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Cardiopulmonary bypass grafting

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https://www.readbyqxmd.com/read/27925235/quantification-of-operational-learning-in-minimal-invasive-extracorporeal-circulation
#1
Kyriakos Anastasiadis, Polychronis Antonitsis, Christos Asteriou, Helena Argiriadou, Apostolos Deliopoulos, Dimitrios Konstantinou, Vassilios Grosomanidis, Paschalis Tossios
Minimal invasive extracorporeal circulation (MiECC) has initiated important new efforts within science and technology towards a more physiologic perfusion. In this study, we aim to investigate the learning curve of our center regarding MiECC. We studied a series of 150 consecutive patients who underwent elective coronary artery bypass grafting by the same surgical team during the initial phase of MiECC application. Patients were randomly assigned into two groups. Group A (n = 75) included patients operated on MiECC, while group B (n = 75) included patients operated with conventional cardiopulmonary bypass (cCPB)...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27920591/left-atrial-myxomectomy-with-intraoperative-severe-mitral-regurgitation-and-complicated-postoperative-course-case-report
#2
Nareg Minaskeian, Patrick P Hu
Primary cardiac tumors are a rare occurrence with myxomas accounting for about half of the benign tumors. Once diagnosed, surgical resection is the standard of care. Our case describes a female in her 50s who underwent a myxoma resection under cardiopulmonary bypass via biatrial approach. Intraoperatively, the thin septal crux between the wall of the aorta and mitral valve was damaged during resection, requiring stem cell tissue matrix for repair. The patient also developed severe mitral regurgitation suggesting infarct to the left coronary system during resection, subsequently receiving a mechanical mitral valve and a saphenous vein bypass graft...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/27906091/impact-of-prophylactic-administration-of-levosimendan-on-short-term-and-long-term-outcome-in-high-risk-patients-with-severely-reduced-left-ventricular-ejection-fraction-undergoing-cardiac-surgery-a-retrospective-analysis
#3
Philippe Grieshaber, Stella Lipp, Andreas Arnold, Gerold Görlach, Matthias Wollbrück, Peter Roth, Bernd Niemann, Jochen Wilhelm, Andreas Böning
BACKGROUND: Patients with severely reduced left-ventricular ejection fraction carry a high risk of morbidity and mortality after cardiac surgery. Levosimendan can be used prophylactically in these patients having shown positive effects on short-term outcome. However, effects on long-term outcome and patient subgroups benefiting the most are unknown. We aim to address these topics with real-life data from our clinical practice. METHODS: Two hundred eigthy eight patients with preoperative LVEF ≤ 35% underwent cardiac surgery with cardiopulmonary bypass between 2009 and 2013...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27894326/preserved-autoregulation-of-coronary-flow-after-off-pump-coronary-artery-bypass-grafting-retrospective-assessment-of-intraoperative-transit-time-flowmetry-with-and-without-intra-aortic-balloon-counterpulsation
#4
Hiroyuki Nakajima, Atsushi Iguchi, Mimiko Tabata, Masaru Kambe, Masahiro Ikeda, Kazuhiko Uwabe, Toshihisa Asakura, Hiroshi Niinami
BACKGROUND: Intra-aortic balloon pumping (IABP) markedly increases graft flow after coronary artery bypass grafting (CABG) with cardiopulmonary bypass. We sought to delineate the effects of IABP on graft flow after off-pump CABG (OPCAB). METHODS: The clinical records of 32 patients (25 male, 7 female; mean age: 70 ± 9 years) who underwent OPCAB with IABP between January 2011 and May 2015 were retrospectively reviewed. Thirteen patients (41%) had a history of myocardial infarction, and 13 patients (41%) had a history of percutaneous coronary intervention...
November 28, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27855591/effects-of-perioperative-fluid-replacement-therapy-in-lung-transplant-patients
#5
Emil Björkbom, Pekka Hämmäinen, Alexey Schramko
OBJECTIVES: Approximately 10 to 25 lung transplant procedures are performed annually in Finland, and 1-year survival has been 95% over the last 10 years. Our aim was to find associations between perioperative fluid replacement therapies and postoperative patient outcomes, with special emphasis on the use of colloids and blood products. MATERIALS AND METHODS: We retrospectively evaluated data from 100 patients who underwent lung transplant with cardiopulmonary bypass support in Finland from 2007 to 2013...
