But when the LV function is severely impaired before operation (EF<30%), the benefits at the heart are less impressive in terms of segmental wall movement, but still significant since other parameters might improve as LV functions improves, the pulmonary hypertension might be relieved and survival is prolonged.It is hard to determine the total risk of the procedure since the group of patients undergoing CABG is a heterogeneous one, hence various subgroups have different risk, but it seems like the results for younger patients are better. Also, a CABG with two rather one internal mammary arteries seems to offer greater protection from CAD but results are not yet conclusive. Grafts
Various conduits can be utilized for CABG- they fall into two main categories, arteries and veins. Arteries have a superior long term patency, but veins are still largely in use due to practicality. Arterial grafts that can be used originate from the part of the Internal Mammary Artery (IMA) that runs near the edge of sternum and can easily be mobilized and anastomosed to the native target vessel of the heart. Left is most often used as it is closer to heart but Right IMA is utilized depending on patient and surgeon preferences. ITAs advantages are mostly due to their endothelial cells that produce factors (Endothelium-derived relaxing factor and prostacyclin) that protect the artery from atherosclerosis and thus stenosis or occlusion. But using two ITAs has drawbacks, high rate of specific complications (deep sternal wound infections) in some subgroups of patients, mainly in obese and diabetic ones.
Ectopic beats are a type of cardiac arrhythmias, which is a variety of cardiac abnormalities relating to rate or rhythm of the cardiac cycle.Ectopic beats may become more frequent during anxiety, panic attack, and the fight-or-flight response due to the increase in sympathetic nervous activity or due to parasympathetic failure, stimulating either more frequent or more vigorous contractions and increasing stroke volume. The consumption of nicotine, alcohol, epinephrine and caffeine may also increase the incidence of ectopic beats, due to their influence on the action of cardiomyocytes. See also
Heart arrhythmia § Origin of impulse
Ectopia (disambiguation)
Junctional escape beat
Palpitation
Premature junctional contraction
Ventricular escape beat

References


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