Preoperative Assessment for Coronary Artery Bypass Graft: Going Back to the Basics

Dimos Karangelis; Konstantinos C. Christodoulou; Efstratios Georgakarakos; Aliki Fiska; Dimitrios Mikroulis

doi:10.58600/eurjther1704

Authors

Dimos Karangelis Department of Cardiac Surgery Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece https://orcid.org/0000-0001-7633-9949
Konstantinos C. Christodoulou Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece & Laboratory of Anatomy, Medical School, Democritus University of Thrace, Alexandroupolis, Greece https://orcid.org/0000-0002-5807-9212
Efstratios Georgakarakos Department of Vascular Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece https://orcid.org/0000-0003-3789-1110
Aliki Fiska Laboratory of Anatomy, Medical School, Democritus University of Thrace, Alexandroupolis, Greece https://orcid.org/0000-0003-1787-6116
Dimitrios Mikroulis Department of Cardiac Surgery Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece https://orcid.org/0000-0002-3585-0166

DOI:

https://doi.org/10.58600/eurjther1704

Keywords:

Cardiac surgery, Color doppler ultrasonography, Clinical examination, Arm pressure gradient, Subclavian artery stenosis

Abstract

As doctors increasingly rely on technological advancements, ever-improving laboratory techniques, and imaging modalities, the importance of a thorough physical evaluation and bedside manner has been noticeably diminished. When it comes to patients scheduled for coronary artery bypass graft (CABG), the preoperative bilateral arm blood pressure (BP) measurement is often omitted; thus, sinister signs of atherosclerotic disease like the brachial gradient are neglected and the surgical plan is jeopardized. We present the case of a 72-year-old male listed for CABG, stressing the necessity of meticulous clinical examination and the routine use of color Doppler ultrasonography (CDUS), prior to surgery. This case aims to highlight the major role of thorough preoperative clinical assessment. The bilateral BP measurement and CDUS are two reliable, expeditious, noninvasive preoperative screening methods, which can detect patients with generalized atherosclerosis, altering, if necessary, the surgical plan, and aiming for the best possible outcome, without complications.

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