Cirurgia coronária com métodos não cardioplégicos

Abstract

Coronary heart disease (CAD) is the leading cause of mortality and morbidity worldwide, with increasing incidence and prevalence. In developed countries, it entails greater economic costs than any other disease. For a large number of patients with CAD, coronary artery bypass grafting (CABG) is an effective treatment strategy that is associated with increased survival. In addition to the surgeon's experience, the success of CABG is also related to the cardio protective method used during the procedure. The cardio protective strategies during CABG have a long evolutionary history. This review article aimed to determine the effectiveness of non-cardiologic techniques as cardio protective methods in CABG. Thus, a controlled review of studies was conducted to address these techniques, comparing them with each other or with cardioplegic techniques. For the embodiment of the present literature review, a survey was conducted from textbooks, scientific research papers, magazines, newspapers and reference websites about this topic during the period January 1950 to January 2016. In relation to the discussion and conclusion, in an initial phase, the evolution of cardio protective techniques in time was contextualized. Later, it was presented a summary of the pre-existing evidence on the different methods of non-cardioplegic cardio protection. In sum, it was demonstrated that although hypothermia and cardioplegic solutions are the main cardio protective technique used today, non-cardioplegic strategies can provide a myocardial protection equally safe and effective, even in high-risk patients, with similar or even better results.