Impact of chronic obstructive pulmonary disease in patients undergoing coronary artery bypass graft surgery

Abstract

Introduction. Cardiovascular disease is the leading cause of morbidity, disability and mortality in modern society. Coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD) are the most common comorbid pathology that worsens the quality of life and prospective prognosis of patients.Aim. The literature review is focused on postoperative outcomes of patients with COPD undergoing coronary artery bypass grafting surgery (CABG).Results. The review presents national and international data the prevalence of COPD in patients having CABG. The issues of risk stratification of comorbid patients in cardiac surgery are considered. It is shown that patients with CAD in combination with COPD are more at risk of various complications after CABG. COPD increases the chances of a complicated course of the in-hospital period by 2.1 times and risk of death in the long-term period after CAPG by 1.8 times. Patients with COPD are at a higher risk of developing postoperative pneumonia, respiratory failure, stroke, kidney failure, and wound infection of the sternum. Long-term 5-year and 10-year survival after CABG is lower in patients with COPD. The longterm adverse prognosis depends on the severity of the bronchial obstruction. Achievements in the field of cardiac surgery have had a significant impact on the results of surgical interventions in the comorbid course of CAD and COPD. Intensive pulmonary rehabilitation after surgery and effective drug therapy can improve the outcomes after CABG in patients with COPD. Hybrid coronary revascularization and minimally invasive coronary surgery appear to be viable alternatives to conventional CABG, offering a less invasive approach to coronary revascularization, which may be especially beneficial to high-risk patients with COPD.