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Coronary Artery Bypass Grafts

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https://www.readbyqxmd.com/read/29242743/open-repair-management-of-a-patient-with-aortic-arch-saccular-aneurysm-penetrating-atherosclerotic-ulcer-one-vessel-coronary-artery-disease-and-an-isolated-dissection-of-the-abdominal-aorta
#1
Harvey Romolo, Dicky A Wartono, Sugisman Suyuti, Bagus Herlambang, Michael Caesario, Ismoyo Sunu
Isolated saccular compared to fusiform aneurysm is considered to be a rare entity with challenges of its own. A 62-year-old female was diagnosed with a case of saccular aneurysm and penetrating atherosclerotic ulcer of the aortic arch. Additionally, she also had one vessel coronary artery disease and type B abdominal aortic dissection. She was then managed with open aortic arch repair and coronary artery bypass grafting. If required, elective endovascular repair will be done for the abdominal aorta on a later date...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29242351/second-arterial-versus-venous-conduits-for-multi-vessel-coronary-artery-bypass-surgery-in-california
#2
Andrew B Goldstone, Peter Chiu, Michael Baiocchi, Hanjay Wang, Bharathi Lingala, Jack H Boyd, Y Joseph Woo
Background -Whether a second arterial conduit improves outcomes after multi-vessel coronary artery bypass grafting remains unclear. Consequently, arterial conduits other than the left internal thoracic artery are seldom used in the United States. Methods -Using a state-maintained clinical registry including all 126 non-federal hospitals in California, we compared all-cause mortality and rates of stroke, myocardial infarction, repeat revascularization, and sternal wound infection between propensity score-matched cohorts who underwent primary, isolated multi-vessel coronary artery bypass grafting with the left internal thoracic artery, and who received a second arterial conduit (right internal thoracic artery or radial artery, N=5,866) or a venous conduit (N=53,566) between 2006 and 2011...
December 14, 2017: Circulation
https://www.readbyqxmd.com/read/29242010/heart-rate-variability-analysis-in-patients-who-have-bradycardia-presenting-to-the-emergency-department-with-chest-pain
#3
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Heart rate variability (HRV) is a noninvasive method to measure the function of the autonomic nervous system. It has been used to risk stratify patients with undifferentiated chest pain in the emergency department (ED). However, bradycardia can have a modifying effect on HRV. OBJECTIVE: In this study, we aimed to determine how bradycardia affected HRV analysis in patients who presented with chest pain to the ED. METHODS: Adult patients presenting to the ED at Singapore General Hospital with chest pain were included in the study...
December 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29241487/surgical-versus-percutaneous-coronary-revascularization-in-patients-with-diabetes-and-acute%C3%A2-coronary-syndromes
#4
Krishnan Ramanathan, James G Abel, Julie E Park, Anthony Fung, Verghese Mathew, Carolyn M Taylor, G B John Mancini, Min Gao, Lillian Ding, Subodh Verma, Karin H Humphries, Michael E Farkouh
BACKGROUND: Randomized trial data support the superiority of coronary artery bypass grafting (CABG) surgery over percutaneous coronary intervention (PCI) in diabetic patients with multivessel coronary artery disease (MV-CAD). However, whether this benefit is seen in a real-world population among subjects with stable ischemic heart disease (SIHD) and acute coronary syndromes (ACS) is unknown. OBJECTIVES: The main objective of this study was to assess the generalizability of the FREEDOM (Future REvascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial in real-world practice among patients with diabetes mellitus and MV-CAD in residents of British Columbia, Canada...
December 19, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29240736/management-of-coronary-artery-disease-in-patients-on-dialysis
#5
Helen Pilmore, Mark Webster, Karishma Sidhu, Gajan Srikumar
AIMS: Coronary artery disease is common in patients with end-stage renal failure (ESRF). However, there is little evidence that revascularisation improves outcomes, compared with medical management. This study assessed survival and cardiovascular outcomes in patients with ESRF undergoing coronary angiography and then having coronary artery bypass graft (CABG) surgery, percutaneous coronary intervention (PCI) or medical management. METHODS: Survival and major adverse cardiac events (MACE) were examined in all patients with ESRF who underwent coronary angiography at Auckland City Hospital between 2003 and 2012...
December 15, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29240627/extracorporeal-membrane-oxygenation-bridges-inoperable-patients-to-definitive-cardiac-operation
#6
Nikola Dobrilovic, Omar Lateef, Lauren Michalak, Maja Delibasic, Jaishankar Raman
Extracorporeal membrane oxygenation (ECMO) offers an opportunity for patient recovery through complete cardiopulmonary support but is associated with complications that limit duration and overall utility. We examine the role of ECMO as a potential bridge to high-risk cardiac surgery in otherwise inoperable cases. This study reports a retrospective, multi-institution experience examining all patients for whom ECMO was used preoperatively as a bridge to definitive cardiac surgery without exception. A consecutive patient database (December 2011 through August 2017) was utilized...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29240056/-hybrid-intervention-for-a-multilevel-aneurysmatic-lesion-of-the-aorta-in-a-patient-with-multifocal-atherosclerosis
#7
K V Kochkina, A V Sidorenko, A V Myznikov, G A Usik, A A Shtark, T A Kochkina, A V Pustovoĭtov, A V Protopopov
A multilevel aneurysmatic lesion of the aorta is a rare pathology. The authors describe herein a clinical case report regarding stage-wise treatment of a patient presenting with aneurysms of the thoracic and abdominal portions of the aorta and a haemodynamically significant lesion of coronary and carotid arteries. Strategy of surgical management was decided upon collegially. Successful endoprosthetic repair of the aneurysm of the thoracic portion of the aorta required closure of the left carotid artery with a graft, which, taking into consideration an existing occlusion of the right internal carotid artery, demanded preliminary carotid-subclavian bypass grafting...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29239459/ischemic-left-ventricle-systolic-dysfunction-an-evidence-based-approach-in-diagnostic-tools-and-therapeutics
#8
Eduardo Gomes Lima, Felipe Pereira Câmara de Carvalho, Jaime Paula Pessoa Linhares Filho, Fabio Grunspun Pitta, Carlos Vicente Serrano
Coronary artery disease (CAD) associated with left ventricular systolic dysfunction is a condition related to poor prognosis. There is a lack of robust evidence in many aspects related to this condition, from definition to treatment. Ischemic cardiomyopathy is a spectrum ranging from stunned myocardium associated with myocardial fibrosis to hibernating myocardium and repetitive episodes of ischemia. In clinical practice, relevance lies in identifying the myocardium that has the ability to recover its contractile reserve after revascularization...
September 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29237922/outcomes-of-coronary-artery-bypass-graft-surgery-versus-percutaneous-coronary-intervention-in-patients-aged-18-45-years-with-diabetes-mellitus
#9
Yang Li, Ran Dong, Kun Hua, Tao-Shuai Liu, Shao-You Zhou, Ning Zhou, Hong-Jia Zhang
BACKGROUND: Debate on treatment for young patients with coronary artery disease still exists. This study aimed to investigate the intermediate- and long-term outcomes between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients aged 18-45 years with diabetes mellitus (DM). METHODS: Between January 2006 and March 2016, a total of 2018 DM patients aged 18-45 years including 517 cases of CABG and 1501 cases of PCI were enrolled in the study...
December 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29237042/dual-antiplatelet-therapy-after-coronary-artery-bypass-surgery-is-there-an-increase-in-bleeding-risk-a-meta-analysis
#10
Yejing Zhao, Hongyu Peng, Xiaonan Li, Yujun Qin, Fangying Cao, Ding Peng, Jinghua Liu
OBJECTIVES: There is increasing evidence that dual antiplatelet therapy (DAPT) when compared with single antiplatelet therapy may improve venous graft patency after coronary artery bypass graft. However, it is not yet known whether postoperative administration of DAPT may increase the potential risk of bleeding, especially in the early postoperative period. METHODS: We searched studies on PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials...
