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https://www.readbyqxmd.com/read/28281737/early-and-mid-term-results-of-coronary-endarterectomy-influence-of-cardiopulmonary-bypass-and-surgical-techniques
#1
Jae Hang Lee, Cheong Lim, Jun Sung Kim, Kay-Hyun Park
BACKGROUND: Coronary endarterectomy (CE) may be a good option for complete revascularization of diffuse coronary artery diseases, but it has not been widely used because the outcomes have not been definitively identified. This study aims to evaluate the mid-term clinical results of CE and compare the outcomes according to the use of cardiopulmonary bypass (CPB) and the surgical technique used. METHODS: Between 2004 and 2014, 69 cases of coronary endarterectomy were performed in 64 patients...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28250357/preoperative-serum-alkaline-phosphatase-and-clinical-outcome-of-off-pump-coronary-artery-bypass-surgery
#2
Tae Kyong Kim, Deok Man Hong, Yoon Hyeong Choi, Chang-Hoon Koo, Youn Joung Cho, Jun-Bean Park, Kyung Woo Park, Hyo-Soo Kim, Yunseok Jeon
BACKGROUND: Serum alkaline phosphatase (ALP) is related to vascular calcification. In a recent study on percutaneous coronary intervention (PCI) with a drug-eluting stent, higher ALP was associated with poor clinical outcomes in terms of mortality, myocardial infarction, and stent thrombosis. The aim of this study was to evaluate the relationship between preoperative ALP and clinical outcome of off-pump coronary artery bypass surgery (OPCAB).Methods and Results:We retrospectively enrolled and reviewed a total of 1,335 patients who underwent OPCAB...
March 2, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28203474/unexpected-radiation-induced-aortic-wall-thickening-requiring-composite-graft-technique-during-off-pump-coronary-artery-bypass-grafting
#3
Paola Redaelli, Amando Gamba, Antonello Stefano Martino, Michele Triggiani
Mediastinal radiation is commonly used to treat Hodgkin's and non-Hodgkin's lymphoma, lung and breast cancer. Cardiac complications after radiation therapy are well described, although rare. A large spectrum of injuries can occur, causing long term morbidity among survivors. We describe a case of post-actinic ascending aortic wall thickening that prevented saphenous vein proximal anastomosis and was successfully managed with aortic no-touch off-pump coronary artery bypass grafting (OPCAB), 25 years after radiation therapy for Hodgkin's lymphoma...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28181055/endotracheal-bioimpedance-cardiography-improves-immediate-postoperative-outcome-a-case-control-study-in-off-pump-coronary-surgery
#4
Thomas Leclercq, Marc Lilot, Thomas Schulz, Alexandre Meyer, Fadi Farhat, Jean-Luc Fellahi
The feasibility and clinical utility of the endotracheal cardiac output monitor (ECOM) to optimize intraoperative hemodynamics and improve short-term outcome in off-pump coronary artery bypass grafting (OPCAB) is unknown. We aimed to compare ECOM with a standard of care in that specific surgical setting. Twenty consecutive adult ECOM-monitored patients undergoing OPCAB were prospectively included (ECOM group) and retrospectively compared to 42 patients scheduled for similar surgery without ECOM monitoring (Control group)...
