Article Impact Level: HIGH Data Quality: STRONG Summary of Circulation, CIR.0000000000001154. https://doi.org/10.1161/CIR.0000000000001154 Dr. Mario Gaudino et al.
Points
- Acute postoperative myocardial ischemia (PMI) after cardiac surgery is a rare but life-threatening complication.
- The diagnosis and management of acute PMI lack universally accepted criteria and are based on limited evidence.
- A multidisciplinary approach involving experts in cardiac surgery, cardiology, anesthesiology, and postoperative care is crucial for prompt diagnosis and appropriate treatment decisions.
- Factors associated with acute PMI may vary depending on the type of cardiac surgery performed.
- Treatment options for acute PMI range from conservative strategies to percutaneous coronary intervention (PCI) and redo coronary artery bypass grafting (CABG). However, the optimal approach remains uncertain due to the limited evidence available.
Summary
Acute postoperative myocardial ischemia (PMI) is a rare but potentially life-threatening complication that can occur after cardiac surgery. This research paper, presented as a scientific statement by the American Heart Association, focuses on diagnosing and treating acute PMI in patients undergoing cardiac surgery. The paper highlights the need for universally accepted criteria for diagnosing acute PMI and the limited availability of high-quality evidence regarding its management.
The multidisciplinary group behind this document emphasizes the importance of a collaborative approach involving cardiac surgery, cardiology, anesthesiology, and postoperative care experts. They aim to facilitate prompt diagnosis and guide treatment decisions for acute PMI. Various factors specific to different types of cardiac surgical procedures are associated with the development of acute PMI. Understanding these factors is crucial for accurate diagnosis and appropriate management.
Treatment options for acute PMI range from conservative strategies to percutaneous coronary intervention (PCI) and redo coronary artery bypass grafting (CABG). However, determining the most effective approach remains challenging due to the need for robust evidence. Therefore, this paper serves as a comprehensive overview of the current evidence, highlighting the need for further research to establish standardized criteria for diagnosis and optimal management of acute PMI.
In summary, this scientific statement addresses the complexities of acute PMI after cardiac surgery. It underscores the need for a multidisciplinary approach and provides clinical guidance for diagnosing and managing this condition. By acknowledging the gaps in knowledge and emphasizing the importance of collaboration, the paper aims to improve patient outcomes and reduce the risks associated with acute PMI.
Link to the article: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001154
References Gaudino, M., Dangas, G. D., Angiolillo, D. J., Brodt, J., Chikwe, J., DeAnda, A., Hameed, I., Rodgers, M. L., Sandner, S., Sun, L. Y., Yong, C. M., & on behalf of the American Heart Association Council on Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Stroke Council. (2023). Considerations on the management of acute postoperative ischemia after cardiac surgery: A scientific statement from the american heart association. Circulation, CIR.0000000000001154. https://doi.org/10.1161/CIR.0000000000001154
