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Cardiopulmonary bypass grafting

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https://www.readbyqxmd.com/read/28813218/five-year-outcomes-after-on-pump-and-off-pump-coronary-artery-bypass
#1
A Laurie Shroyer, Brack Hattler, Todd H Wagner, Joseph F Collins, Janet H Baltz, Jacquelyn A Quin, G Hossein Almassi, Elizabeth Kozora, Faisal Bakaeen, Joseph C Cleveland, Muath Bishawi, Frederick L Grover
Background Coronary-artery bypass grafting (CABG) surgery may be performed either with cardiopulmonary bypass (on pump) or without cardiopulmonary bypass (off pump). We report the 5-year clinical outcomes in patients who had been included in the Veterans Affairs trial of on-pump versus off-pump CABG. Methods From February 2002 through June 2007, we randomly assigned 2203 patients at 18 medical centers to undergo either on-pump or off-pump CABG, with 1-year assessments completed by May 2008. The two primary 5-year outcomes were death from any cause and a composite outcome of major adverse cardiovascular events, defined as death from any cause, repeat revascularization (CABG or percutaneous coronary intervention), or nonfatal myocardial infarction...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28777131/robotic-versus-conventional-coronary-artery-bypass-grafting-direct-comparison-of-long-term-clinical-outcome
#2
Markus Kofler, Lukas Stastny, Sebastian Johannes Reinstadler, Julia Dumfarth, Juliane Kilo, Guy Friedrich, Thomas Schachner, Michael Grimm, Johannes Bonatti, Nikolaos Bonaros
OBJECTIVE: Robotic coronary artery bypass grafting (CABG) was shown to be a safe and feasible method for the treatment of coronary artery disease in highly selected patients. However, long-term outcome data comparing robotic CABG with conventional CABG are still missing. Therefore, we aimed to compare robotic with conventional CABG in terms of perioperative and long-term outcomes. METHODS: Of 2947 consecutive elective patients with coronary artery disease operated at a single center between 2001 and 2013, 280 underwent robotic CABG...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28741663/carbon-dioxide-flush-of-an-integrated-minimized-perfusion-circuit-prior-to-priming-prevents-spontaneous-air-release-into-the-arterial-line-during-clinical-use
#3
Marco C Stehouwer, Roel de Vroege, Gerard J F Hoohenkerk, Frederik N Hofman, Johannes C Kelder, Bas Buchner, Bastian A de Mol, Peter Bruins
Recently, an oxygenator with an integrated centrifugal blood pump (IP) was designed to minimize priming volume and to reduce blood foreign surface contact even further. The use of this oxygenator with or without integrated arterial filter was compared with a conventional oxygenator and nonintegrated centrifugal pump. To compare the air removal characteristics 60 patients undergoing coronary artery bypass grafting were alternately assigned into one of three groups to be perfused with a minimized extracorporeal circuit either with the conventional oxygenator, the oxygenator with IP, or the oxygenator with IP plus integrated arterial filter (IAF)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28741335/cardiopulmonary-bypass-time-every-minute-counts
#4
Sudharsan Madhavan, Siew-Pang Chan, Wei-Chuan Tan, Jolane Eng, Bowen Li, Hai-Dong Luo, Leok-Kheng K Teoh
BACKGROUND: This study was conducted to examine the impact of CPB times on post-operative outcomes. We sought to determine the optimum cut-offs of CPB per graft time and cumulative CPB time and their predictive accuracy for mortality in conjunction with EuroSCORE II. METHODS: The de-identified data of 1,960 patients who had undergone isolated on-pump CABG from 2009 to 2014 were analyzed. The risk strata of CPB/graft and cumulative CPB times, identified with a decision tree, were added into an augmented model for predicting short- and intermediate-term post-operative clinical events...