February 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28180098/analysis-of-risk-factors-for-conversion-from-off-pump-to-on-pump-coronary-artery-bypass-graft
#5
Junghyeon Lim, Won Yong Lee, Yong Joon Ra, Jae Han Jeong, Ho Hyun Ko
BACKGROUND: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. METHODS: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group)...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28178154/significant-elevation-of-biomarkers-of-myocardial-necrosis-after-coronary-artery-bypass-grafting-without-myocardial-infarction-established-assessed-by-cardiac-magnetic-resonance
#6
Leandro Menezes Alves da Costa, Whady Hueb, Cesar Higa Nomura, Alexandre Ciappina Hueb, Alexandre Volney Villa, Fernando Teiichi Costa Oikawa, Rodrigo Morel Vieira de Melo, Paulo Cury Rezende, Carlos Alexandre Wainrober Segre, Cibele Larrosa Garzillo, Eduardo Gomes Lima, Jose Antonio Franchini Ramires, Roberto Kalil Filho
The release of myocardial necrosis biomarkers after off-pump coronary artery bypass grafting (OPCAB) frequently occurs. However, the correlation between biomarker release and the diagnosis of procedure-related myocardial infarction (MI) (type 5) has been controversial. This study aimed to evaluate the amount and pattern of cardiac biomarker release after elective OPCAB in patients without evidence of a new MI on cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE).Patients with normal baseline cardiac biomarkers referred for elective OPCAB were prospectively included...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28150286/endogenic-erythropoietin-secretion-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#7
Anna Drohomirecka, Mariusz Kuśmierczyk, Szymon Kocańda, Krzysztof Kuśmierski, Piotr Kołsut, Krzysztof Kotliński, Aleksandra Brutkiewicz, Grzegorz Religa, Jacek Różański, Tomasz Zieliński
BACKGROUND: Erythropoietin (EPO) deficiency or inadequate EPO secretion in response to bleeding may result in profound or prolonged anaemia after cardiac surgery. The aim of the study was to evaluate the changes in EPO secretion in patients undergoing off-pump coronary artery bypass grafting (OPCAB). METHODS: Blood samples from 43 patients (mean age 65.1±7.6 years) were obtained before surgery and on the 1st, 2nd, and 6th day post isolated OPCAB. EPO levels ³4...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28131775/single-centre-experience-of-off-pump-multi-vessel-coronary-artery-bypass-grafting-using-proximal-suture-device
#8
Suguru Ohira, Kiyoshi Doi, Satoshi Numata, Sachiko Yamazaki, Keiichi Itatani, Hidetake Kawajiri, Kazuki Morimoto, Hitoshi Yaku
BACKGROUND: To investigate the results of off-pump coronary artery grafting (OPCAB) with the proximal suture device (PSD) regarding postoperative stroke and graft patency. METHODS: The PSD was used in 376 patients (32.0%), aorta-no-touch OPCAB was performed in 523 patients (45.2%), on-pump beating CABG (on-beat group) in 125 patients (10.6%) including 51 conversions (conversion rate: 5.4%), and CABG with aortic clamp use (clamp group) in 152 patients. In the PSD group, Enclose II was used in 267 patients (71...
December 23, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28109102/-long-term-outcomes-of-off-pump-coronary-artery-bypass-grafting-in-patients-aged-over-75-years
#9
Yi Guo, Chong-Lei Ren, Chang-Qing Gao, Cang-Song Xiao, Hua-Jun Zhang
OBJECTIVE: To investigate the long-term outcomes of off-pump coronary artery bypass grafting (OPCAB) in patients aged over 75 years and analyze the risk factors affecting the outcomes of the procedure. METHODS: Clinical data were reviewed for 97 consecutive patients aged 75 years or above receiving OPCAB at our center between November, 2000 and November, 2013. The perioperative data including length of ICU stay, duration of mechanical ventilation, incidence of postoperative complications and mortality rate of the patients were analyzed...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28096825/determination-of-the-value-of-glycated-hemoglobin-hba1c-and-fructosamine-in-assessing-the-risk-of-perioperative-complications-after-cardiac-surgery-in-patients-with-type-2-diabetes
#10
Anetta M Kowalczuk-Wieteska, Marta Wróbel, Dominika Rokicka, Aleksandra Szymborska-Kajanek, Jerzy Foremny, Paweł Nadziakiewicz, Marian Zembala, Krzysztof Strojek
