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https://www.readbyqxmd.com/read/29774399/endothelial-dysfunction-following-coronary-artery-bypass-grafting-influence-of-patient-and-procedural-factors
#1
J Hadem, R Rossnick, B Hesse, M Herr, M Hansen, A Bergmann, G Kensah, C Maess, H Baraki, P Kümpers, A Lukasz, I Kutschka
BACKGROUND: Angiopoietin-2 (Angpt2) mediates endothelial dysfunction (ED) following coronary artery bypass grafting (CABG). Its triggers are, however, poorly understood. METHODS: We examined the time course of ED beyond the early phase of postoperative recovery in 75 patients following CABG with a special focus on different cardiopulmonary bypass (CPB) modes as potential triggers of Angpt2 release. RESULTS: Nine patients (12.0%) underwent off-pump coronary artery bypass (OPCAB), 31 patients (41...
May 17, 2018: Herz
https://www.readbyqxmd.com/read/29753665/off-pump-versus-on-pump-coronary-artery-bypass-grafting-a-systematic-review-and-analysis-of-clinical-outcomes
#2
REVIEW
Shahzad Shaefi, Aaron Mittel, Dan Loberman, Harish Ramakrishna
Surgical coronary artery bypass grafting (CABG) is the standard of care for revascularization of left main or three-vessel coronary artery disease. The off-pump coronary artery bypass graft (OPCAB) procedure avoids the use of cardiopulmonary bypass. Theoretically, OPCAB may improve long-term outcomes by reducing the rates of perioperative myocardial injury, stroke, neurocognitive impairment, and cardiac-related mortality. Several high-quality clinical trials have been conducted since OPCAB became popular in the 1990s and have demonstrated no benefit of OPCAB over traditional CABG with respect to these outcomes despite favorable short-term reductions in transfusion requirements and other postoperative complications...
April 4, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29707327/the-curative-effect-of-synthetic-treatment-for-refractory-acute-myocardial-infarction
#3
Jing Xie, Ding-Xiong Xie, Yi-Rong Gan, Jiong Li, Yan-Zhen Wang, Zong-Ke Kou, Rui Mao, Tian-Xiang Liang, Yun-Long Zhang
Background: This study aims to investigate the curative effect of synthetic treatment for refractory acute myocardial infarction (AMI). Methods: A total of 76 patients with coronary AMI accompanied by shock, who were treated with combined therapy from August 1999 to April 2017, were included into this study. Sixty patients received emergency percutaneous coronary intervention (PCI). Among these patients, 39 patients received intra-aortic balloon counterpulsation (IABP), eight patients had failed PCI underwent emergency off-pump coronary artery bypass (E-OPCAB), and eight patients were treated by hybrid cardiac surgery...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29701336/cabg-to-cbp-or-not-to-cbp-a-propensity-score-matched-survival
#4
Pedro Magro, Sérgio Boshoff, José Calquinha, Miguel Sousa Uva, José Neves
INTRODUCTION: Over the past 3 decades two main strategies have been employed for surgical coronary revascularization (CABG): on- pump CABG with cardioplegia (ONCAB) and off-pump CABG (OPCAB). The objective of this study is to evaluate the short-term and long-term survival of the two strategies. METHODS: This study consists of 8-year cohort, retrospective single-center analysis with an intention-to-treat design. 2954 patients underwent CABG (OPCAB n=2123; ONCAB= 831) for CAD...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29681566/off-pump-coronary-artery-bypass-grafting-with-mini-sternotomy-in-the-treatment-of-triple-vessel-coronary-artery-disease
#5
Pixiong Su, Song Gu, Yan Liu, Xitao Zhang, Jun Yan, Xiangguang An, Jie Gao, Yue Xin, Jian Zhou
We have developed off-pump coronary artery bypass approach with lower distal mini-sternotomy (TM-OPCAB) for multivessel coronary revascularization. The aim of this retrospective study is to provide evidence for the feasibility and safety of this technique in the treatment of triple-vessel diseases.Two hundred eighty-eight patients with triple-vessel coronary artery disease who underwent TM-OPCAB or standard off-pump coronary artery bypass surgery (S-OPCAB) were included in this study after propensity-score matching...
