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Cardiopulmonary bypass grafting

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https://www.readbyqxmd.com/read/28332137/correction-of-dilutional-anemia-induces-renal-dysfunction-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-a-consequence-of-microcirculatory-alterations
#1
Güçlü Aykut, Meltem Kilercik, Cem Arıtürk, Halim Ulugöl, Uğur Aksu, Türkan Kudsioğlu, Nazan Atalan, Nihan Yapıcı, Hasan Karabulut, Fevzi Toraman
BACKGROUND: In this study we aimed to evaluate the effects of dilutional anemia resulting from cardiopulmonary bypass (CPB) and its correction with red blood cell (RBC) transfusion on tissue oxygenation and renal function in diabetic patients undergoing coronary artery bypass grafting (CABG). METHOD: 70 diabetic patients who underwent elective CABG and whose hematocrit values had been between 24-28% at any time during CBP were prospectively randomized and equally allocated to two groups: patients who received RBC during CPB (group I, n = 35) vs...
March 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28331446/lung-transplantation-and-the-routine-use-of-cardiopulmonary-bypass-and-median-sternotomy-experience-at-the-ochsner-multi-organ-transplant-institute
#2
Michael Bates, Matthew Factor, P Eugene Parrino, Aditya Bansal, Reinaldo Rampolla, Leonardo Seoane, Jose Mena, Matthew Gaudet, William Smith, P Michael McFadden
BACKGROUND: From 1990-2005 at Ochsner Medical Center in New Orleans, LA, cardiopulmonary bypass (CPB) was used only when necessary during lung transplantation surgeries. Ochsner's lung transplant program was closed for more than 4 years after Hurricane Katrina, and since the program's reestablishment in 2010, the majority of lung transplantation surgeries have been performed with the patient on CPB and with a median sternotomy incision. The purpose of this study was to compare the outcomes of the CPB and non-CPB groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28329189/mid-term-results-of-zone-0-thoracic-endovascular-aneurysm-repair-after-ascending-aorta-wrapping-and-supra-aortic-debranching-in-high-risk-patients
#3
Felice Pecoraro, Mario Lachat, Michael Hofmann, Neal S Cayne, Lyubov Chaykovska, Zoran Rancic, Gilbert Puippe, Thomas Pfammatter, Nicola Mangialardi, Frank J Veith, Dominique Bettex, Francesco Maisano, Thomas A Neff
OBJECTIVES: Surgical repair of aneurysmal disease involving the ascending aorta, aortic arch and eventually the descending aorta is generally associated with significant morbidity and mortality. A less invasive approach with the ascending wrapping technique (WT), supra-aortic vessel debranching (SADB) and thoracic endovascular aneurysm repair (TEVAR) in zone 0 was developed to reduce the associated risk in these patients. METHODS: During a 10-year period, consecutive patients treated by the ascending WT, SADB and TEVAR in zone 0 were included...
March 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28302346/postoperative-acute-kidney-injury-and-blood-product-transfusion-after-synthetic-colloid-use-during-cardiac-surgery
#4
Rajika Tobey, Hao Cheng, Mei Gao, Zhongmin Li, J Nilas Young, W Douglas Boyd, Fuhai Ji, Hong Liu
OBJECTIVES: This study assessed the effect of 2 types of hydroxyethyl starches (HES) on renal integrity and blood transfusion in cardiac surgery patients. DESIGN: Retrospective investigation. SETTING: Patients from a single tertiary medical center. PARTICIPANTS: Inclusion criteria included coronary artery bypass graft (CABG) and/or valve surgery that included cardiopulmonary bypass with aortic cross-clamping. INTERVENTIONS: Intraoperative HES and blood product administration...
