Sternotomy complications after Coronary Artery Bypass Grafting [CABG] risk factors?

The development of a sternotomy complication is multifactorial and numerous studies point to a multitude of patient- and procedure-related variables as underlying factors in this complication. Retrospective study analysis of 132 patients operated upon coronary artery bypass grafting. Sternal wound complications occurred to 19 patients [14.4], statistical analysis of the results demonstrated that prolonged mechanical ventilation, post operative blood loss and transfusion, prolonged bypass time, and diabetes mellitus was significant predictor risk factors for sternal wound complications risk factors. Identification of both patients' related risk factors and procedures related risk factors for sternal wound infection is very beneficial. Patients related factors should be lessened as much as possible while procedures related factors should be eliminated to abort any chance for sternal wound complication

Role of echocardiography in peri-operative assessment of coronary artery bypass graft surgery

Wall motion abnormalities detected by TEE are more common than ST segment changes detected by ECG. TEE is twice as predictive as ECG in identifying patients who have perioperative myocardial infarction. The study included 50 patients with chronic coronary heart disease underwent CABG surgery. Our results showed that the intraoperative post CABG effect in EF is not significant p>0.05, With DTI we can detect early manifestations of ischaemia through assessment of regional diastolic and systolic velocities. Our results have shown that there is intraoperative immediate significant improvement in the segmental wall motion score index. In patients with multivessel disease, intraoperative TEE and tissue Doppler imaging may be valuable and accurate methods to determine any acute changes in function, this would help to identify if complete and successful revascularization had been performed and define territories requiring more grafting