Our Summary

This article is a review of research related to cardiac anesthesiology (anesthesia used in heart surgery) published in 2019. After looking through over 1400 published studies, the authors identified five key topics that were prominent in the year’s research. These were:

  1. Transcatheter techniques: this refers to surgical procedures that use a thin tube (catheter) to repair the heart, instead of open-heart surgery.

  2. Delirium and anesthesiology: delirium is a state of confusion that can occur after anesthesia.

  3. Coagulation management following cardiopulmonary bypass: this is about how to manage blood clotting after a procedure that temporarily takes over the function of the heart and lungs during surgery.

  4. Perfusion management with del Nido cardioplegia: this is about how to manage the flow of blood to the heart using a specific technique (del Nido cardioplegia) that protects the heart during surgery.

  5. Applied clinical research: this refers to studies that directly involve patients to determine the effectiveness and safety of interventions or treatments.

These areas of research have pushed the boundaries of what is possible in cardiac anesthesiology and set high aspirations for future research.

FAQs

  1. What are the five major themes identified in 2019 literature about cardiac anesthesiology and anesthesiology outcomes?
  2. What is del Nido cardioplegia and how does it relate to perfusion management?
  3. What is the significance of coagulation management following cardiopulmonary bypass in cardiac anesthesiology?

Doctor’s Tip

One helpful tip a doctor might tell a patient about heart bypass surgery is to follow a healthy lifestyle after the procedure, including maintaining a balanced diet, staying physically active, quitting smoking, and managing stress. These lifestyle changes can help improve the long-term success of the bypass surgery and overall heart health.

Suitable For

Patients who are typically recommended for heart bypass surgery are those with severe coronary artery disease, which is caused by a buildup of plaque in the arteries that supply blood to the heart muscle. Common indications for heart bypass surgery include:

  1. Severe blockages in multiple coronary arteries that cannot be effectively treated with medication or less invasive procedures such as angioplasty.
  2. Patients with left main coronary artery disease, which is a blockage in the artery that supplies blood to the left side of the heart.
  3. Patients with severe chest pain (angina) that limits their daily activities and quality of life.
  4. Patients with heart failure or reduced heart function due to coronary artery disease.
  5. Patients who have had a previous heart attack and are at high risk for future cardiac events.

It is important for patients to undergo a thorough evaluation by a cardiologist or cardiac surgeon to determine if heart bypass surgery is the most appropriate treatment option for their specific condition.

Timeline

Before heart bypass surgery:

  1. Patient undergoes a series of tests and evaluations to determine the need for bypass surgery.
  2. Patient is advised to stop taking certain medications and to make necessary lifestyle changes.
  3. Patient meets with the surgical team to discuss the procedure and potential risks.
  4. Patient undergoes preoperative preparations, which may include fasting, blood tests, and anesthesia consultation.

After heart bypass surgery:

  1. Patient is monitored closely in the intensive care unit (ICU) immediately after surgery.
  2. Patient may experience pain, discomfort, and fatigue in the days following surgery.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  4. Patient is discharged from the hospital and continues to follow up with their healthcare team for postoperative care and monitoring.
  5. Patient makes lifestyle changes, such as adopting a healthy diet and exercise routine, to promote heart health and prevent future complications.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with heart bypass surgery?
  2. How long will the recovery process take, and what can I expect during this time?
  3. What lifestyle changes will I need to make after the surgery to maintain heart health?
  4. Will I need to take any medications long-term following the surgery?
  5. How frequently will I need to follow up with you or a cardiologist after the surgery?
  6. Are there any alternative treatment options to consider before proceeding with heart bypass surgery?
  7. What is your experience and success rate with performing heart bypass surgeries?
  8. What is the expected outcome of the surgery in terms of improving heart function and quality of life?
  9. How can I best prepare for the surgery, both physically and mentally?
  10. Are there any specific restrictions or limitations I should be aware of after the surgery?

Reference

Authors: Clendenen N, Abrams B, Morabito J, Grae L, Mosca MS, Weitzel N. Journal: Semin Cardiothorac Vasc Anesth. 2020 Jun;24(2):138-148. doi: 10.1177/1089253220921588. Epub 2020 Apr 29. PMID: 32349616