November 18, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27847701/the-effect-of-desmopressin-on-the-amount-of-bleeding-in-patients-undergoing-coronary-artery-bypass-graft-surgery-with-a-cardiopulmonary-bypass-pump-after-taking-anti-platelet-medicine
#6
Ali Mirmansoori, Farnoush Farzi, Abbas Sedighinejad, Vali Imantalab, Ali Mohammadzadeh, Zahra Atrkar Roushan, Samaneh Ghazanfar Tehran, Maryam Nemati, Afsaneh Dehghan
BACKGROUND: Coronary artery bypass grafting (CABG) is a common surgical intervention at the end-stages of coronary artery occlusion disease. Despite the effectiveness of CABG, it may have particular complications, such as bleeding during and after surgery. So far, there have been many drugs used to reduce bleeding. OBJECTIVES: This study aimed at investigating the effects of desmopressin on the amount of bleeding in patients undergoing CABG with a cardiopulmonary bypass pump (CPBP) who were taking anti-platelet medicine...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843778/acute-severe-thrombocytopenia-occurring-after-administration-of-eptifibatide-postpones-emergent-coronary-artery-surgery
#7
Brent T Boettcher, Timothy J Olund, Paul S Pagel
INTRODUCTION: Eptifibatide is a platelet glycoprotein IIb/IIIa (GP IIb/IIIa) receptor antagonist that inhibits fibrinogen binding to the activated GP IIb/IIIa site and prevents platelet-platelet interaction and clot formation. GP IIb/IIIa inhibitors improve outcome in patients undergoing percutaneous coronary intervention for acute coronary syndrome. Thrombocytopenia is a complication of GP IIb/IIIa inhibitors, but severe thrombocytopenia is unusual. Most reported cases of severe thrombocytopenia after eptifibatide occurred in patients with acute coronary syndrome...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27836299/on-pump-versus-off-pump-coronary-artery-bypass-grafting-in-patients-with-end-stage-renal-disease-and-coronary-artery-disease-a-nation-wide-propensity-score-matched-database-analyses
#8
Jien-Jiun Chen, Lian-Yu Lin, Yao-Hsu Yang, Juey-Jen Hwang, Pau-Chung Chen, Jiunn-Lee Lin, Nai-Hsin Chi
OBJECTIVE: The usage of on or off cardiopulmonary bypass in patients with coronary artery disease receiving coronary artery bypass grafting (CABG) surgery had been debated and had not yet been investigated thoroughly in patients with end-stage renal disease (ESRD). We aimed to study cardiovascular outcomes and total mortality in these patients by using our National Health Insurance (NHI) database. METHOD: By using our NHI ESRD claim database, we searched ESRD patients aged more than 18years, who received CABG and divided them into on pump and off pump groups...
November 3, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27828807/predictors-and-outcomes-of-sternotomy-conversion-and-cardiopulmonary-bypass-assistance-in-minimally-invasive-coronary-artery-bypass-grafting
#9
Maria L Rodriguez, Harry R Lapierre, Benjamin Sohmer, Jean-Philippe Ruel, Marc A Ruel
OBJECTIVE: This work's objective was to identify the determinants of conversion of minimally invasive coronary artery bypass grafting to sternotomy, with and without cardiopulmonary bypass assistance, and to compare clinical outcomes in patients who needed conversion. METHODS: This is a prospectively collected data on patients who underwent minimally invasive coronary bypass done by a single surgeon from February 2005 to September 2014. Statistical analyses were expressed as mean values ± standard deviation or proportions...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27825685/pericardiectomy-after-previous-bypass-grafting-analyzing-risk-and-effectiveness-in-this-rare-clinical-entity
#10
Erin A Gillaspie, Joseph A Dearani, Richard C Daly, Kevin L Greason, Lyle D Joyce, Jae Oh, Hartzell V Schaff, John M Stulak
BACKGROUND: Historically the most common causes of pericarditis necessitating pericardiectomy are infection, radiation, idiopathic causes, and inflammation. More recently, there has been a rise in iatrogenic pericardial constriction, with most cases occurring after coronary artery bypass grafting (CABG). To date, there has been no large series evaluating the incidence, presentation, and effectiveness of surgical intervention. We review our 20-year experience managing this special subset of patients...
