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https://www.readbyqxmd.com/read/29789184/infused-cardioplegia-index-a-new-tool-to-improve-myocardial-protection-a-cohort-study
#1
J J Jiménez Rivera, C Llanos Jorge, J L Iribarren Sarrías, M Brouard Martín, J Lacalzada Almeida, J L Pérez Vela, R Avalos Pinto, R Pérez Hernández, S Ramos de la Rosa, G Yanes Bowden, R Martínez Sanz
BACKGROUND: Strategies for cardio-protection are essential in coronary artery bypass graft surgery. The authors explored the relationship between cardioplegia volume, left ventricular mass index and ischemia time by means of the infused cardioplegia index and its relationship with post-operative low cardiac output syndrome. DESIGN: All patients undergoing coronary artery bypass graft surgery between January 2013 and December 2015 were included. Low cardiac output syndrome was defined according to criteria of the SEMICYUC's consensus document...
May 19, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29784004/positive-impact-of-retrograde-autologous-priming-in-adult-patients-undergoing-cardiac-surgery-a-randomized-clinical-trial
#2
Britt Hofmann, Claudia Kaufmann, Markus Stiller, Thomas Neitzel, Andreas Wienke, Rolf-Edgar Silber, Hendrik Treede
BACKGROUND: Adult cardiac surgery with extracorporeal circulation is known to be associated with increased risk of blood transfusion leading to adverse outcomes. Procedures like retrograde autologous priming (RAP) may reduce these negative side effects. This randomized prospective study was initiated to assess whether RAP using specifically designed RAP bag (Terumo) has immediate effects on patient outcome. METHODS: One hundred eighteen adults undergoing elective CABG or elective aortic valve replacement were randomly assigned by a computer program into two groups: the RAP group (n = 54) in which the retrograde autologous priming was applied and the non-RAP (n = 64) group in which the same setting was used without the possibility to save priming volume...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29781070/antiplatelet-therapy-for-patients-undergoing-coronary-artery-bypass-surgery
#3
Christine M DeStephan, David J Schneider
Considerable variation in the use and duration of antiplatelet medications during the perioperative and postoperative care of patients undergoing coronary artery bypass grafting (CABG) reflects limited studies focused directly on these patients as well as variation in the results reported. In this review we will highlight the incidence and mechanisms of graft closure as well as the evidence in support of antiplatelet therapy that is balanced by the impact of antiplatelet therapy on the risk of bleeding to provide recommendations for the use of antiplatelet therapy in patients undergoing CABG...
May 21, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#4
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29780070/chronic-obstructive-pulmonary-disease-and-off-pump-coronary-surgery
#5
Cengiz Ovalı, Aykut Şahin
PURPOSE: To determine to what extent chronic obstructive pulmonary disease (COPD) affects mortality and morbidity rates in patients treated with off-pump coronary artery bypass graft (CABG). METHODS: A total of 321 patients treated with off-pump CABG were included in the present study. Of the 321 patients, 46 patients had COPD and they were designated as Group 1 and the remaining 275 patients did not have COPD and they were considered as Group 2. We compared the data obtained from the patients in both groups...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29779035/combined-coronary-artery-bypass-graft-cabg-surgery-and-lung-resection-for-lung-cancer-in-patients-more-than-50-years-of-age
#6
Ban Liu, Chao Chen, Chang Gu, Qianfan Li, Jingjing Liu, Yiwei Pu, Yu Lin, Zilun Wei, Zhi Li, Yangyang Zhang
BACKGROUND The co-existence of coronary heart disease (CHD) and lung cancer is increasing in an increasingly aging population. The aim of this study was to evaluate patient outcome from combined off-pump coronary artery bypass graft (CABG) surgery and lung resection in patients more than 50 years-of-age. MATERIAL AND METHODS A retrospective clinical study of 23 patients with a mean age of 70.2±8.4 years (range, 51-86 years) included 18 men and five women with CHD and lung cancer who underwent a single operation with combined off-pump CABG surgery and lung resection, for non-small cell lung cancer (NSCLC) (n=22) and small cell lung cancer (n=1)...
May 20, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#7
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29777264/empagliflozin-reduces-cardiovascular-events-mortality-and-renal-events-in-participants-with-type-2-diabetes-after-coronary-artery-bypass-graft-surgery-subanalysis-of-the-empa-reg-outcome%C3%A2-randomised-trial
#8
Subodh Verma, C David Mazer, David Fitchett, Silvio E Inzucchi, Egon Pfarr, Jyothis T George, Bernard Zinman
AIMS/HYPOTHESIS: After coronary artery bypass graft (CABG) surgery in individuals with type 2 diabetes, there remains a considerable residual cardiovascular risk. In the EMPA-REG OUTCOME® trial in participants with type 2 diabetes and established cardiovascular disease, empagliflozin reduced the risk of cardiovascular death by 38%, all-cause mortality by 32%, hospitalisation for heart failure by 35% and incident or worsening nephropathy by 39% vs placebo when given in addition to standard of care...
