and post-operative management of conduits for coronary artery bypass grafting: a clinical consensus statement of the European Society of Cardiology Working Group on Cardiovascular Surgery and the European Association for Cardio-Thoracic Surgery Coronary Task Force.

Autor:	Sandner S; Department of Cardiac Surgery, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.; Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA., Antoniades C; Division of Cardiovascular Medicine, Radcliffe Department Medicine, University of Oxford, Oxford, UK., Caliskan E; Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany., Czerny M; Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Germany.; Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany., Dayan V; University Cardiovascular Center, National Institute of Cardiac Surgery, Montevideo, Uruguay., Fremes SE; Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Glineur D; Division of Cardiac Surgery, Memorial University, St. John's, Newfoundland, Canada.; Department of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada., Lawton JS; Department of Surgery, Division of Cardiac Surgery, Johns Hopkins University, Baltimore, MD, USA., Thielmann M; Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany., Gaudino M; Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2024 Oct 16. Date of Electronic Publication: 2024 Oct 16.
DOI:	10.1093/eurheartj/ehae654
Abstrakt:	The structural and functional integrity of conduits used for coronary artery bypass grafting is critical for graft patency. Disruption of endothelial integrity and endothelial dysfunction are incurred during conduit harvesting subsequent to mechanical or thermal injury and during conduit storage prior to grafting, leading to acute thrombosis and early graft failure. Late graft failure, in particular that of vein grafts, is precipitated by progressive atherogenesis. Intra-operative management includes appropriate selection of conduit-specific harvesting techniques and storage solutions. Arterial grafts are prone to vasospasm subsequent to surgical manipulation, and application of intra-operative vasodilatory protocols is critical. Post-operative management includes continuation of oral vasodilator therapy and selection of antithrombotic and lipid-lowering agents to attenuate atherosclerotic disease progression in conduits. In this review, the scientific evidence underlying the key aspects of intra- and post-operative management of conduits for coronary artery bypass grafting is examined. Clinical consensus statements for best clinical practice are provided, and areas requiring further research are highlighted. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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