December 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28301911/the-prevalence-and-clinical-relevance-of-asa-nonresponse-after-cardiac-surgery
#5
Saskia Wand, Elisabeth Hannah Adam, Anna Julienne Wetz, Patrick Meybohm, Nils Kunze-Szikszay, Kai Zacharowski, Aron Frederick Popov, Anton Moritz, Lisa Moldenhauer, Julia Kaiser, Martin Bauer, Christian Friedrich Weber
We aimed to identify the prevalence of acetylsalicylic acid (ASA) nonresponse in patients after coronary artery bypass graft (CABG) surgery and the possible consequences for the rate of major cardiovascular events. This prospective, observational, bicentric cohort study was conducted in two German University hospitals. A total of 400 patients (200 in each study center) undergoing elective CABG surgery were enrolled after written informed consent. Platelet function was analyzed on day 3 (d3) and day 5 (d5) postoperatively following stimulation with arachidonic acid (ASPItest) and with thrombin receptor-activating peptide 6 (TRAPtest) using multiple electrode aggregometry (Multiplate)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28290819/-volume-of-coronary-artery-bypass-surgery-and-risk-of-postoperative-atrial-fibrillation
#6
O A Rubanenko, O V Fatenkov, S M Khokhlunov, D V Duplyakov
PURPOSE: To identify prevalence of atrial fibrillation (AF) in dependence of volume of coronary artery bypass grafting (CABG) as assessed by the number of grafts. MATERIAL AND METHODS: The study included 431 patients with ischemic heart disease (IHD) who underwent CABG. Group 1 comprised patients with single-vessel bypass graft (n=47, 78.7% men, mean age 59.6+/-5.6 years), group 2 - with multivessel bypass grafts (n=384, 76.8% men, mean age 61.0+/-8,1 years). During the observation period postoperative AF developed in 3 patients (6...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290812/-transaortic-implantation-of-aortic-valve-bioprosthesis-in-high-risk-patient-with-simultaneous-off-pump-coronary-artery-bypass-grafting
#7
R S Akchurin, T J Imaev, A E Komlev, P M Lepilin, A S Kolegaev, M E Nikonova
Transaortic approach represents an alternative variant of transcatheter aortic valve implantation (TAVI) which combines benefits of antegrade transapical approach and high safety profile characteristic of transfemoral approach. This method has substantial advantages over subclavian and transapical approaches in cases of pronounced myocardial hypertrophy, left ventricular dysfunction, thinning of left ventricular wall. We describe here a hybrid intervention with simultaneous coronary artery bypass grafting and TAVI in a patient from high surgical risk group with multivessel coronary artery involvement and critical aortic stenosis...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28286090/surgical-revascularisation-in-the-early-phase-of-st-segment-elevation-myocardial-infarction-haemodynamic-status-is-more-important-than-the-timing-of-the-operation
#8
Vilem Rohn, Tomas Grus, Jan Belohlavek, Jan Horak
BACKGROUND: Surgical revascularisation in patients with acute myocardial infarction with ST-Segment Elevation (STEMI) is usually considered as a second choice when direct angioplasty/stent fails. However, improvements in surgical technique and postoperative care may justify coronary artery bypass grafting (CABG) in STEMI. METHODS: This was a retrospective analysis of prospectively gathered data of 135 patients with acute STEMI, treated with CABG in our department from February 2008 to December 2012...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28265218/minimally-invasive-lvad-deactivation-in-a-65-year-old-man-with-recurrent-pump-thrombosis-and-left-ventricular-recovery
#9
Akshay Pendyal, Christopher V Chien, James O Mudd, Jill M Gelow
Pump thrombosis is a dire sequela after left ventricular assist device (LVAD) implantation. Treatment comprises antiplatelet agents, anticoagulants, thrombolytic agents, and pump exchange. Although pump exchange is the definitive therapy, it is also the most invasive, often exposing patients to the risks of repeat sternotomy and cardiopulmonary bypass. In some cases, patients experience left ventricular recovery after LVAD implantation. The optimal strategy surrounding the management of LVADs in patients who have experienced ventricular recovery is unknown; techniques range from total system explantation to partial pump resection...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28263144/prediction-of-prolonged-ventilation-after-coronary-artery-bypass-grafting-data-from-an-artificial-neural-network
#10
Eric Stephen Wise, David P Stonko, Zachary A Glaser, Kelly L Garcia, Jennifer J Huang, Justine S Kim, Justiss A Kallos, Joseph R Starnes, Jacob W Fleming, Kyle M Hocking, Colleen M Brophy, Susan S Eagle
OBJECTIVES: The need for mechanical ventilation 24 hours after coronary artery bypass grafting (CABG) is considered a morbidity by the Society of Thoracic Surgeons. The purpose of this investigation was twofold: to identify simple preoperative patient factors independently associated with prolonged ventilation and to optimize prediction and early identification of patients prone to prolonged ventilation using an artificial neural network (ANN). METHODS: Using the institutional Adult Cardiac Database, 738 patients who underwent CABG since 2005 were reviewed for preoperative factors independently associated with prolonged postoperative ventilation...