May 19, 2018: Diabetologia
https://www.readbyqxmd.com/read/29775430/gene-expression-profile-analysis-of-aortic-vascular-smooth-muscle-cells-reveals-upregulation-of-cadherin-genes-in-myocardial-infarction-patients
#9
Anselm A Derda, Chin Cheng Woo, Thidathip Wongsurawat, Mark Richards, Chuen Neng Lee, Theo Kofidis, Vladimir A Kuznetsov, Vitaly A Sorokin
Myocardial infarction (MI) induced by acute coronary arterial occlusion is usually secondary to atherosclerotic plaque rupture. Dysregulated response of vascular smooth muscle cells (VSMCs) in atherosclerotic plaques may promote plaque rupture. Cadherins (CDHs) form adherens junctions and are known stabilizers of atherosclerotic plaques. To date, the expression patterns of cadherin have not been well investigated in MI aortic VSMCs. We aimed to investigate the expression of cadherin genes in the aortic wall of patients with and without MI...
May 18, 2018: Physiological Genomics
https://www.readbyqxmd.com/read/29773466/in-vivo-morphologic-comparison-of-saphenous-vein-grafts-and-native-coronary-arteries-following-non-st-elevation-myocardial-infarction
#10
Tom Hsun-Wei Huang, Kalpa De Silva, Usaid K Allahwala, Edward J Danson, Pasi K Karjalainen, Olli A Kajander, Ravinay Bhindi
OBJECTIVE: This study aimed to assess the pathophysiological differences between saphenous vein grafts (SVG) and native coronary arteries (NCA) following presentation with non-ST elevated myocardial infarction (NSTEMI). BACKGROUND: There is accelerated pathogenesis of de novo coronary disease in harvested SVG following coronary artery bypass (CABG) surgery, which contributes to both early and late graft failure, and is also causal in adverse outcomes following vein graft PCI...
April 16, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29771744/sleep-quality-during-and-after-cardiothoracic-intensive-care-and-psychological-health-during-recovery
#11
Nittaya Caruana, Sharon McKinley, Rosalind Elliott, Leila Gholizadeh
BACKGROUND: Intensive care patients experience poor sleep quality. Psychological distress and diminished health-related quality of life (HRQOL) are also common among former intensive care unit (ICU) patients. Coronary artery bypass graft (CABG) surgery is a frequent reason adults require treatment in ICU. The effect of on- versus off-pump surgery on sleep and recovery has not been reported. OBJECTIVE: The aim of this study was to assess sleep quality of CABG patients during and after ICU, psychological well-being, HRQOL during recovery, and whether on- versus off-pump surgery affects sleep and recovery...
May 16, 2018: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29771724/early-impact-of-medicare-accountable-care-organizations-on-inpatient-surgical-spending
#12
Hari Nathan, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To evaluate whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. BACKGROUND: ACOs have proliferated rapidly and now cover more than 32 million Americans. Medicare Shared Savings Program (MSSP) ACOs have shown modest success in reducing medical spending. Whether they have reduced surgical spending remains unknown. METHODS: We used 100% Medicare claims from 2010 to 2014 for patients aged 65 to 99 years undergoing 6 common elective surgical procedures [abdominal aortic aneurysm (AAA) repair, colectomy, coronary artery bypass grafting (CABG), hip or knee replacement, or lung resection]...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29762925/association-between-myxomatous-mitral-valve-disease-and-skeletal-back-abnormalities
#13
Alireza Movahed, David Majdalany, Marc Gillinov, William Schiavone
BACKGROUND: Myxomatous mitral valve disease (MMVD) is one of the most prevalent valvular heart diseases, while back pain, neck pain and upper-extremity numbness are some of the most common complaints in outpatient settings. Decreased thoracic kyphosis (straight back) is a known cause of hastening back or neck problems, radiculopathy, or even myelopathy. The study aim was to examine the relationship between MMVD, straight back, and the need for cervical fusion. METHODS: In this single-center retrospective study, patients who underwent mitral valve repair or replacement due to MMVD (cases) based on age, gender and body mass index (BMI), were matched with patients who underwent coronary artery bypass grafting (CABG) surgery and had no history of mitral valve disease (controls)...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#14
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29761259/-sense-of-coherence-scale-according-to-antonovsky-as-a-possible-predictor-for-return-to-work-for-cardiac-surgery-intensive-care-patients
#15
C Benstoem, R Wübker, M Lüngen, T Breuer, G Marx, R Autschbach, A Goetzenich, H Schnoering
BACKGROUND: For cardiac surgery patients who were employed prior to surgery, the return to their professional life is of special importance. In addition to medical reasons, such as pre-existing conditions, the success of the operation or postoperative course and patient-intrinsic reasons, which can be assessed with the Sense of Coherence (SOC) scale by Antonovsky, may also play a role in the question of a possible return into working life. METHODS: In this study 278 patients (invasive coronary artery bypass graft surgery and/or surgery on heart valves, age < 60 years, employed) were questioned postoperatively via post with the SOC questionnaire...
