Diagnóstico y alternativas terapéuticas en la isquemia miocárdica aguda perioperatoria en cirugía coronaria

Abstract

Ischemia and infarct after surgical revascularization are a relatively frequent complication, with high morbidity and mortality. Early diagnosis is essential. However, this is less standardized and more complicated to diagnose than in patients who have not undergone surgery since there is no specific biomarker that allows the clinician to differentiate between myocardial ischemia due to the procedure itself and myocardial damage due to perioperative infarct. Once detected, perioperative ischemia should be treated immediately in order to limit myocardial damage. The objectives of this study have been 1. To show the diagnostic criteria for perioperative infarct and ischemia. 2. to show the different therapeutic options available. 3. to propose a treatment algorithm that includes the differential diagnosis, how to control vasospasm, implantation of balloon counterpulsation, and the possible revascularization strategies (percutaneous coronary intervention vs reoperation).

Cardioprotective effects of atorvastatin plus trimetazidine in percutaneous coronary intervention

“…However, balloon dilatation and stent implantation operations during PCI will both induce myocardial ischemia and myocardial microembolization, which will lead to perioperative myocardial injury and affect therapy efficacy. 2 , 3 …”

Lipid emulsion enhances cardiac performance after ischemia–reperfusion in isolated hearts from summer-active arctic ground squirrels

“…Myocardial ischemia/reperfusion (IR) and their resulting tissue injury are also an unavoidable consequence of cardiac surgery and heart transplantation, and remain a major source of perioperative morbidity and mortality (Bueno-Gonzalez et al 2010; Ueki et al 2016). Prognosis after myocardial IR injury primarily depends on the quantity of irreversibly damaged myocardium (Miller et al 1995).…”