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Cardiopulmonary bypass grafting

A Ammar, K Mahmoud, A Elkersh, Z Kasemy
There is a strong association between pre-operative diastolic dysfunction and difficulty in weaning from cardiopulmonary bypass. We compared the effects of propofol and isoflurane on left ventricular diastolic function in patients with pre-existing diastolic dysfunction undergoing coronary artery bypass grafting. We randomly allocated 60 patients to receive either propofol or isoflurane anaesthesia, and assessed left ventricular diastolic function using transoesophageal echocardiography. We measured early (E), late (A) diastolic velocities, E/A ratio, A-wave duration and deceleration time using pulsed wave Doppler, and early (Em), late (Am) diastolic velocities of the mitral annulus, Em/Am ratio and isovolumetric relaxation time using tissue Doppler...
November 2016: Anaesthesia
Thijs C D Rettig, Linda M Peelen, Guillaume S C Geuzebroek, Wilton A van Klei, Christa Boer, Jan Willem van der Veer, Jan Hofland, Ewoudt M W van de Garde, Peter G Noordzij
OBJECTIVE: The aim of this study was to investigate whether acute kidney injury (AKI) after coronary artery bypass grafting can be attributed to intraoperative hypotension during cardiopulmonary bypass (IOH-CPB). DESIGN: Retrospective analysis. SETTING: Tertiary-care hospital. PARTICIPANTS: Patients undergoing on-pump coronary artery bypass grafting from June 2011 to January 2014. INTERVENTIONS: None...
July 30, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Rawat, Yatin Mehta
Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass...
October 2016: Annals of Cardiac Anaesthesia
Ahmet Yavuz Balci, Unsal Vural, Rezan Aksoy, M Fatih Özdemir, Seçkin Satilmiş, Mehmet Kizilay, Mutlu Şenocak, Huseyin Şaşkin, Ilyas Kayacioğlu, Ibrahim Yekeler
BACKGROUND: This study was designed to determine the short- and long-term effects of proximal aortic anastomosis, performed during isolated coronary artery bypass grafting (CABG) in patients with dilatation of the ascending aorta who did not require surgical intervention. METHODS: The study was performed on 192 (38 female and 160 male patients; mean age, 62.1 ± 9.2 years; range, 42-80 years) patients with dilatation of the ascending aorta who underwent CABG surgery between 1 June 2006 and 31 May 2014...
August 22, 2016: Cardiovascular Journal of Africa
Sevil Özkan, Fatih Özdemir, Oğuz Uğur, Refik Demirtunç, Ahmet Yavuz Balci, Mehmet Kizilay, Ünsal Vural, Mehmet Kaplan, Ibrahim Yekeler
BACKGROUND: The metabolic syndrome (MS) is a clustering of factors that are associated with increased cardiovascular risk. A low-grade inflammatory process acts as the underlying pathophysiology, which suggests that the MS may have a detrimental effect on coronary interventions, including coronary artery bypass grafting (CABG) surgery performed with cardiopulmonary bypass (CPB). We aimed to evaluate the effect of the MS on morbidity and mortality rates in the early postoperative period in patients undergoing CABG...
July 13, 2016: Cardiovascular Journal of Africa
David Freiermuth, Berend Mets, Daniel Bolliger, Oliver Reuthebuch, Thomas Doebele, Markus Scholz, Michael Gregor, Matthias Haschke, Manfred Daniel Seeberger, Jens Fassl
OBJECTIVES: This study aimed to evaluate the pharmacokinetic profiles of sevoflurane and isoflurane during use of minimized extracorporeal circulation to perform coronary artery bypass graft surgery. Furthermore, cardiovascular stability during bypass and the postoperative release of troponins were evaluated. DESIGN: Prospective, randomized study. SETTING: University hospital. PARTICIPANTS: The study comprised 31 adult patients undergoing coronary artery bypass grafting...
July 12, 2016: Journal of Cardiothoracic and Vascular Anesthesia
H W Wu, L Sun, D M Li, H Jing, B Xu, C T Wang, L Zhang
Objective: To summarize the short- and mid-term results on endovascular repair of primary retrograde Stanford type A aortic dissection with an entry tear in distal aortic arch or descending aorta. Methods: Between December 2009 and December 2014, 21 male patients of primary retrograde Stanford type A aortic dissection with a mean age of (52±9) years received endovascular repair in Department of Cardiothoracic Surgery, Jinling Hospital. Among the 21 cases, 17 patients were presented as ascending aortic intramural hematoma, 4 patients as active blood flow in false lumen and partial thrombosis, 8 patients as ulcer on descending aorta combined intramural hematoma in descending aorta, and 13 patients as typical dissection changes...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
H Etienne, M Majewski, F Cochennec, L Segaux, J-P Becquemin
INTRODUCTION: Ruptured descending thoracic aneurysm (rDAA) is a rare but devastating condition. Open aortic surgery which uses cardiopulmonary bypass is associated with a high mortality. Thoracic Endovascular Aortic Repair (TEVAR) is a less invasive approach for which it remains unclear whether outcomes are superior or equivalent to open aortic surgery. In this study, we report our early and midterm outcomes with TEVAR for rDAA. METHODS: This is an observational, retrospective, single center study which included patients with rDAA and treated by TEVAR...