April 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29659846/is-administration-of-dual-antiplatelet-therapy-beneficial-for-patients-following-off-pump-coronary-artery-bypass-grafting
#6
Maciej Peksa, Sleiman Sebastian Aboul-Hassan, Jakub Marczak, Romuald Cichon
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether administration of dual-antiplatelet therapy (DAPT) following off-pump coronary artery bypass grafting (OPCAB) would improve postoperative clinical outcomes or minimize the incidence of postoperative graft failure. In total, 101 papers were found using the reported search, 14 of which represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
April 5, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#7
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#8
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29608874/meta-analysis-of-repeat-revascularization-of-off-pump-and-on-pump-coronary-artery-bypass-surgery
#9
Pengyu Zhou, Peng Zhu, Zezhou Xiao, Xuefeng Lin, Rongning Xu, Shaoyi Zheng
BACKGROUND: There is an ongoing debate focusing on clinical outcomes after off-pump coronary artery bypass grafting (OPCAB) and on-pump coronary artery bypass grafting (ONCAB). The objective of present meta-analysis is to update and compare repeat revascularization rate between OPCAB and ONCAB procedure. METHODS: Data sources including PubMed, EMBASE, the Cochrane Library, and ISI Web of Knowledge were searched between 1966 and October 2017. Studies considered for inclusion should conform to the following criteria: prospective randomized clinical trials comparing OPCAB and ONCAB...
March 30, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29579209/does-minimally-invasive-coronary-artery-bypass-improve-outcomes-compared-to-off-pump-coronary-bypass-via-sternotomy-in-patients-undergoing-coronary-artery-bypass-grafting
#10
Daniel S Florisson, Joshua A DeBono, Reece A Davies, Andrew E Newcomb
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'In patients undergoing off-pump coronary artery bypass grafting, for single or multivessel disease, does minimally invasive direct coronary artery bypass (MIDCAB) or off-pump coronary artery bypass (OPCAB) provide the superior outcome including a reduction in morbidity and mortality?'. A total of 187 papers were found using the reported search, of which 12 represented the best evidence to answer the clinical question...
March 22, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29562416/-myocardial-revascularization-among-patients-with-severe-left-ventricular-dysfunction-a-comparison-between-on-pump-beating-heart-and-off-pump-coronary-artery-bypass-grafting
#11
J Q Shen, Q Ji, W J Ding, L M Xia, K Song, L Wei, Y X Sun, C S Wang
Objective: To evaluate the impacts of an on-pump beating-heart versus an off-pump coronary artery bypass grafting (CABG) technique for surgical revascularization on the early clinical outcomes in patients with a left ventricular ejection fraction (EF) of 35% or less. Methods: A total of 216 consecutive patients with an echocardiographic estimated EF of 35% or less who underwent non-emergency, primary, isolated CABG from January 2010 to December 2014 at Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University were included in this study and were divided into either an OBCAB group (patients who received on-pump beating-heart CABG surgery, n =88) or an OPCAB group (patients who received off-pump CABG surgery, n =128)...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29561966/short-term-and-mid-term-clinical-outcomes-following-hybrid-coronary-revascularization-versus-off-pump-coronary-artery-bypass-a-meta-analysis
#12
Li Dong, Yi-Kun Kang, Xiang-Guang An
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) is one of the standard treatments for coronary artery disease (CAD) while hybrid coronary revascularization (HCR) represents an evolving revascularization strategy. However, the difference in outcomes between them remains unclear. OBJECTIVE: We performed a meta-analysis to compare the short-term and mid-term outcomes of HCR versus OPCAB for the treatment of multivessel or left main CAD. METHODS: We searched the PubMed, EMBASE, Web of Science and Cochrane databases to identify related studies and a routine meta-analysis was conducted...
March 19, 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29523917/how-do-different-extracorporeal-circulation-systems-affect-metoprolol-bioavailability-in-coronary-artery-bypass-surgery-patients
#13
Hannu Kokki, Martin Maaroos, Sten Ellam, Jari Halonen, Ilkka Ojanperä, Merja Ranta, Veli-Pekka Ranta, Aleksandra Tolonen, Oscar Lindberg, Matias Viitala, Juha Hartikainen
PURPOSE: Cardiac surgery and conventional extracorporeal circulation (CECC) impair the bioavailability of drugs administered by mouth. It is not known whether miniaturized ECC (MECC) or off-pump surgery (OPCAB) affect the bioavailability in similar manner. We evaluated the metoprolol bioavailability in patients undergoing CABG surgery with CECC, MECC, or having OPCAB. METHODS: Thirty patients, ten in each group, aged 44-79 years, scheduled for CABG surgery were administered 50 mg metoprolol by mouth on the preoperative day at 8-10 a...
June 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29490052/transcatheter-aortic-valve-implantation-and-off-pump-coronary-artery-bypass-surgery-an-effective-hybrid-procedure-in-selected-patients
#14
Benedikt Mayr, Christian Firschke, Magdalena Erlebach, Sabine Bleiziffer, Markus Krane, Michael Joner, Ulf Herold, Christian Nöbauer, Rüdiger Lange, Marcus-André Deutsch
OBJECTIVES: Simultaneous surgical off-pump coronary revascularization and transcatheter aortic valve implantation (TAVI) as a hybrid procedure may be a therapeutic option for patients with a TAVI indication who are not suitable for percutaneous coronary intervention and for patients who have an indication for combined surgical aortic valve implantation and coronary artery bypass grafting but present with a porcelain aorta. Early outcomes of these patients are analysed in this study. METHODS: From February 2011 to April 2017, hybrid TAVI/off-pump coronary artery bypass (OPCAB) was performed in 12 (60%) patients, hybrid TAVI/minimally invasive direct coronary artery bypass in 6 (30%) patients and staged TAVI/OPCAB in 2 (10%) patients...