November 5, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27795837/effects-of-low-dose-selenium-on-the-inflammatory-response-in-coronary-artery-bypass-graft-surgery-a-clinical-trial
#11
Abbas Sedighinejad, Vali Imantalab, Ali Mirmansouri, Ali Mohammadzadeh Jouryabi, Gholamreza Kanani, Nassir Nassiri Sheikhani, Mohammad Haghighi, Zahra Atrkarroushan, Gelareh Biazar
BACKGROUND: Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. It is suggested that selenium (Se), an essential trace element, has a protective role against oxidative stress. Decreased intraoperative Se levels might be an independent predictive factor for postoperative multiorgan failure. In spite of its proposed advantages, however, the optimal timing and dosage are not well known...
August 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/27794072/off-pump-left-ventricular-assist-device-exchange-via-re-do-left-mini-thoracotomy-with-original-outflow-graft-preservation
#12
Jessika Iwanski, Phat L Tran, Catherine Jerman, Richard Smith, Toshinobu Kazui, Zain Khalpey
Complications associated with long-term left ventricular assist device (LVAD) use may require pump exchange due to device thrombosis or thromboembolism. Minimally invasive off-pump procedures represent an advantageous alternative to standard full sternotomy exchanges and those performed with the use of cardiopulmonary bypass. By mitigating surgical invasion and trauma to the central chest, the potential for post-operative bleeding, transfusions and complications can be reduced. This case report describes the successful off-pump exchange of a HeartWare LVAD via left re-do-thoracotomy with the re-use of the original outflow graft...
October 27, 2016: Perfusion
https://www.readbyqxmd.com/read/27793101/pulmonary-artery-compression-by-a-localized-epicardial-hematoma-in-a-patient-with-idiopathic-thrombocytopenic-purpura-after-percutaneous-coronary-intervention-a-case-report
#13
Satoshi Kawaguchi, Toshiharu Takeuchi, Naoyuki Hasebe
BACKGROUND: The most common complication of coronary artery perforation, a rare complication of percutaneous coronary intervention (PCI), is hemopericardium with cardiac tamponade. However, localized extra-coronary bleeding can lead to epicardial hematoma, which is a rare phenomenon. We report the case of an unusual delayed presentation of post-PCI hematoma with unrecognized guidewire perforation. CASE PRESENTATION: A 70-year-old man with idiopathic thrombocytopenic purpura (ITP) and a history of coronary artery bypass grafting (CABG) underwent PCI...
October 28, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27788941/long-term-outcomes-of-external-repair-as-a%C3%A2-rescue-operation-for-atrioventricular-groove-disruption
#14
Nikola Dobrilovic, Jaishankar Raman, James G Fingleton, Andrew Maslow, Arun K Singh
BACKGROUND: Atrioventricular groove disruption (AVGD) is an uncommon but lethal complication of mitral valve operations associated with mortality approaching 90%. Traditionally, an "internal" repair is performed requiring prosthesis explantation, complete atrioventricular groove reconstruction using a patch positioned from within the cardiac cavity, and subsequent prosthesis reimplantation. This is a massive undertaking that is usually unsuccessful. We examine the utility of an alternative, "external" approach for rescue of AVGD...
October 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27780561/minimally-invasive-extracorporeal-circulation-circuit-is-not-inferior-to-off-pump-coronary-artery-bypass-grafting-meta-analysis-using-the-bayesian-method
#15
REVIEW
Bernhard Winkler, Paul P Heinisch, Brigitta Gahl, Soheila Aghlmandi, Hans Jörg Jenni, Thierry P Carrel
The pathophysiologic side effects of cardiopulmonary bypass have already been identified. Minimally invasive extracorporeal circulation technologies (MiECT) and off-pump coronary artery bypass graft surgery (OPCABG) aim to reduce these problems. This metaanalysis provides a comparison of MiECT and OPCABG in randomized and observational studies. A fully probabilistic, Bayesian approach of primary and secondary endpoints was conducted. MiECT does not give inferior results when compared with OPCABG. However, there is a trend to borderline significantly higher blood loss in this group in randomized controlled trials...
