Perioperative myocardial infarction.
POMI can occur during all types of cardiac surgery, but is most common during coronary artery surgery. Although the causes of POMI are usually multifactorial, an understanding of these causes provides the clinician a better basis for developing strategies to prevent as well as treat this complication. POMI usually results in a benign postoperative course, but can contribute to intra- or postoperative death, postoperative low cardiac output syndrome, as well as diminished long-term exercise tolerance and survival. These latter events highlight the importance of POMI after cardiac surgery and depend on the extent and location of the infarct as well as the functionality of the remaining viable myocardium. Future advances in surgical, medical, and anesthetic management will be necessary to further decrease the incidence and severity of POMI so as to afford patients the best chance of survival and a productive life after heart surgery.
Tuman
K J
KJ
Department of Anesthesiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
D000768:Anesthesia, General; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000209:etiology; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors