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Coronary Artery Bypass Grafts

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https://www.readbyqxmd.com/read/28718100/risk-factors-for-delirium-after-cardiac-surgery-a-historical-cohort-study-outlining-the-influence-of-cardiopulmonary-bypass
#1
Jason B O'Neal, Frederic T Billings, Xulei Liu, Matthew S Shotwell, Yafen Liang, Ashish S Shah, Jesse M Ehrenfeld, Jonathan P Wanderer, Andrew D Shaw
PURPOSE: Cardiopulmonary bypass (CPB) induces a significant inflammatory response that may increase the risk for delirium. We hypothesized that exposure to CPB during coronary artery bypass grafting (CABG) surgery would correlate with an increased risk of delirium. METHODS: We reviewed clinical data from two databases at our medical centre - the Cardiac Surgery Perioperative Outcomes Database and the Society of Thoracic Surgeons Database. Patients undergoing elective CABG surgery (on-pump and off-pump) from November 1, 2009 to September 30, 2015 were included in the study...
July 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28717115/coronary-artery-disease-and-type-2-diabetes-mellitus
#2
Ryo Naito, Katsumi Miyauchi
Type 2 diabetes mellitus (T2DM) is a major risk factor of coronary artery diseases (CAD). Clinical outcomes in CAD with T2DM are poor despite improvement in medications and intervention devices. Coronary artery bypass grafting (CABG) is superior to percutaneous coronary intervention (PCI) in treating diabetic patients with multivessel coronary artery diseases (MVD). However, selecting a revascularization strategy should depend not only on the lesion complexity but also on the patient's background and comorbidities...
July 14, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#3
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
July 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28716335/management-of-chronic-total-coronary-occlusion-in-stable-ischemic-heart-disease-by-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-versus-medical-therapy
#4
Mony Shuvy, Feng Qiu, Alyssandra Chee-A-Tow, John J Graham, Wael Abuzeid, Christopher Buller, Bradley H Strauss, Harindra C Wijeysundera
Coronary chronic total occlusions (CTOs) are found in approximately 20% of angiograms. We sought to assess the variation in the management of patients with CTOs and to compare the clinical outcomes of CTO lesions with those of non-CTO lesions. We conducted a population-based cohort study and included all patients with stable angina who underwent cardiac catheterization from October 1, 2012, to June 30, 2013, in Ontario, Canada. The primary outcome was a composite of mortality and hospitalization for myocardial infarction...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28715503/effects-of-preoperative-aspirin-on-perioperative-platelet-activation-and-dysfunction-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-surgery-a-prospective-randomized-study
#5
Jiwon Lee, Chul-Woo Jung, Yunseok Jeon, Tae Kyong Kim, Youn Joung Cho, Chang-Hoon Koo, Yoon Hyeong Choi, Ki-Bong Kim, Ho Young Hwang, Hang-Rae Kim, Ji-Young Park
The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during OPCAB due to preoperative aspirin use, we conducted a randomized controlled trial using flow cytometry and the Multiplate® analyzer. Forty-eight patients scheduled for elective OPCAB were randomized to the aspirin continuation (100 mg/day until operative day) and discontinuation (4 days before the operative day) groups...
2017: PloS One
https://www.readbyqxmd.com/read/28714229/implementing-a-protocol-to-optimize-blood-use-in-a-cardiac-surgery-service-results-of-a-pre-post-analysis-and-the-impact-of-high-volume-blood-users
#6
Juan B Grau, Jacqueline H Fortier, Cyrus Kuschner, Giovanni Ferrari, Mariano E Brizzio, Alex Zapolanski, Richard E Shaw
BACKGROUND: Blood transfusions are a common and costly intervention for cardiac surgery patients. Evidence suggests that a more restrictive transfusion strategy may reduce costs and transfusion-related complications without increasing perioperative morbidity and mortality. STUDY DESIGN AND METHODS: A transfusion-limiting protocol was developed and implemented in a cardiovascular surgery unit. Over a 5-year period, data were collected on patient characteristics, procedures, utilization of blood products, morbidity, and mortality, and these were compared before and after the protocol was implemented...
July 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28712580/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#7
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
BACKGROUND: The del Nido cardioplegia (DC) procedure offers prolonged cardiac protection with single-dose administration and has proven safe in adult coronary artery bypass grafting (CABG) surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: Between August 2011 and May 2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n = 101) or DC (n = 77)...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28712068/qualitative-angiographic-and-quantitative-myocardial-perfusion-assessment-using-fluorescent-cardiac-imaging-during-graded-coronary-artery-bypass-stenosis
#8
Christian Detter, Detlef Russ, Jan Felix Kersten, Hermann Reichenspurner, Sabine Wipper
Intraoperative graft assessment in coronary artery bypass (CAB) grafting is important to avoid early graft failure. This study aimed to evaluate the accuracy of fluorescent cardiac imaging (FCI) for intraoperative qualitative angiographic and quantitative myocardial perfusion assessment during graded CAB stenosis compared to coronary angiography (CA). After CAB grafting to the left anterior descending coronary artery, graded distal bypass stenoses were created in ten pigs by 25, 50, 75, and 100% flow reduction assessed by transit-time flow measurement (TTFM)...
July 15, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28711325/improving-coronary-artery-bypass-grafting-readmission-outcomes-from-2000-to-2012-in-the-medicare-population
#9
Christian McNeely, Kathleen Kwedar, Stephen Markwell, Christina M Vassileva
OBJECTIVE: The study objective was to examine trends in 30-day readmission after coronary artery bypass grafting in the Medicare population over 13 years. METHODS: The study included isolated coronary artery bypass grafting procedures in the Medicare population from January 2000 to November 2012. Comorbidities and causes of readmission were determined using Internal Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes. RESULTS: The cohort included 1,116,991 patients...
June 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28709667/routine-use-of-topical-bacitracin-to-prevent-sternal-wound-infections-after-cardiac-surgery
#10
Joshua L Chan, Andrada C Diaconescu, Keith A Horvath
BACKGROUND: The development of sternal wound infections remains a serious complication after cardiac surgery. A number of studies have assessed the use of topical antibiotics placed on the sternal edges. We evaluated the routine use of bacitracin ointment applied over the sternotomy skin incision as a prophylactic measure against sternal wound infections. METHODS: A retrospective review of all coronary artery bypass graft and valve surgery cases performed at a single institution between 2006 and 2015 was performed (n = 1,495)...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28707171/optimal-use-of-arterial-grafts-during-current-coronary-artery-bypass-surgery
#11
REVIEW
Suzuki Tomoaki
Multiple arterial grafting, including the use of the bilateral internal thoracic arteries (ITAs), has strong benefits on patient clinical outcomes after coronary artery bypass grafting (CABG) but is far from commonly accepted at present. We reviewed the previous randomized and leading observational studies and assembled an up-to-date profile on multiple arterial grafting. Many of the previous trials successfully showed the beneficial effects of arterial grafting after CABG. Although many of these were retrospective studies, the data presented, mostly from world-famous surgeons, show that multiple arterial grafting does have advantages with regard to the long-term patient outcome without increasing rates of early mortality or morbidity...
July 13, 2017: Surgery Today
https://www.readbyqxmd.com/read/28705052/antioxidative-mechanism-in-the-course-of-varicose-veins
#12
Anna Horecka, Jadwiga Biernacka, Anna Hordyjewska, Wojciech Dąbrowski, Piotr Terlecki, Tomasz Zubilewicz, Irena Musik, Jacek Kurzepa
Objective Our objective was to evaluate the state of oxidative stress in the great saphenous varicose vein wall and blood of varicose vein patients taken from the antecubital vein. Methods The superoxide dismutase, reduced glutathione (GSH) and total antioxidant status were measured with commercially available colorimetric kits in erythrocytes, plasma and varicose vein wall of 65 patients (second degree of clinical state classification, etiology, anatomy and pathophysiology) aged 22-70 (49 women, 16 men) in comparison to normal great saphenous vein walls collected from 10 patients who underwent coronary artery bypass graft and blood collected from 20 healthy individuals...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28701603/is-endothelin-gene-polymorphism-associated-with-postoperative-atrial-fibrillation-in-patients-undergoing-coronary-artery-bypass-grafting
#13
Ira Dhawan, Minati Choudhury, Milind P Hote, Anushree Gupta, Poonam Malhotra, Kalaivani V Mani
BACKGROUND: The mechanism of development of atrial fibrillation (AF) in patients undergoing coronary artery bypass grafting (CABG) has not been clearly defined, and the involvement of multiple factors such as advanced age, withdrawal of β-blockers, inadequate atrial protection, and electrolyte imbalance, particularly hypomagnesemia has been documented by several authors. Despite all the available pharmacologic prophylaxis, incidence of AF still remains high in this group of patients...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28701599/interesting-images-multiple-coronary-artery-aneurysms
#14
Jonathon M Howard, Omar Viswanath, Alfredo Armas, Orlando Santana, Gerald P Rosen
We present the case of a 65-year-old male who presented with stable angina and dyspnea on exertion. His initial workup yielded a positive treadmill stress test for reversible apical ischemia, and transthoracic echocardiogram demonstrated impaired systolic function. Cardiac catheterization was then performed, revealing severe atherosclerotic disease including multiple coronary artery aneurysms. As a result, the patient was advised to and subsequently underwent a coronary artery bypass graft. This case highlights the presence of multiple coronary artery aneurysms and the ability to appreciate these pathologic findings on multiple imaging modalities, including coronary angiogram, transesophageal echocardiography, and direct visualization through the surgical field...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28701594/coronary-artery-bypass-graft-patients-perception-about-the-risk-factors-of-illness-educational-necessities-of-second-prevention
#15
Ali Soroush, Saeid Komasi, Mozhgan Saeidi, Behzad Heydarpour, Danilo Carrozzino, Mario Fulcheri, Paolo Marchettini, Massimo Rabboni, Angelo Compare
BACKGROUND: Patients' beliefs about the cause of cardiac disease (perceived risk factors) as part of the global psychological presentation are influenced by patients' health knowledge. Hence, the present study aimed to assess the relationship between actual and perceived risk factors, identification of underestimated risk factors, and indication of underestimation of every risk factor. MATERIALS AND METHODS: In this cross-sectional study, data of 313 coronary artery bypass graft (CABG) patients admitted to one hospital in the west of Iran were collected through a demographic interview, actual risk factors' checklist, open single item of perceived risk factors, and a life stressful events scale...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28701593/neutrophil-gelatinase-associated-lipocalin-as-a-biomarker-for-predicting-acute-kidney-injury-during-off-pump-coronary-artery-bypass-grafting
#16
Muralidhar Kanchi, R Manjunath, Jos Massen, Lloyd Vincent, Kumar Belani
BACKGROUND: Acute kidney injury (AKI) following cardiac surgery is a major complication resulting in increased morbidity, mortality, and economic burden. In this study, we assessed the usefulness of estimating serum neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker in predicting AKI in patients with stable chronic kidney disease (CKD) and undergoing off-pump coronary artery bypass grafting (OP-CABG). PATIENTS AND METHODS: We prospectively studied sixty nondialysis-dependent CKD patients with estimated glomerular filtration rate <60 ml/min/1...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28701487/differential-event-rates-and-independent-predictors-of-long-term-major-cardiovascular-events-and-death-in-5795-patients-with-unprotected-left-main-coronary-artery-disease-treated-with-stents-bypass-surgery-or-medication-insights-from-a-large-international-multicenter
#17
Se Hun Kang, Jung-Min Ahn, Cheol Hyun Lee, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Identifying predictive factors for major cardiovascular events and death in patients with unprotected left main coronary artery disease is of great clinical value for risk stratification and possible guidance for tailored preventive strategies. METHODS AND RESULTS: The Interventional Research Incorporation Society-Left MAIN Revascularization registry included 5795 patients with unprotected left main coronary artery disease (percutaneous coronary intervention, n=2850; coronary-artery bypass grafting, n=2337; medication alone, n=608)...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28698412/-cardiac-rehabilitation-in-minimally-invasive-cardiac-surgery-coronary-artery-bypass-grafting
#18
Yo Takahashi, Akihiko Yamauchi, Masaki Tabuchi, Daisuke Toritsuka, Osamu Arasaki, Masahiro Tamashiro, Masanori Kakazu, Katsuaki Iju, Mitsuru Kume, Shogo Sakihama, Yuta Matayoshi
OBJECTIVES: A purpose is to compare the in-hospital rehabilitation progress after minimally invasive cardiac surgery coronary artery bypass grafting (MICS CABG) with that after off pump coronary artery bypass grafting( OPCAB). METHODS: We analyzed 60 patients who underwent coronary artery bypass grafting surgery from January 2015 to December 2016. Fourteen patients underwent MICS CABG (MICS CABG group) and 46 patients underwent OPCAB (OPCAB group). The post-operative days to start standing position and independent walking, and hospitalization duration were analyzed between the 2 groups...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28698347/carbon-dioxide-surgical-field-flooding-and-aortic-no-touch-off-pump-coronary-artery-bypass-grafting-to-reduce-neurological-injuries-after-surgical-coronary-revascularisation-canon-protocol-for-a-randomised-controlled-investigator-and-patient-blinded-single
#19
Szwed Krzysztof, Pawliszak Wojciech, Serafin Zbigniew, Kowalewski Mariusz, Tomczyk Remigiusz, Perlinski Damian, Szwed Magdalena, Tomaszewska Marta, Anisimowicz Lech, Borkowska Alina
INTRODUCTION: Neurological injuries remain a major concern following coronary artery bypass grafting (CABG) that offsets survival benefit of CABG over percutaneous coronary interventions. Among numerous efforts to combat this issue is the development of off-pump CABG (OPCABG) that obviates the need for extracorporeal circulation and is associated with improved neurological outcomes. The objective of this study is to examine whether the neuroprotective effect of OPCABG can be further pronounced by the use of two state-of-the-art operating techniques...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697940/characterization-of-perioperative-contralateral-stroke-after-carotid-endarterectomy
#20
W Darrin Clouse, Emel A Ergul, Virendra I Patel, R Todd Lancaster, Glenn M LaMuraglia, Richard P Cambria, Mark F Conrad
OBJECTIVE: Contralateral stroke is an infrequent cause of perioperative stroke after carotid endarterectomy (CEA). Whereas the risks of ipsilateral stroke complicating CEA have been discriminated, factors that lead to contralateral stroke are poorly defined. The purpose of this study was to identify the risk of perioperative (30-day) contralateral stroke after CEA as well as predisposing preoperative and operative factors. Its specific effect on long-term survival was interrogated. METHODS: The Vascular Study Group of New England (VSGNE) was queried from April 1, 2003, to February 29, 2016, for all CEAs...
July 8, 2017: Journal of Vascular Surgery
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