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Follow-up after Cardiovascular Surgery - ECAB

Follow-up after Cardiovascular Surgery - ECAB

O P Yadava

(2013)

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Book Details

Abstract

Follow-up of patients after surgery is of utmost importance as results of the surgery heavily depend on the treatment of patient in the follow-up period. A good follow-up and proper treatment also provides protection to the patient from various complications and recurrence of the disease. Therapeutic guidelines and algorithms for treatment of the patients after discharge from the hospitals exist for a number of cardiovascular disorders. Still, follow-up and postdischarge treatment is very often found to be inappropriate and incomplete. This results in many avoidable complications for both the patient as well as the treating clinician. This book is designed to update the readers on follow-up regimens for some of the important cardiovascular surgical procedures. Typical supportive case scenarios are included to exemplify and highlight the various points discussed. Thus it provides an excellent opportunity to widen one’s perspective in this area.


Table of Contents

Section Title Page Action Price
Front Cover Front cover
Front Matter ia
Elsevier Clinical Advisory Board:Cardiology ic
Copyright ie
About the Authors if
Contents ih
Introduction 1
ECAB Clinical Update InformationFollow-up afterCardiovascular Surgery i
Follow-up after Palliative Cardiac Operations in the Neonatal Period 2a
Introduction 2
Selected Case Scenarios 3
Aorto-Pulmonary Shunts 8
Tetralogy of Fallot with Pulmonary Atresia 12
Unique Problems with Neonatal BTS 13
Follow-up after Coronary Artery Bypass Surgery 38a
Postoperative Adverse Clinical Events 40
Recurrence of Angina/Myocardial Infarction 40
Sudden Death 42
Neuropsychiatric Outcomes 42
Depression 43
Postoperative Chest Pain 44
Postoperative Fever 45
Postoperative Pleural Effusion 46
Postoperative Atrial Fibrillation 46
Postoperative Scar 46
Visual Disturbances 47
Hoarseness of Voice 47
Edema Feet 47
Laboratory Testing 48
Monitoring for Ventricular Arrhythmias 48
Evaluation of Recurrent Ischemia 50
Postoperative Imaging for Atherosclerosis Progression 52
Frequency of Follow-Up 52
Who should be Studied after cabg? 53
Management of Recurrent Ischemia 54
Use of Medications 55
Antiplatelet Therapy 57
Risk Factor Control 60
Diet 60
Management of Hyperlipidemia 61
Smoking Cessation 62
Alcohol Consumption 63
Hormonal Manipulation in Women 64
Miscellaneous 64
Cardiac Rehabilitation 66
Follow-up after Heart Valve Replacement 84
Problems with Follow-up in India 85
Choice of Valvular Prosthesis 86
Risk Stratification 88
Statistical Analysis of Valve Follow-up Data 89
Statistical Terms Used in Valve Follow-up 89
Survival after Valve Replacement 90
Management During Follow-up 94
Management of Anticoagulation 95
Prosthetic Valves, Anticoagulation, and Pregnancy 97
Thrombotic Occlusion of the Valve 97
Re-operation 98
Survival after Surgery 99
Mechanical Complications 99
Endocarditis 100
Endocarditis Prophylaxis 101
Patient Prosthesis Mismatch 101
Heart Failure after Valve Replacement 102
Pulmonary Hypertension 103
Arrhythmia 104
Sudden Death 104
Late Follow-up 105
Follow-up after Vascular Surgery 109a
Technical and Clinical Success of the Procedure 112
Looking for Complications and Planning Timely Management of Complications 115
Systemic Complications 116
Cardiac Complications 116
Pulmonary Complications 116
Renal Complications 116
Perioperative Hemorrhage 117
Local Complications 117
Graft Thrombosis 117
Infection in Prosthetic Vascular Graft 118
Anastomotic and other Pseudoaneurysms 119
Aortoenteric Fistulae 119
Other Complications 120
Complications of Endovascular Grafting for Anaurysm 121
Management of Untreated/New Aneurysm at other Site 122
Follow-up after Management of Dissection of Ascending Aorta for Management of Descending Thoracic Aortic Dissection and fo ... 124
Follow-up for Prevention and Management of Risk Factors for Atherosclerosis after Vascular Surgery 124
Diabetes Mellitus 125
Hyperlipidemia 126
Arterial Hypertension 127
Antiplatelet Treatment 128
Smoking 129
Follow-up in Patients with Takayasu's Arteritis and other Autoimmune Disease as Cause of Vascular Disease 129
Summary 129
Case Study Follow-up after Vascular Surgery 139
Case Study I: A Patient with Blocked Infrainguinal Graft 139
History 139
On Examination 139
Management 140
Follow-up 140
Case Study II: A Patient with Infected Aortobifemoral Graft 140
History 140
On Examination 141
Management 141
Follow-up 141
Editors Comment 143
Forthcoming Books 145