LIMA to LAD is performed in the operating theatre and other lesions are treated with PCI, either at the operating room, right after the anastomosis or serval days later. After the procedure
After the procedure, the patient is usually transferred to the intensive care unit, where they are extubated if it hasnt been done already in the operating theatre. The following day they exit the ICU, and 4 days later, if no complications occur, the patient is discharged from the hospital.A series of drugs are commonly used in the early postoperative period. Dobutamine, a beta agent, can be used to increase the cardiac output that sometimes occurs some hours after the operation. Beta blockers are used to prevent atrial fibrillation and other supraventricular arrhythmias. Biatrial pacing through the pacing wires inserted at operation might help towards preventing atrial fibrillation. Aspirin 80mg is used to prevent graft failure. Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin receptor blockers (ARBs) are used to control blood pressure, especially in patients with low cardiac function (<40%). Amlodipine, a calcium channel blocker, is used for patients that radial artery was used as a graft.After the discharge, patients might suffer from insomnia, low appetite, decreased sex drive, and memory problems. This effect is usually transient and lasts 6 to 8 weeks. A tailored exercise plan usually benefits the patient. Results
CABG is the best procedure to reduce mortality from severe CAD and improve quality of life. Operative mortality relates strongly to age of patient.
Grades
Grade 1: if there is no initial lesion on the area, no amputation or lasting effects are expected
Grade 2: if there is a lesion on the distal body part, tissue and fingernails can be destroyed
Grade 3: if there is a lesion on the intermediate or near body part, auto-amputation and loss of function can occur
Grade 4: if there is a lesion very near the body (such as the carpals of the hand), the limb can be lost. Sepsis and/or other systemic problems are expected.A number of long term sequelae can occur after frostbite. These include transient or permanent changes in sensation, paresthesia, increased sweating, cancers, and bone destruction/arthritis in the area affected. Epidemiology
There is a lack of comprehensive statistics about the epidemiology of frostbite. In the United States, frostbite is more common in northern states. In Finland, annual incidence was 2.5 per 100,000 among civilians, compared with 3.2 per 100,000 in Montreal. Research suggests that men aged 30–49 are at highest risk, possibly due to occupational or recreational exposures to cold. History
Frostbite has been described in military history for millennia. The Greeks encountered and discussed the problem of frostbite as early as 400 BCE. Researchers have found evidence of frostbite in humans dating back 5,000 years, in an Andean mummy. Napoleons Army was the first documented instance of mass cold injury in the early 1800s. According to Zafren, nearly 1 million combatants fell victim to frostbite in the First and Second World Wars, and the Korean War.