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Patient Management OPCAB

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Off-Pump Coronary Artery Bypass

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Abstract

Patient management is important particularly in OPCAB from the standpoint of a hypercoagulability state and an occasional complication of AF after surgery.

Hypercoagulability state after OPCAB could potentially jeopardize early graft patency, as well as induce pulmonary infarction associated with deep vein thrombosis, and stroke, especially in atrial fibrillation. Accordingly, several institutions have tried an aggressive anticoagulation strategy with a continuous postoperative heparin administration for 2–5 days after surgery and early use of aspirin or clopidogrel in addition to aspirin. Furthermore, warfarin is administered by the majority of surgeons controlling INR at around 2.0, when vein grafts are selected for coronary revascularization.

In order to prevent AF after OPCAB, several trials and studies were performed in Japan focusing on the efficacy of perioperative beta-blocker administration, including intravenous landiolol hydrochloride treatment.

Annual alternation of CABG patients demonstrated that the percentage of the elderly aged over 80 years gradually increased from 5 % in 2000 to 11 % in 2012, in Japan. Postoperative care for elderly patients, prevention of respiratory complications, wound healing and infection, and mental confusion and delirium have come to be important.

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Authors and Affiliations

  1. Department of Cardiovascular, Thoracic and Pediatric Surgery, Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan

    Mitsuaki Sadahiro

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  1. Mitsuaki Sadahiro
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Correspondence to Mitsuaki Sadahiro .

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Editors and Affiliations

  1. Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan

    Tohru Asai

  2. Department of Cardiovascular Surgery, Nippon Medical School, Bunkyo-ku, Tokyo, Japan

    Masami Ochi

  3. Department of Cardiovascular Surgery, Fukushima Medical University, Fukushima, Fukushima, Japan

    Hitoshi Yokoyama

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© 2016 Springer Japan

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Sadahiro, M. (2016). Patient Management OPCAB. In: Asai, T., Ochi, M., Yokoyama, H. (eds) Off-Pump Coronary Artery Bypass. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54986-4_20

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  • DOI: https://doi.org/10.1007/978-4-431-54986-4_20

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54985-7

  • Online ISBN: 978-4-431-54986-4

  • eBook Packages: MedicineMedicine (R0)

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