INTRODUCTION: Patients with diabetes have a worse postoperative course and longer length of hospital stay after surgery. A good indicator of proper long-term (3 months) glycemic control is glycated hemoglobin (HbA1c), and fructosamine in the short term (2-3 weeks). AIM: To determine the degree of glycemic control evaluated preoperatively by HbA1c and/or fructosamine influence on the postoperative course of patients with diabetes undergoing coronary artery bypass grafting (CABG) in 2014-2015...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28074802/goal-directed-therapy-improves-the-outcome-of-high-risk-cardiac-patients-undergoing-off-pump-coronary-artery-bypass
#11
RANDOMIZED CONTROLLED TRIAL
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Singh Rawat, Yatin Mehta, Sameer Taneja, R Ravi, Milind P Hote
BACKGROUND: There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074788/comparison-of-two-doses-of-heparin-on-outcome-in-off-pump-coronary-artery-bypass-surgery-patients-a-prospective-randomized-control-study
#12
RANDOMIZED CONTROLLED TRIAL
Murali Chakravarthy, Dattatreya Prabhakumar, Patil Thimmannagowda, Jayaprakash Krishnamoorthy, Antony George, Vivek Jawali
INTRODUCTION: While off pump coronary artery bypass surgery is practiced with an intention to reduce the morbidity associated with cardiopulmonary bypass, the resultant 'hypercoagulability' needs to be addressed. Complications such as cavitary thrombus possibly due to the hyper coagulability after off pump coronary artery bypass surgery have been described. Many clinicians use higher doses of heparin - up to 5 mg/kg in order to thwart this fear. Overall, there appears to be no consensus on the dose of heparin in off pump coronary artery bypass surgeries...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27955911/impact-of-multiple-arterial-grafts-in-off-pump-and-on-pump-coronary-artery-bypass-surgery
#13
Umberto Benedetto, Massimo Caputo, Giovanni Mariscalco, Mario Gaudino, Pierpaolo Chivasso, Alan Bryan, Gianni D Angelini
OBJECTIVES: There is growing concern that off-pump coronary artery bypass (OPCAB) is associated with reduced long-term survival compared with traditional on-pump coronary artery bypass (ONCAB); however, most of available comparisons between OPCAB and ONCAB focus on single-artery (SA) revascularization. We sought to investigate the impact of using multiple arterial (MA) conduits in the comparison between OPCAB versus ONCAB by performing a single-center, long-term propensity score base analysis...
February 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27942403/the-future-of-off-pump-coronary-artery-bypass-grafting-a-north-american-perspective
#14
Bobby Yanagawa, Rashmi Nedadur, John D Puskas
Off-pump coronary artery bypass graft (OPCAB) is currently performed routinely in a minority of specialized centers and in many more centers, utilized only when a porcelain aorta mandates a no-touch aortic technique. The OPCAB literature can be summarized as follows: (I) large-scale randomized trials in relatively low risk patients that include surgeons with a range of experience demonstrating no consistent beneficial differences in major cardiovascular and cerebrovascular outcomes but lower transfusion rates and shorter length of stay, tempered by some reports of higher rates of incomplete revascularization and lower rates of long term graft patency; (II) smaller randomized controlled trials (RCTs) from highly specialized programs demonstrating equivalent or superior outcomes with OPCAB and similar completeness of revascularization and graft patency; and (III) observational data from large databases demonstrating a consistent benefit of OPCAB, especially in higher-risk patient subsets...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27942401/two-decades-of-off-pump-coronary-artery-bypass-surgery-harefield-experience
#15
REVIEW
Shahzad G Raja
The morbidity and mortality associated with conventional coronary artery bypass grafting (CABG) attributed to invasiveness of cardiopulmonary bypass (CPB) has been well documented. Recognition of this invasiveness with a focus centered on abolishing, or at least reducing the CPB associated morbidity and mortality led to the resurgence of off-pump coronary artery bypass (OPCAB) surgery nearly two decades ago. At about the same time, OPCAB was adopted at Harefield hospital partly as an institutional drive to promote innovation and partly as a strategy to improve outcomes...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27942400/we-should-ban-the-opcab-approach-in-cabg-just-as-we-should-ban-jetliners-and-bicycles-or-maybe-not