October 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27777290/long-term-survival-and-freedom-from-reintervention-after-off-pump-coronary-artery-bypass-grafting-a-propensity-matched-study
#16
Bilal H Kirmani, Michael V Holmes, Andrew D Muir
BACKGROUND: The long-term outcomes of off-pump coronary artery bypass grafting (CABG) are the subject of speculation. Our institution has >15 years of experience performing CABG both off-pump (OPCAB) and on cardiopulmonary bypass (CPB). Our null hypothesis was that there would be no difference in a long-term composite of death and revascularisation between the 2 methods. METHODS: We performed a retrospective cohort study of all isolated CABG at our institution from 2001 to 2015...
October 25, 2016: Circulation
https://www.readbyqxmd.com/read/27773575/efficacy-of-a-newly-modified-technique-for-distal-limited-open-stenting-in-octogenarians-with-aortic-arch-aneurysm
#17
Mitsumasa Hata, Yukihiko Orime, Shinji Wakui, Tetsuya Nakamura, Rei Hinoura, Atsushi Harada, Kenji Akiyama
OBJECTIVE: We assessed the efficacy of distal limited open stenting procedure in octogenarians with distal aortic arch aneurysm. METHODS: During the last 5 years, 24 patients underwent distal limited open stenting. Mean patient age was 81.6 ± 2.5 years, ranging from 80 to 90 years. The hemicircumference of the anterior surface of the arch around the left common carotid artery was obliquely incised, and a J-Graft Open Stent (Japan Lifeline Co, Ltd, Tokyo, Japan) was inserted into the descending aorta...
September 24, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27771985/five-year-outcomes-after-off-pump-or-on-pump-coronary-artery-bypass-grafting
#18
André Lamy, P J Devereaux, Dorairaj Prabhakaran, David P Taggart, Shengshou Hu, Zbynek Straka, Leopoldo S Piegas, Alvaro Avezum, Ahmet R Akar, Fernando Lanas Zanetti, Anil R Jain, Nicolas Noiseux, Chandrasekar Padmanabhan, Juan-Carlos Bahamondes, Richard J Novick, Liang Tao, Pablo A Olavegogeascoechea, Balram Airan, Toomas-Andres Sulling, Richard P Whitlock, Yongning Ou, Peggy Gao, Shirley Pettit, Salim Yusuf
Background We previously reported that there was no significant difference at 30 days or at 1 year in the rate of the composite outcome of death, stroke, myocardial infarction, or renal failure between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report the results at 5 years (the end of the trial). Methods A total of 4752 patients (from 19 countries) who had coronary artery disease were randomly assigned to undergo off-pump or on-pump CABG...
October 23, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27771273/in-hospital-and-long-term-mortality-in-35-173-chinese-patients-undergoing-coronary-artery-bypass-grafting-in-beijing-impact-of-sex-age-myocardial-infarction-and-cardiopulmonary-bypass
#19
Jiayang Wang, Wenyuan Yu, Dong Zhao, Nan Liu, Yang Yu
OBJECTIVE: The purpose of this study was to investigate the independent risk factors for mortality, the correlation between female sex and mortality, and the effects of cardiopulmonary bypass on prognosis in Chinese patients undergoing coronary artery bypass grafting (CABG). SETTING: A retrospective, observational study. PARTICIPANTS: The study included 26,926 (76.6%) men and 8,247 (23.4%) women. INTERVENTIONS: Patients undergoing isolated CABG were included in this study...
August 4, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27734482/a-randomised-controlled-trial-comparing-the-effects-of-propofol-with-isoflurane-in-patients-with-diastolic-dysfunction-undergoing-coronary-artery-bypass-graft-surgery
#20
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
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