February 24, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28262298/should-we-ablate-atrial-fibrillation-during-coronary-artery-bypass-grafting-and-aortic-valve-replacement
#11
Talal Al-Atassi, Donna-May Kimmaliardjuk, Camille Dagenais, Michael Bourke, Buu-Khanh Lam, Fraser D Rubens
BACKGROUND: This study evaluates the safety and efficacy of concomitant atrial fibrillation (AF) ablation in patients with AF undergoing coronary artery bypass grafting (CABG) or aortic valve replacement (AVR) or both. METHODS: This is a single-center retrospective study of patients with AF presenting for CABG or AVR or both between 2009 and 2013. They were divided into an ablation group that underwent concomitant AF ablation and a control group that did not. Follow-up data were obtained using telephone interviews...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28252540/retrograde-extrusion-of-coronary-thrombus-during-urgent-aortocoronary-bypass-surgery-a-case-report
#12
Glenio B Mizubuti, Yuri Koumpan, G Andrew Hamilton, Rachel Phelan, Anthony M H Ho, Robert C Tanzola, Louie T S Wang
A 73-year-old man underwent urgent coronary artery bypass grafting after an acute myocardial infarction. An angiogram had revealed multivessel disease with a circumflex artery lesion suspected as the primary culprit. On separation from cardiopulmonary bypass, transesophageal echocardiography revealed a new mobile mass in the aortic root. Cardiopulmonary bypass was reinstituted and a large thrombus emanating from the left coronary ostium was surgically removed. We hypothesize that the thrombus had originated from coronary retrograde extrusion during venous grafting...
March 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28221206/significance-of-new-q-waves-and-their-location-in-postoperative-ecgs-after-elective-on-pump-cardiac-surgery-an-observational-cohort-study
#14
Eckhard Mauermann, Daniel Bolliger, Jens Fassl, Martin Grapow, Esther E Seeberger, Manfred D Seeberger, Miodrag Filipovic, Giovanna A L L Buse
BACKGROUND: The clinical significance of new pathological Q waves after on-pump cardiac surgery is uncertain. OBJECTIVES: To determine whether or not either the occurrence per se or the location of new pathological Q waves after on-pump cardiac surgery is associated with 12-month, all-cause mortality and/or major adverse cardiac events (MACEs). DESIGN: Observational cohort study. SETTING: Single university hospital from January 2007 to October 2010...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28219577/method-of-hemorrhage-control-from-the-aorta-after-repair-of-a-dissected-aortic-aneurysm
#15
Joseph Galea, Alexander Manché
Patients with Marfan syndrome and presenting with acute aortic dissection have fragile aorta, causing bleeding problems in the anastomosis between the graft and the aorta. Hemostatic impairment following circulatory arrest and prolonged cardiopulmonary bypass contribute to these problems. We describe a technique to control persistent bleeding from the anastomosis in the aortopulmonary recess using two kissing inflated balloons at the tip of two Foley catheters to tamponade the bleeding sites.
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28219560/a-novel-approach-to-essential-thrombocythemia-and-cardiac-surgery
#16
Bradford B Smith, Gregory A Nuttall, Rajiv K Pruthi, David L Joyce, Matthew S Schuldes, Mark M Smith
Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by persistent thrombocytosis (>450 × 10(9)/L). Patients with ET are at risk for thrombotic or hemorrhagic complications especially during cardiovascular operations. We discuss a patient with ET requiring coronary artery bypass grafting with a presenting platelet count of 1631 × 10(9)/L. Platelet reduction with an intraoperative autologous transfusion technique decreased the platelet count to 758 × 10(9)/L before initiation of cardiopulmonary bypass...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28197291/postoperative-right-ventricular-failure-in-cardiac-surgery
#17
REVIEW
Victor H Nieto Estrada, Daniel L Molano Franco, Albert A Valencia Moreno, Jose A Rojas Gambasica, Cristian C Cortes Nunez
Two cases of patients that developed right ventricular failure (RVF) after cardiac valve surgery are presented with a narrative revision of the literature. RVF involves a great challenge due to the severity of this condition; it has a low incidence among non-congenital cardiac surgery patients, is more likely associated with cardiovascular and pulmonary complications related to cardiopulmonary bypass (CPB), and is a cause of acute graft failure and of a higher early mortality in cardiac transplant. The morphologic and hemodynamic characteristics of the right ventricle and some specific factors that breed pulmonary hypertension after cardiac surgery are in favor of the onset of RVF...
December 2016: Cardiology Research
https://www.readbyqxmd.com/read/28195969/acute-mesenteric-ischemia-among-postcardiac-surgery-patients-presenting-with-multiple-organ-failure
#18
Alexis Guillaume, Sébastien Pili-Floury, Sidney Chocron, Eric Delabrousse, Bénédicte De Parseval, Stephane Koch, Emmanuel Samain, Gilles Capellier, Gaël Piton
BACKGROUND: Acute mesenteric ischemia (AMI) is a rare but severe complication after cardiac surgery. However, AMI is likely to be more frequent in the subgroup of patients presenting with multiple organ failure after a cardiac surgery. The primary objective of this study was to identify AMI risk factors among patients requiring intensive care unit (ICU) admission after cardiac surgery. METHODS: Retrospective observational study of all the patients requiring admission to two ICUs in a large university hospital after a cardiac surgery procedure...
March 2017: Shock
https://www.readbyqxmd.com/read/28193536/blood-brain-barrier-disruption-after-cardiopulmonary-bypass-diagnosis-and-correlation-to-cognition
#19
Dan Abrahamov, Oren Levran, Sharon Naparstek, Yael Refaeli, Shani Kaptson, Mahmud Abu Salah, Yaron Ishai, Gideon Sahar
BACKGROUND: Cardiopulmonary bypass (CPB) elicits a systemic inflammatory response that may impair blood-brain barrier (BBB) integrity. BBB disruption can currently be detected by dynamic contrast enhancement magnetic resonance imaging (MRI), reflected by an increase in the permeability constant (K(trans)). We aimed to determine (1) whether CPB induces BBB disruption, (2) duration until BBB disruption resolution, and (3) the obtainable correlation between BBB injury (location and intensity) and neurocognitive dysfunction...
February 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28149590/one-stage-hybrid-surgery-for-acute-stanford-type-a-aortic-dissection-with-david-operation-aortic-arch-debranching-and-endovascular-graft-a-case-report
#20
Lulu Liu, Chaoyi Qin, Jianglong Hou, Da Zhu, Bengui Zhang, Hao Ma, Yingqiang Guo
Acute Stanford type A aortic dissection requires an extremely complex surgical strategy and presents high risk of complications. Although many different procedures were reported to treat this aortic dissection, high mortality rate and incidences of complications still exist. This study presents a 59-year-old lady with acute Stanford type A aortic dissection, which originated from the aortic root to proximal part of right external iliac artery and involved the brachiocephalic trunk, left carotid artery, celiac trunk, and left renal artery...
December 2016: Journal of Thoracic Disease
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