May 14, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29759735/preoperative-serum-st2-level-predicts-acute-kidney-injury-after-adult-cardiac-surgery
#16
Kevin W Lobdell, Devin M Parker, Donald S Likosky, Michael Rezaee, Moritz Wyler von Ballmoos, Shama S Alam, Sherry Owens, Heather Thiessen-Philbrook, Todd MacKenzie, Jeremiah R Brown
OBJECTIVE: The purpose of this study was to evaluate the relationship between preoperative levels of serum soluble ST2 (ST2) and acute kidney injury (AKI) after cardiac surgery. Previous research has shown that biomarkers facilitate the prediction of AKI and other complications after cardiac surgery. METHODS: Preoperative ST2 proteins were measured in 1498 patients undergoing isolated coronary artery bypass graft surgery at 8 hospitals participating in the Northern New England Biomarker Study from 2004 to 2007...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29758209/bilateral-internal-mammary-artery-utilization-in-diabetics-friend-or-foe
#17
Todd C Crawford, Xun Zhou, Charles D Fraser, J Trent Magruder, Alejandro Suarez-Pierre, Diane Alejo, Jennifer Bobbitt, Clifford E Fonner, Kurt Wehberg, Brad Taylor, Christopher Kwon, Michael Fiocco, John V Conte, Rawn Salenger, Glenn J Whitman
BACKGROUND: Bilateral internal mammary artery (BIMA) grafting in diabetic patients undergoing coronary artery bypass grafting (CABG) remains controversial. Our study compared morbidity and mortality between 1)diabetic and non-diabetic BIMA patients and 2)diabetic BIMA versus diabetic patients who underwent left internal mammary artery (LIMA) grafting only. METHODS: Patients who underwent isolated CABG from July 2011 - June 2016 at any of the 10 centers in Maryland were propensity scored across 16 variables...
May 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29756691/cerebrovascular-autoregulation-impairments-during-cardiac-surgery-with-cardiopulmonary-bypass-are-related-to-postoperative-cognitive-deterioration-prospective-observational-study
#18
Birute Kumpaitiene, Milda Svagzdiene, Edmundas Sirvinskas, Virginija Adomaitiene, Vytautas Petkus, Rolandas Zakelis, Solventa Krakauskaite, Romanas Chomskis, Arminas Ragauskas, Teodoro F Dagi, Rimantas Benetis
BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs in approximately 33-83% of patients after cardiac surgery with cardiopulmonary bypass (CPB). Recent clinical data suggest that real-time, intraoperative monitoring of patient- specific cerebrovascular autoregulation (CA) may help to prevent POCD by detecting individual critical limits for mean arterial pressure (MAP) outside which CA is impaired. Objectives of the study were to detect the episodes of impaired CA during cardiac surgery with CPB, and to investigate the association between CA impairment and POCD...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29754790/aortic-clamping-strategy-and-postoperative-stroke
#19
Mohamad Alaeddine, Vinay Badhwar, Maria V Grau-Sepulveda, Lawrence M Wei, Chris C Cook, Michael E Halkos, Vinod H Thourani, Jeffrey P Jacobs, Roland Matsouaka, James Meza, Matthew Brennan, Thomas G Gleason, Danny Chu
OBJECTIVE: The effect of aortic clamping strategy on short-term stroke during proximal graft construction for coronary artery bypass grafting (CABG) remains undefined. The aim of this study was to test the hypothesis that partial occluding clamp (POC) technique does not increase incidence of postoperative stroke compared with single clamp (SC) technique for performing proximal coronary anastomoses. METHODS: We identified 52,611 patients who underwent on-pump CABG in the Society of Thoracic Surgeons Adult Cardiac Surgery Database from July 1, 2014 to March 31, 2015...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29754654/dual-antiplatelet-therapy-for-perioperative-myocardial-infarction-following-cabg-surgery
#20
Alice Wang, Angie Wu, Daniel Wojdyla, Renato D Lopes, L Kristin Newby, Mark F Newman, Peter K Smith, John H Alexander
OBJECTIVES: Perioperative myocardial infarction (MI) after coronary artery bypass graft surgery (CABG) has been associated with adverse outcome. Whether perioperative MI should be treated with dual antiplatelet therapy (DAPT) is unknown. We compared the effect of DAPT versus aspirin alone on short-term outcomes among patients with perioperative MI following CABG. METHODS: We used data from 3 clinical trials that enrolled patients undergoing isolated CABG: PREVENT IV (2002-2003), MEND-CABG II (2004-2005), and RED-CABG (2009-2010) (n = 9117)...
May 2018: American Heart Journal
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