September 23, 2016: Annals of Vascular Surgery
Muhammad Sohail Chaudhri, Muhammad Usman Ali Shah, Muhammad Imran Asghar, Rashad Siddiqi, Asif Mahmood Janjua, Afsheen Iqbal
OBJECTIVE: To compare mean per-operative flow capacity between skeletonized and pedicled left internal mammary artery (LIMA) in patients undergoing coronary artery bypass grafting (CABG) surgery. STUDY DESIGN: Randomized control trial. PLACE AND DURATION OF STUDY: Department of Cardiac Surgery, Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC-NIHD), Rawalpindi, Pakistan from February to August, 2013. METHODOLOGY: Patients undergoing CABG for coronary artery disease, under 80 years, excluded by the exclusion criteria; and fulfilling the inclusion criteria were randomly assigned to two groups of 70 each...
September 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Łukasz Lewicki, Janusz Siebert, Jan Rogowski
BACKGROUND: Postoperative atrial fibrillation (AF) is a common arrhythmia that occurs after coronary artery bypass grafting (CABG). New surgical techniques, particularly off-pump coronary artery bypass (OPCAB), are thought to be less invasive and results in fewer complications, i.e. AF, but available data are inconsistent. The aim of this study is to present the incidence and risk factors of AF in patients operated on with or without cardiopulmonary bypass. METHODS: We studied 1836 consecutive patients with stable coronary artery disease who were operated on with (CABG) or without (OPCAB) cardiopulmonary bypass...
September 26, 2016: Cardiology Journal
Michel Kindo, Tam Hoang Minh, Stéphanie Perrier, Jonathan Bentz, Arnaud Mommerot, Philippe Billaud, Jean-Philippe Mazzucotelli
OBJECTIVES: The purpose of this study was to assess the impact on hospital mortality and morbidity of extensive myocardial revascularization, using arterial grafts in patients undergoing isolated coronary artery bypass grafting (CABG). METHODS: Our prospective perioperative database was used to define two groups of patients who underwent isolated CABG with cardiopulmonary bypass, based on the years in which the operation was performed: Group A (2000-2003; 898 patients) and Group B (2009-2012; 1249 patients)...
September 22, 2016: Interactive Cardiovascular and Thoracic Surgery
Sarah Djebara, Patrick Biston, Emmanuel Fossé, Anne Daper, Marc Joris, Karim Zouaoui Boudjeltia, Christophe Lelubre, Philippe Cauchie, Michael Piagnerelli
Distinction between inflammation secondary to surgery, especially coronary artery bypass graft with cardiopulmonary bypass (CPB), and inflammation due to infection is difficult in surgical intensive care unit (ICU) patients. Development of biomarkers of infection could help clinicians in the early identification and thus treatment of sepsis in these patients. We compared the time course of the neutrophil CD64 index, a high affinity immunoglobulin FC γ receptor I whose expression is increased in bacterial infection, in 39 patients undergoing cardiac surgery with CPB and 11 patients admitted to the ICU with severe sepsis or septic shock...
September 19, 2016: Shock
Aamir Furqan, Sohail Ahmad, Liaqat Ali, Rahat Akhtar, Mr Mirza Ahmad Raza Baig, Rana Altaf
OBJECTIVES: Comparison of effects of propofol and isosorbide dinitrate during rewarming on cardiopulmonary bypass in patients undergoing coronary artery bypasses grafting. METHODS: It was randomized prospective clinical trial. One hundred and twenty patient (120) undergoing CABG surgery were included in this study. Group-I (Study group, n=60): in which only propofol infusion used during rewarming and Group-II (control Group, n=60) in which isosorbide dinitrate and propofol infusion combination was used during rewarming...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Razvan Purza, Subhamay B Ghosh, Chris Walker, Brett Hiebert, Lillian Koley, G Scott Mackenzie, Hilary P Grocott
BACKGROUND: Although there have been several large reviews documenting the complications following intraoperative transesophageal echocardiography (TEE), most of these prior reports are almost 2 decades old and may not reflect current practices. The purpose of this study was to determine the incidence and types of complications following TEE in a contemporary cardiac surgical population. METHODS: We conducted a retrospective analysis of all cardiac surgical patients having undergone an intraoperative TEE between April 1, 2004, and April 30, 2012...