February 26, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29444321/left-ventricular-regional-dyssynchrony-predicts-improvements-in-moderate-ischaemic-mitral-regurgitation-after-off-pump-coronary-artery-bypass
#15
Xiaotian Sun, Guoqian Huang, Jiechun Huang, Meng Shi, Fangrui Wang, Liewen Pang, Yiqing Wang
OBJECTIVES: The aim of this study was to explore the predictors of the improvement in moderate ischaemic mitral regurgitation (IMR) after off-pump coronary artery bypass grafting (OPCAB) focusing on left ventricular (LV) dyssynchrony. METHODS: A prospective study was performed among 135 patients (age at surgery, mean ± SD: 67.0 ± 8.2 years, 33.3% women) with prior myocardial infarction and moderate IMR undergoing OPCAB from 2008 to 2015. Preoperative and follow-up clinical and echocardiographic parameters were analysed, focusing on LV global/regional dyssynchrony...
February 12, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29373889/paraplegia-after-off-pump-coronary-artery-by-pass-grafting
#16
Aghigh Haidari, Feridoun Sabzi, Samsam Dabiri
Paraplegia is an exceedingly rare neurologic complication after off-pump coronary artery bypass graft (OPCAB) surgery commonly caused by spinal cord ischemia (SCI). SCI is not a well unknown clinical phenomenon in the postoperative course. SCI has been reported after noncardiac surgery in otherwise healthy subjects in whom only one risks factor i.e. severe hypotension has been documented. SCI has also been reported as a rare complication among the other neurologic sequels of cardiac surgery. We report a case of paraplegia in a patient with metabolic syndrome and multiples risk factors after an OPCAB...
December 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29312714/off-vs-on-pump-coronary-artery-bypass-graft-surgery-on-hospital-outcomes-in-134-117-octogenarians
#17
Umberto Benedetto, Gianni D Angelini, Massimo Caputo, Dmitriy N Feldman, Luke K Kim, Christopher Lau, Antonino Di Franco, Leonard N Girardi, Mario Gaudino
Background: In octogenarian patients there is a potential for more tangible clinical benefits from off-pump coronary artery bypass (OPCAB) compared to conventional coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) (COCAB). We aimed to investigate whether, compared to COCAB, OPCAB is associated with better operative outcomes in octogenarians by analyzing the Nationwide Inpatient Sample (NIS) databases 2003-2011. Methods: Of the 134,117 discharge records from 797 hospitals analyzed of patients aged ≥80 years undergoing first time isolated CABG from 2003 to 2011, 70...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29297472/effect-of-hybrid-treatment-on-rehabilitation-and-clinical-condition-of-patients-with-multivessel-coronary-artery-disease
#18
Joanna Foik, Anna Brzęk, Marek J Gierlotka, Michał O Zembala, Mariusz Gąsior, Marian Zembala
INTRODUCTION    Rehabilitation after coronary revascularization procedures is an intrinsic part of treatment during the in‑hospital period. OBJECTIVES    We aimed to compare the course and effects of rehabilitation in patients receiving hybrid treatment (minimally invasive direct coronary artery bypass / percutaneous coronary intervention) or classic treatment (coronary artery bypass grafting / off‑pump coronary artery bypass) during hospitalization. PATIENTS AND METHODS    The study included 200 patients participating in a prospective randomized clinical trial (POLMIDES) that assessed the effect of hybrid treatment on in‑hospital outcomes and long‑term results in patients with multivessel coronary artery disease...
February 28, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29279528/long-period-and-high-level-of-d-dimer-after-coronary-artery-bypass-grafting-surgery
#19
Zanxin Wang, Zhaoyang Qian, Jing Ren, Jianlong Men, Junmin Wen, Minxin Wei
Hyper-coagulation after off-pump coronary artery bypass grafting (OPCAB) is one of the main reasons for graft thrombosis. D-dimer is closely linked to the activation of coagulation. Few studies have reported the variation range and long-term abnormal coagulation after OPCAB in the Chinese population. Our study aimed to determine the characteristics and value of D-dimer after OPCAB.In this prospective study, 265 patients who underwent OPCAB for the first time were recruited from 2011 to 2012. The D-dimer level of the patients was tested before surgery and on the 1st, 4th, and 14th day, and 1st, 2nd, and 3rd month after surgery...
January 27, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29230573/incidence-of-perioperative-stroke-in-clampless-aortic-anastomosis-during-off-pump-coronary-artery-bypass-grafting
#20
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
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