User:Cinadon36/sandbox13


 * CABG


 * I think also that this article needs to be simplified a bit - it's full of acronyms, medical jargon and written I think from a surgical / medical perspective. Concepts should be wikilinked where possible. I wrote an essay about this topic if it helps: WP:ANATSIMPLIFY. See also: Wikipedia:Manual_of_Style/Medicine-related_articles.
 * I can't help but feel this article is not as comprehensive as it could be (see Wikipedia:Manual_of_Style/Medicine-related_articles for common headings) - I think in particular the non surgical course before and after the operation could be more fully explained, and, in fact, lots of things are just listed but not much attempt is made to explain in simple terms why they occur.


 * Uses (or Medical uses if clarification is required)
 * Contra-indications
 * Risks/Complications
 * Technique (avoid step-by-step instructions)
 * Recovery or Rehabilitation
 * History (e.g., when it was invented)
 * Society and culture (includes legal issues, if any)
 * Special populations
 * Other animals

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 * NOBLE
 * EXCEL
 * FREEDOM
 * BEST
 * STITCH
 * SYNTAX
 * ISCHAEIMIA TRIAL
 * FAME 3 TRIAL

Action
DRUGS
 * Dopamine
 * Dob

Postoperative medications
After the procedure a number of drugs are needed to optimize patients chances of survival. For graft patency, antiplatelet drugs are given, most commonly Aspirin- dosage varies from 81 to 325mg per day. In cases where someone can not take aspirin, Clopidogrel 75mg is a good alternative. Dual antiplatelet therapy, (that is aspirin plus another T1P12 drug such as Clopidogrel, prasugrel or ticagrelor) has not been found to be beneficial for the patients unless he has a history of stent placement. Time of initiation of aspirin, also varies, current recommendations suggest starting aspirin within 6 hours after surgery.

Anihypertensive drugs ACE inhibitors and Angiotensin II receptor blocker have been found to be helpful, not only by their anti-hypertensive properties, but they also protect the grafts from the progression of CAD, and may help heart healing process after an MI. This is because of their potential to increase vasoprotective Nitric Oxide, and their anti-inflammation properties. Significant problems of ACE is that they may cause hypertension on injure the Kidney, so it is prudent to delay the initiation of the drug until patient is stable and monitor Creatinine, an indicator of renal function.

Statins are used to lower blood cholesterol. They particularly protect Saphenous Vein Grafts. Statins are well tolerated and ideally the blood cholesterol levels should be kept low (LDL level <100 mg/dL).

Beta blockers are used in the early postoperative setting to prevent atrial fibrillation and to help control heart rate. Their protective role is not limited in the early period but studies has shown that beta blockers reduce adverse effects years after the operation. Current recommendations include starting beta blockers the day before the operation.

Patients, upon leaving the hospital should be encouraged to modify risk factors for atherosclerosis, to follow a healthy lifestyle, stop smoking if they are smoking and tackle obesity.

Rehabilitation

 * The role of cardiac rehabilitation in patients with heart disease Author links open overlay panelSean R.McMahonaPhilip A.AdesaPaul D.Thompsonb https://doi.org/10.1016/j.tcm.2017.02.005


 * Participation in Cardiac Rehabilitation and Survival After Coronary Artery Bypass Graft Surgery A Community-Based Study Quinn R. Pack, Kashish Goel, Brian D. Lahr, Kevin L. Greason, Ray W. Squires, Francisco Lopez-Jimenez, Zixin Zhang and Randal J. Thomas Originally published8 Jul 2013 https://doi.org/10.1161/CIRCULATIONAHA.112.001365Circulation. 2013;128:590–597


 * LAZAR at the end of the chapter

Special population
CABG is also performed in babies and children. The problem addressed is not CAD, as it is extremely rare to children, but various anomalies of the arteries or the valves of the heart, but still, the operation is rare. Most common disease that prompts the need for CABG is Kawasaki disease. The operation is carried by specialized pediatric cardiac surgeons. Since the arteries of the babies are much smaller than adults, surgeons used surgical microscope to perform the operation. Internal Mammary Arteries outperform saphenous vein grafts since they can adapt to the body growth better.