July 24, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#5
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740708/staged-percutaneous-coronary-intervention-followed-by-minimally-invasive-mitral-valve-surgery-versus-combined-coronary-artery-bypass-graft-and-mitral-valve-surgery-for-two-vessel-coronary-artery-disease-and-moderate-to-severe-ischemic-mitral-regurgitation
#6
Christos G Mihos, Steve Xydas, Roy F Williams, Andrés M Pineda, Evin Yucel, Hector Davila, Nirat Beohar, Orlando Santana
BACKGROUND: The optimal treatment for concomitant two-vessel coronary artery disease (CAD) and moderate to severe ischemic mitral regurgitation (IMR) remains unclear. We compared the results of a staged percutaneous coronary intervention followed by minimally invasive mitral valve surgery (PCI+MIVS) versus combined coronary artery bypass graft and mitral valve surgery (CABG+MVS) in this population. METHODS: All consecutive patients with two-vessel CAD and moderate to severe IMR, who underwent PCI+MIVS or CABG+MVS at our institution between February 2009 and April 2014, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28719755/clinical-risk-factors-and-prognostic-model-for-primary-graft-dysfunction-after-lung-transplantation-in-patients-with-pulmonary-hypertension
#7
Mary K Porteous, James C Lee, David J Lederer, Scott M Palmer, Edward Cantu, Rupal J Shah, Scarlett L Bellamy, Vibha N Lama, Sangeeta M Bhorade, Maria M Crespo, John F McDyer, Keith M Wille, A Russell Localio, Jonathan B Orens, Pali D Shah, Ann B Weinacker, Selim Arcasoy, David S Wilkes, Lorraine B Ware, Jason D Christie, Steven M Kawut, Joshua M Diamond
RATIONALE: Pulmonary hypertension from pulmonary arterial hypertension or parenchymal lung disease is associated with an increased risk of primary graft dysfunction after lung transplantation. OBJECTIVE: We evaluated the clinical determinants of severe primary graft dysfunction in pulmonary hypertension and developed and validated a prognostic model. METHODS: We conducted a retrospective cohort study of patients in the multi-center Lung Transplant Outcomes Group with pulmonary hypertension at transplant listing...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28718100/risk-factors-for-delirium-after-cardiac-surgery-a-historical-cohort-study-outlining-the-influence-of-cardiopulmonary-bypass
#8
Jason B O'Neal, Frederic T Billings, Xulei Liu, Matthew S Shotwell, Yafen Liang, Ashish S Shah, Jesse M Ehrenfeld, Jonathan P Wanderer, Andrew D Shaw
PURPOSE: Cardiopulmonary bypass (CPB) induces a significant inflammatory response that may increase the risk for delirium. We hypothesized that exposure to CPB during coronary artery bypass grafting (CABG) surgery would correlate with an increased risk of delirium. METHODS: We reviewed clinical data from two databases at our medical centre - the Cardiac Surgery Perioperative Outcomes Database and the Society of Thoracic Surgeons Database. Patients undergoing elective CABG surgery (on-pump and off-pump) from November 1, 2009 to September 30, 2015 were included in the study...
July 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28712580/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#9
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
BACKGROUND: The del Nido cardioplegia (DC) procedure offers prolonged cardiac protection with single-dose administration and has proven safe in adult coronary artery bypass grafting (CABG) surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: Between August 2011 and May 2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n = 101) or DC (n = 77)...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28701609/a-rare-case-of-acyanotic-congenital-heart-disease-large-patent-ductus-arteriosus-with-pre-ductal-coarctation-of-descending-thoracic-aorta-with-patent-ductus-arteriosus-closure-and-extra-anatomical-bypass-grafting
#10
Zara Wani, Deepak Tiwari, Rajeev Gehlot, Deepak Kumar, Sushil Chhabra, Meenaxi Sharma
We report a case of 18-year-old female patient with large patent ductus arteriosus (PDA)-preductal coarctation of descending thoracic aorta. She underwent large PDA closure with a prosthetic graft from ascending aorta to descending thoracic aorta by mid-sternotomy on cardiopulmonary bypass machine under total hypothermic circulatory arrest.
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#11
G L Verbeek, P S Myles, G P Westall, E Lin, S L Hastings, S F Marasco, J Jaffar, A C Meehan
Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28660196/endovascular-repair-of-traumatic-isthmic-ruptures-special-concerns
#12
REVIEW
Nikolaos Patelis, Athanasios Katsargyris, Chris Klonaris
Injury of the aortic isthmus is the second most frequent cause of death in cases of blunt traumatic injury. Conventional open repair is related to significant morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) has increasing role in traumatic isthmic rupture, as it avoids the thoracotomy-related morbidity, aortic cross clamping, and cardiopulmonary bypass. Additionally to the technical difficulties of open repair, multi-trauma patients may not tolerate the manipulations necessary to undergo open surgery, due to concomitant injuries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28651740/impact-of-prior-coronary-stenting-on-the-outcome-of-subsequent-coronary-artery-bypass-grafting
#13
Yu-Ting Cheng, Shao-Wei Chen, Chih-Hsiang Chang, Pao-Hsien Chu, Dong-Yi Chen, Victor Chien-Chia Wu, Kuo-Sheng Liu, Yu-Yun Nan, Feng-Chun Tsai, Pyng-Jing Lin
BACKGROUND: The percentage of patients referred for coronary artery bypass grafting (CABG) who have previously undergone percutaneous coronary interventions (PCIs) is increasing. The purpose of this study was to review the outcomes of patients who had received coronary stenting before CABG, and to examine the validity of a mortality risk stratification system in this patient group. METHODS: From 2010 to 2012, 439 patients who underwent isolated CABG at our medical center were reviewed...
