Complicaciones cardiovasculares

Abstract

Coronary artery bypass grafting is one of the most common surgical procedures today. Its results have improved significantly over time thanks to better patient selection, advances in surgical techniques, and technology. As a consequence, mortality and associated morbidity have decreased significantly. On the other hand, with the introduction of percutaneous coronary angioplasty, it has been observed that patients who are referred to surgery at present time are cases with greater anatomical complexity or diabetics. Risk factors for developing complications and early death after coronary surgery can be classified as demographic factors (age and sex), previous cardiovascular diseases (myocardial infarction, heart failure, valvular heart disease, previous stroke, or peripheral vascular disease) or previous cardiovascular surgical interventions, left ventricular function, arrhythmias, comorbidities (diabetes mellitus, kidney disease, chronic obstructive pulmonary disease). In addition to these factors, the frailty, cognitive status, and hemodynamic status of the patient and the urgency or not of the intervention are important risk determinants. Major complications of coronary artery bypass surgery are conventionally reported within 30 days, and include death, myocardial infarction, stroke, atrial fibrillation, major bleeding, kidney failure requiring dialysis, and infection of the operative wound. Mortality reported in large series is 1 to 2 % but it is strongly influenced by the severity of the conditions of the patients who undergo surgery and the experience of the medical and surgical teams.