#16
REVIEW
Paul Sergeant
Implementing a new technical process demands a complex preparation. In cardiac surgery this complex preparation is often reduced to visiting a surgeon who is familiar with a technique. The science of learning has identified that several steps are needed towards a successful implementation. The first step is the creation of a complete conceptual approach; this demands the deposit in writing of the actions and reactions of every involved party in this new approach. By definition a successful implementation starts with the creation of a group of involved individuals willing to collaborate towards a new goal...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27942399/impact-of-off-pump-coronary-artery-bypass-grafting-on-survival-current-best-available-evidence
#17
REVIEW
Pierpaolo Chivasso, Gustavo A Guida, Daniel Fudulu, Vito D Bruno, Roberto Marsico, Hristo Sedmakov, Mustafa Zakkar, Filippo Rapetto, Alan J Bryan, Gianni D Angelini
The superiority of either off-pump (OPCAB) or on-pump (ONCAB) coronary artery bypass grafting (CABG) remains unclear despite a large body of literature evidence comparing the two approaches. The potential advantages of avoiding cardiopulmonary bypass (CPB), minimizing aortic manipulation and maintaining pulsatile flow may be associated with reduced inflammatory responses and embolic events. Numerous studies compared OPCAB with ONCAB and the cumulative data have been presented in meta-analyses of both randomized and observational studies...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27942398/off-pump-coronary-artery-bypass-grafting-in-octogenarians
#18
REVIEW
Shahzad G Raja
Enhanced life expectancy has confronted cardiac surgery with a rapidly growing population of octogenarians needing coronary artery bypass grafting (CABG). Octogenarians are deemed a high-risk patient population with increased postoperative morbidity and mortality following conventional CABG using cardiopulmonary bypass (CPB). In such patients reducing the invasiveness of the surgical procedure by avoiding CPB may be tried in an attempt to improve outcomes. The increasing performance of off-pump coronary artery bypass (OPCAB) grafting within certain centers reflects surgeon preference to avoid the inherent risks of CPB and cardioplegic arrest including hemodilution, nonpulsatile arterial flow, global myocardial ischemia, atherosclerotic embolization from aortic manipulation, and systemic inflammatory response...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27942397/off-pump-coronary-artery-bypass-grafting-in-high-risk-patients-a-review
#19
REVIEW
Gustavo A Guida, Pierpaolo Chivasso, Daniel Fudulu, Filippo Rapetto, Christo Sedmakov, Roberto Marsico, Mustafa Zakkar, Alan J Bryan, Gianni D Angelini
The role of off-pump coronary artery bypass (OPCAB) grafting in high risk patients remains controversial. While there have been studies showing the potential benefits of it, there is still a lot to be learned from the application of this technique in this sub-group of patients. The results of the different trials and papers that we reviewed seem to indicate a benefit in the OPCAB group. Despite of the fact that trials were significantly different in methodology, especially when choosing the risk score stratification tool or the cut-off to define high risk the literature seems to suggest a benefit from the use of OPCAB surgery...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27942394/current-outcomes-of-off-pump-versus-on-pump-coronary-artery-bypass-grafting-evidence-from-randomized-controlled-trials
#20
REVIEW
Daniel Fudulu, Umberto Benedetto, Gustavo Guida Pecchinenda, Pierpaolo Chivasso, Vito Domenico Bruno, Filippo Rapetto, Alan Bryan, Gianni Davide Angelini
Coronary artery bypass grafting remains the standard treatment for patients with extensive coronary artery disease. Coronary surgery without use of cardiopulmonary bypass avoids the deleterious systemic inflammatory effects of the extracorporeal circuit. However there is an ongoing debate surrounding the clinical outcomes after on-pump versus off-pump coronary artery bypass (ONCAB versus OPCAB) surgery. The current review is based on evidence from randomized controlled trials (RCTs) and meta-analyses of randomized studies...
November 2016: Journal of Thoracic Disease
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