June 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28651228/ante-situm-liver-resection-with-inferior-vena-cava-replacement-under-hypothermic-cardiopolmunary-bypass-for-hepatoblastoma-report-of-a-case-and-review-of-the-literature
#14
Roberta Angelico, Annalisa Passariello, Michele Pilato, Tommaso Cozzolino, Marcello Piazza, Roberto Miraglia, Paolo D'Angelo, Mariella Capasso, Maria Cristina Saffioti, Daniele Alberti, Marco Spada
INTRODUCTION: Hepatoblastoma with tumour thrombi extending into inferior-vena-cava and right atrium are often unresectable with an extremely poor prognosis. The surgical approach is technically challenging and might require major liver resection with vascular reconstruction and extracorporeal circulation. However, which is the best surgical technique is yet unclear. PRESENTATION OF CASE: A 11-months-old boy was referred for a right hepatic lobe mass(90×78mm) suspicious of hepatoblastoma with tumoral thrombi extending into the inferior-vena-cava and the right atrium, bilateral lung lesions and serum alpha-fetoprotein level of 50...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#15
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28634554/false-positive-transit-time-flowmetry-graft-failure-in-multivessel-coronary-spasm-following-off-pump-coronary-artery-bypass-grafting
#16
George Kassimis, George Krasopoulos
Intraoperative Transit Time Flowmetry is currently recommended to assess graft patency during coronary artery bypass grafting (CABG), especially in presence of haemodynamic instability or inability to wean the patient from cardiopulmonary bypass, new regional wall motion abnormalities, or significant ventricular arrhythmias. The VeriQ™ system is one of the currently available systems, which detects imperfections that may be corrected by graft revision. In this case report, multivessel coronary spasm (CS) post-CABG interferes with these intraoperative parameters misleading initially into false results...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#17
Philippa Jane Temple Bowers, Manu Narain Mathur
OBJECTIVES: Axillary artery cannulation has been used as an alternative site for cardiopulmonary bypass during surgery for aortic dissections and aneurysmal disease of the ascending aorta and arch. This study reports our experience with reusing the axillary artery for cardiopulmonary bypass during complex aortic and cardiac surgical procedures. METHODS: This was a retrospective review of a single surgeon's experience of recannulating the axillary artery for redo operations in complex aortic surgery...
July 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28612026/postoperative-compensatory-ammonium-excretion-subsequent-to-systemic-acidosis-in-cardiac-patients
#18
Friederike Roehrborn, Daniel-Sebastian Dohle, Indra N Waack, Konstantinos Tsagakis, Heinz Jakob, Johanna K Teloh
BACKGROUND: Postoperative acid-base imbalances, usually acidosis, frequently occur after cardiac surgery. In most cases, the human body, not suffering from any severe preexisting illnesses regarding lung, liver, and kidney, is capable of transient compensation and final correction. The aim of this study was to correlate the appearance of postoperatively occurring acidosis with renal ammonium excretion. MATERIALS AND METHODS: Between 07/2014 and 10/2014, a total of 25 consecutive patients scheduled for elective isolated coronary artery bypass grafting with cardiopulmonary bypass were enrolled in this prospective observational study...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28610886/conversion-from-off-pump-coronary-artery-bypass-grafting-to-on-pump-coronary-artery-bypass-grafting
#19
Brent Keeling, Vinod Thourani, Gorav Aliawadi, Sunghee Kim, Derek Cyr, Vinay Badhwar, Jeff Jacobs, J Matthew Brennan, James Meza, Roland Matsouaka, Michael E Halkos
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) has been shown to be an effective strategy for surgical revascularization. The purpose of this study was to define the incidence of intraoperative conversion from OPCAB to on-pump coronary artery bypass grafting (ONCAB) and report outcomes based on the reason for conversion. METHODS: Starting in July 2007, the Society of Thoracic Surgeons database captured patients that were planned OPCAB but then were converted to ONCAB...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28605930/central-retinal-vein-occlusion-after-coronary-artery-bypass-surgery-a-case-report
#20
Ufuk Ciloglu, Mustafa Aldag, Sebnem Albeyoglu, Veysel Aykut, Canan Karakaya, Burcu Gonul
OBJECTIVE: The aim of this study is to report a case of central retinal vein occlusion (CRVO) after coronary artery bypass graft (CABG) surgery. In this report, we present the third case in the literature with CRVO after cardiopulmonary bypass (CPB), and the first case after CABG. CASE REPORT: A 59-year-old male patient complaining of chest pain was admitted to our hospital. The patient underwent an elective coronary angiography and was diagnosed with three-vessel coronary artery disease...
May 2017: Acta Medica Academica
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