[Modified bedside diagnosis in patients at risk for aortocoronary venous bypass surgery]

Early detection of perioperative complications during cardiosurgical operations is of differential diagnostic and differential therapeutic importance. Various risk groups of aortocoronary venous bypass operations have been analysed under different aspects: age, (not significant), implemented bypass rate (aneurysm resection 1.75/p less than 0.01 compared with 2.65-2.9), death rate (= greater than 21 days) 4 to 6.3% (including patients with "bad ventricle", p less than 0.05), and the proportion of clinically relevant complications of 19 to 40% (aneurysm resection 40%/p less than 0.001). Monitoring the marker proteins is an appropriate method of judging the perioperative risk of perioperative myocardial damage in preoperatively defined high-risk patients (approximately 25% modified according to centre conditions). Patients who died always had early pathologic dynamics of marker proteins. Patients with perioperative risks (aneurysm resection and ejection fraction global less than = 30%), left main artery stenosis and unstable angina pectoris symptoms) were found to have pathologic dynamics of marker proteins to a significantly varying extent (compared to a test group). This modified approach of bedside diagnostics of risk patients confirms the preoperative selection of risk patients and forms the economically viable future basis for an individualized perioperative course control.