September 16, 2016: Annals of Thoracic Surgery
Peter S Y Yu, Simon C H Yu, Cheuk-Man Chu, Micky W T Kwok, Yuk-Hoi Lam, Malcolm J Underwood, Randolph H L Wong
An elderly man presented with fever and evidence of Salmonella infection, and was diagnosed to have coexisting constrictive pericarditis and mycotic aneurysm of the aortic arch. Pericardiectomy was performed under cardiopulmonary bypass with good result. To avoid deep hypothermic circulatory arrest, an aorto-brachiocephalic bypass, instead of total arch replacement, was performed. This was followed by a staged carotid-carotid bypass, thoracic endovascular stent graft placement. He was subsequently treated with prolonged antibiotics, and inflammatory marker normalized afterwards...
August 2016: Journal of Thoracic Disease
Yusuke Date, Katsuyuki Miyazu, Masahiro Ikeda
We report the case of a 28-year-old man with a rare angiosarcoma complicated by acute myocardial infarction secondary to tumor embolism. He was transported to our emergency unit because of sudden onset of chest pain. The echocardiography showed a 42×60 mm mass in the left ventricle, and the coronary angiography showed embolic occlusion of the proximal left anterior descending and circumflex arteries. Emergent surgical removal of the mass was attempted under cardiopulmonary bypass, concomitant with double coronary artery bypass grafting and mitral valve replacement with a mechanical prosthesis...
September 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Mehmet Ezelsoy, Kerem Oral, Baris Caynak, Zehra Bayramoglu, Belhhan Akpinar
OBJECTIVE: Minimally invasive bypass grafting is a promising surgical treatment in proximal LAD stenosis procedures. The main goal of this study was to make comparisons between robotically assisted minimally invasive coronary bypass surgery and conventional surgery in isolated proximal LAD lesions in terms of pain and quality of life improvement. METHODS: The study contains patients with proximal LAD lesions who were treated with robotically assisted minimally invasive coronary artery bypass surgery and conventional bypass surgery between June 2005 and November 2012...
2016: Heart Surgery Forum
Michele Heath, Suraj Yalamuri, Julie Walker, Cory Maxwell, Adam Williams, Sharon McCartney, Mani Daneshmand
The presence of cold agglutinins (CA) during cardiac surgery with cardiopulmonary bypass usually creates the need for an altered surgical plan. In this case, the CA were discovered after the initiation of bypass, limiting the time, and cardioplegia solutions that could be used in the new approach. The inability to cannulate the coronary sinus with a retrograde cardioplegia catheter excluded the standard approach to myocardial preservation with CA of using continuous warm blood. For this case, we used intermittent cold crystalloid delivered via the antegrade needle for the first half of the procedure and through the saphenous vein graft anastomosis during the aortic valve portion of the cross-clamp period...
June 2016: Journal of Extra-corporeal Technology
Stéphanie Perrier, Nicolas Meyer, Tam Hoang Minh, Tarek Announe, Jonathan Bentz, Philippe Billaud, Arnaud Mommerot, Jean-Philippe Mazzucotelli, Michel Kindo
BACKGROUND: This study was conducted to identify preoperative predictors of postoperative atrial fibrillation (POAF) after isolated coronary artery bypass grafting (CABG) by using a Bayesian analysis that included information from prior studies. METHODS: We performed a prospective observational study from October 2008 to December 2013 of 1,481 patients who underwent isolated CABG with cardiopulmonary bypass and had no history of AF. Bayesian analysis was used to study the preoperative risks factors for POAF...
August 28, 2016: Annals of Thoracic Surgery
Athanasia Vlahou, Konstantinos Diplaris, Fotini Ampatzidou, Lampos Karagounnis, George Drossos
Objectives Atrial fibrillation (AF) is the most common complication after coronary artery bypass grafting (CABG). It is associated with prolonged hospital stay and increased cost. The aim of this study is to investigate the relationship between transfusion of blood derivatives and occurrence of postoperative paroxysmal AF. Materials and Methods From June 2012 to February 2014, 446 patients undergoing CABG with cardiopulmonary bypass (CPB) were prospectively evaluated for occurrence of postoperative AF. Patients and procedural variables were recorded and were associated with the development of new-onset AF with logistic regression analysis...
August 30, 2016: Thoracic and Cardiovascular Surgeon
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