What are complications of coronary artery bypass grafting (CABG)?

Updated: Dec 04, 2019
  • Author: Rohit Shahani, MD, MS, MCh; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Answer

In the initial postoperative period, there is a decline in myocardial function secondary to myocardial edema and ischemia-reperfusion injury. Additional factors (eg, incomplete revascularization and postoperative graft failure) may exacerbate the dysfunction. Patients may exhibit a low-output syndrome, with 4-9% requiring the use of inotropes or intra-aortic balloon pulsation. Additionally, segmental transmural myocardial infarction occurs in 1-5% of patients, and postoperative arrhythmias occur in approximately 30% of patients after CABG. [59]

Adverse neurologic outcomes are a major concern in cardiac surgery, with 3.1% for major (type I) events (eg, major neurologic deficits and coma) occurring in 3.1% of cases, and 3% for less-debilitating (type II) events (deterioration of intellectual function or memory). Both types of events result in a significant increase in mortality: 21% for type I events and 10% for type II. [60] Despite the increased mortality associated with type II events, the majority of survivors return to normal activity in the following 3-12 months. [61]

Postoperative renal failure is a significant cause of mortality after CABG. There is a 4% incidence of renal failure; 20% of these patients require dialysis, and the mortality is 50%.


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