December 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29235056/separating-arterial-pressure-increases-and-decreases-in-assessing-cardiac-baroreflex-sensitivity-via-sequence-and-bivariate-phase-rectified-signal-averaging-techniques
#11
Beatrice De Maria, Vlasta Bari, Marco Ranucci, Valeria Pistuddi, Giovanni Ranuzzi, Anielle C M Takahashi, Aparecida M Catai, Laura Dalla Vecchia, Sergio Cerutti, Alberto Porta
Cardiac baroreflex (cBR) is activated by both arterial pressure (AP) increases and decreases. Sequence method, a widely utilized tool assessing cBR sensitivity (cBRS) from spontaneous heart period (HP) and systolic AP (SAP) variations, allows the separated computation of cBRS from positive and negative SAP variations. The recently proposed phase-rectified signal averaging (PRSA) method has the same feature but it has been applied so far solely to positive SAP variations. We adapted the PRSA method to compute cBRS over negative SAP variations and we compared the results with those derived from sequence method over two protocols: (i) graded head-up tilt (HUT) at 15, 30, 45, 60, and 75° in 19 healthy subjects and (ii) general anesthesia induction in 118 patients undergoing coronary artery bypass graft surgery...
December 13, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29234615/sterile-necrosis-of-the-sternum-a-rare-complication-following-coronary-artery-bypass-surgery
#12
Emmanouel Papadakis, Maria Kalliopi Konstantinidou, Meletios A Kanakis
We herein present the unique case of a 68-year-old male diabetic patient who developed sterile necrosis of the sternum 1 month after myocardial revascularization with the use of bilateral internal thoracic artery grafts. The sternum had been closed by the bilateral Robicsek wiring technique. The sternum was removed, and bilateral pectoralis major flaps were used to cover the defect. The patient had an uneventful recovery.
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29233155/a-meta-model-for-computer-executable-dynamic-clinical-safety-checklists
#13
Shan Nan, Pieter Van Gorp, Xudong Lu, Uzay Kaymak, Hendrikus Korsten, Richard Vdovjak, Huilong Duan
BACKGROUND: Safety checklist is a type of cognitive tool enforcing short term memory of medical workers with the purpose of reducing medical errors caused by overlook and ignorance. To facilitate the daily use of safety checklists, computerized systems embedded in the clinical workflow and adapted to patient-context are increasingly developed. However, the current hard-coded approach of implementing checklists in these systems increase the cognitive efforts of clinical experts and coding efforts for informaticists...
December 12, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29232299/the-axillary-intra-aortic-balloon-pump-as-a-bridge-to-recovery-allows-early-ambulation-in-long-term-use-case-series-and-literature-review
#14
Nnamdi Nwaejike, Andre Y Son, Chetan B Patel, Jacob N Schroder, Carmelo A Milano, Mani A Daneshmand
We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29231752/differences-between-slovak-and-dutch-patients-scheduled-for-coronary-artery-bypass-graft-surgery-regarding-clinical-and-psychosocial-predictors-of-physical-and-mental-health-related-quality-of-life
#15
Noha El-Baz, Daniela Ondusova, Martin Studencan, Jaroslav Rosenberger, Sijmen A Reijneveld, Jitse P van Dijk, Berrie Middel
BACKGROUND: Differences in health-related quality of life in coronary artery disease patients and associated factors between patients of central and western European descent are rarely investigated. We aim to test differences between Dutch and Slovak health-related quality of life, whether nationality predicted health-related quality of life and if standardised beta weights of health-related quality of life determinants differ across countries. DESIGN: An observational multicentre study at university cardiac centres in the Netherlands and Slovakia...
