Abstract
A 64-year-old, type 2 diabetic patient is admitted for exercise-induced angina pectoris. He is known with a history of COPD and still smokes 10–15 cigarettes/day. His cholesterol is 270 mg/dL, he weighs 110 kg for 1.69 m, his blood pressure is 165/95 mmHg and his HbA1c is 10.5%. He is currently treated with Metformin 2 × 850 mg and Diltiazem 200 mg. On admission, troponines remain normal, and a coronary angiography shows a main stem stenosis of 90% and an occlusion of the right coronary artery at the origin. Echocardiography shows a moderate LV hypertrophy but a preserved systolic function. Coronary artery bypass surgery is suggested, and in the preoperative evaluation a pulmonary function test is performed, which shows the values in the Table 9.1.
Keywords
- Cardiac Rehabilitation
- Phrenic Nerve
- Internal Mammary Artery
- Inspiratory Muscle
- Cardiac Rehabilitation Program
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References
Bharucha D, Marinchak R. Arrhythmias after cardiac sugery: atrial fibrillation and atrial flutter. UpToDate. Version 16.3. Oktober 2008.
Bjarnason-Wehrens B, Mayer-Berger W, Meister ER, Baum K, Hambrecht R, Gielen S. Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil. 2004;11:352-361.
Crowe JM, Bradley CA. The effectiveness of incentive spirometry with physical therapy for high-risk patients after coronary artery bypass surgery. Phys Ther. 1997;77:260-268.
Dawson DM et al. Perioperative nerve lesions. Arch Neurol. 1989;46:1355-1360.
Dronkers J, Veldman A, Hoberg E, Van der Waal C. Prevention of pulmonary complicationis after upper abdominal surgery by preoperative intensive inspiratory muscle training: a randomizes controlled pilot study. Clin Rehabil. 2008;22:134-142.
El-Ansari D, Adams R, Toms L, Elkins M. Sternal instability following coronary artery bypass grafting. Physiother Theory Pract. 2000;16:27-33.
El-Ansari D, Waddington G, Adams R. Relationship between pain and upper limb movement in patients with chronic sternal instability following cardiac surgery. Physiother Theory Pract. 2007;23:273-280.
Hulzebos EH, Helders PJM, Favié NJ, De Bie RA, Brutel de la Rivière R, Van Meeteren NLU. Van Meeteren NLU Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high risk patients undergoing CABG surgery. JAMA. 2006;296:1851-1857.
Hulzebos EH, Van Meeteren NLU, van den Buijs BJWM, de Bie RA, Brutel de la Rivière A, Helders PJM. Feasibility of preoperative inspiratory muscle training in patients undergoing coronary artery bypass surgery with high risk of postoperative pulmonary complications: a randomised controlled pilot study. Clin Rehab. 2006;20:949-959.
Lederman RJ et al. Peripheral nervous system complications of coronary artery bypass graft surgery. Ann Neurol. 1982;12(3):297-301.
Light RW. Pleural effusions after coronary artery bypass graft surgery. Curr Opin Pulm Med. 2002;8:308.
Locke TJ, Griffiths TL, Mould H, Gibson GJ. Rib cage mechanics after median sternotomy. Thorax. 1990;45:465-468.
Maisel A, Rawn A, Stevenson A. A trial fibrillation after cardiac surgery. Ann Intern Med. 2001;135:1061.
Matte P, Jacquet L, Van Dyck M, Goenen M. Effects of conventional physiotherapy, continuous positive airway pressure and non-invasive ventilatory support with bilevel positive airway pressure after coronary artery bypass grafting. Acta Anaesthesiol Scand. 2000;44(1):75-81.
Nomori H, Kobayashi R, Fuyuno G, Morinaga S, Yashima H. Preoperative respiratory muscle training. Assessment in thoracic surgery patients with special reference to postoperative pulmonary complications. Chest. 1994;105:1782-1788.
O-Yurvati AH, Carnes MS, Clearfield MB, Stoll ST, McConathy WJ. Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery. J Am Osteopath Assoc. 2005;105(10):475-481.
Ragnarsdóttir M, Kristjánsdóttir Á, Ingvarsdóttir I, Hannesson P, Torfason B, Cahalin LP. Short-term changes in pulmonary function and respiratory movements after cardiac surgery via median sternotomy. Scand Cardiovasc J. 2004;38:46-52.
Sharma AD et al. Peripheral nerve injuries during cardiac surgery. Risk factors, diagnosis, prognosis, and prevention. Anesth Analg. 2000;91:1358-1369.
Shenkman Z, Shir Y, Weiss YG, Bleiberg B, Gross D. The effects of cardiac surgery on early and late pulmonary functions. Acta Anaesthesiol Scand. 1997;41:1193-1199.
Tripp H, Bolton R. Phrenic nerve injury following cardiac surgery: a review. J Card Surg. 1998;13:218-223.
Vasquez-Jimenez JF et al. Injury of the common peroneal nerve after cardiothoracic operations. Ann Thorac Surg. 2002;73:119-122.
Weiner P, Zeidan F, Zamir D, et al. Prophylactic inspiratory muscle training in patients undergoing coronary artery bypass graft. World J Surg. 1998;22:427-431.
Wheatcroft M, Shrivastava V, Nyawo B, Rostron A, Dunning J. Does pleurotomy during internal mammary artery harvest increase post-operative pulmonary complications? Interact CardioVasc Thorac Surg. 2005;4:143-146.
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Dendale, P. (2010). Rehabilitation of Patients After CABG/Sternotomy. In: Niebauer, J. (eds) Cardiac Rehabilitation Manual. Springer, London. https://doi.org/10.1007/978-1-84882-794-3_9
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