December 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29230573/incidence-of-perioperative-stroke-in-clampless-aortic-anastomosis-during-off-pump-coronary-artery-bypass-grafting
#16
Francesco Formica, Giuseppe Tata, Gurmeet Singh, Serena Mariani, Stefano D'Alessandro, Luigi Amerigo Messina, Fabio Sangalli, Giovanni Paolini
This study aimed to assess if clampless off-pump coronary artery bypass grafting (OPCAB) decreases the incidence of perioperative stroke (POS) rate and in-hospital mortality. The secondary aim was to evaluate 12-year rates of overall mortality. Between January 2003 to December 2015, data of 645 consecutive patients undergoing isolated CABG were retrospectively collected. 363 underwent aortic no-touch OPCAB (No-touch group) and 282 underwent OPCAB with the Heartstring device (HS group). In-hospital mortality and perioperative stroke rate as primary endpoint, as well as long-term follow-up outcome were analysed...
December 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29230572/responsiveness-of-internal-thoracic-arteries-to-nitroglycerin-in-patients-with-renal-failure
#17
Masashi Tawa, Takeshi Kinoshita, Tohru Asai, Tomoaki Suzuki, Takaharu Ishibashi, Tomio Okamura
Nitroglycerin is commonly used as an antispasmodic for treating spasm of coronary artery bypass grafts. This study investigated whether the presence of renal failure affects reactivity to nitroglycerin in internal thoracic arteries obtained from patients undergoing coronary bypass surgery. The patients were divided into three groups according to estimated glomerular filtration rate (eGFR, mL/min/1.73 m2): without renal failure (60 ≤ eGFR, n = 13), with moderate renal failure (30 ≤ eGFR < 60, n = 10), and with severe renal failure (eGFR < 30, n = 10)...
December 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29229263/the-hemodynamic-effects-of-different-pacing-modalities-after-cardiopulmonary-bypass-in-patients-with-reduced-left-ventricular-function
#18
R C W Gielgens, I H F Herold, A H M van Straten, B M van Gelder, F A Bracke, H H M Korsten, M A Soliman Hamad, R A Bouwman
OBJECTIVES: Patients with decreased left ventricular function undergoing cardiac surgery have a greater chance of difficult weaning from cardiopulmonary bypass and a poorer clinical outcome. Directly after weaning, interventricular dyssynchrony, paradoxical septal motion, and even temporary bundle-branch block might be observed. In this study, the authors measured arterial dP/dtmax, mean arterial pressure (MAP), and cardiac index using transpulmonary thermodilution, pulse contour analysis, and femoral artery catheter and compared the effects between right ventricular (A-RV) and biventricular (A-BiV) pacing on these parameters...
July 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29228313/transfusion-of-red-blood-cells-in-coronary-surgery-is-there-an-effect-on-long-term-mortality-when-adjusting-for-risk-factors-and-postoperative-complications
#19
Long Tran, Guri Greiff, Hilde Pleym, Alexander Wahba, Roar Stenseth, Vibeke Videm
OBJECTIVES: The aim of this study was to compare long-term mortality in patients undergoing primary isolated coronary artery bypass grafting who received ≥1 units of red blood cells (RBCs) or no RBCs. We hypothesized that a possible difference in long-term mortality was due to preoperative morbidity and/or postoperative morbidity. METHODS: This prospective cohort study, part of the Cardiac Surgery Outcome Study (CaSOS) at St. Olavs University Hospital, Trondheim, Norway, included patients operated on from 2000 through 2014 (n = 4014) and excluded those with large intra- or postoperative blood loss or 30-day mortality...
December 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29228235/the-potential-role-of-external-venous-supports-in-coronary-artery-bypass-graft-surgery
#20
Jamie A Mawhinney, Craig A Mounsey, David P Taggart
Despite the apparent superiority of arterial conduits for coronary artery bypass grafting (CABG), the long saphenous vein remains the most commonly used graft. The high failure rate of long saphenous vein grafts (SVGs) over time is therefore an important limiting factor for the long-term outcomes of CABG. Various methods to improve SVG patency have been proposed, although few have had a significant impact on clinical practice. External SVG supports have been a focus of research over the past 50 years, with their use intended to minimize well-documented pathophysiological changes that occur in the SVG following implantation into the coronary circulation...
December 8, 2017: European Journal of Cardio-thoracic Surgery
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