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Coronary artery bypass grafting

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https://www.readbyqxmd.com/read/28817444/strategies-for-reducing-population-surgical-costs-in-medicare-local-referrals-to-low-cost-hospitals
#1
Hari Nathan, Jyothi R Thumma, Edward C Norton, Justin B Dimick
OBJECTIVE: We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. SUMMARY BACKGROUND DATA: Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied. METHODS: Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010-2012...
August 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28816833/perioperative-use-of-erythromycin-reduces-cognitive-decline-after-coronary-artery-bypass-grafting-surgery-a-pilot-study
#2
Evanthia Thomaidou, Helena Argiriadou, Georgios Vretzakis, Kalliopi Megari, Nikolaos Taskos, Georgios Chatzigeorgiou, Kyriakos Anastasiadis
OBJECTIVES: Adverse neurologic outcome can be a debilitating complication after cardiac surgery. The aim of this study was to investigate the potential neuroprotective action of erythromycin, a well known antibiotic agent, regarding postoperative cognitive decline in patients undergoing cardiac surgery. METHODS: Forty patients scheduled for elective coronary artery bypass grafting surgery were prospectively randomly assigned in 2 groups: the erythromycin group (n = 19) who received erythromycin at a dose of 25 mg/kg before and after surgery and the control group (n = 21) who did not receive it...
August 14, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28816101/measurement-of-total-hemoglobin-reduces-red-cell-transfusion-in-hospitalized-patients-undergoing-cardiac-surgery-a-retrospective-database-analysis
#3
Christopher Craver, Kathy W Belk, Gerard J Myers
INTRODUCTION: Historically, perioperative hemoglobin monitoring has relied on calculated saturation, using blood gas devices that measure plasma hematocrit (Hct). Co-oximetry, which measures total hemoglobin (tHb), yields a more comprehensive assessment of hemodilution. The purpose of this study was to examine the association of tHb measurement by co-oximetry and Hct, using conductivity with red blood cell (RBC) transfusion, length of stay (LOS) and inpatient costs in patients having major cardiac surgery...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28813218/five-year-outcomes-after-on-pump-and-off-pump-coronary-artery-bypass
#4
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/28807577/a-comparison-of-inflammatory-responses-between-robotically-enhanced-coronary-artery-bypass-grafting-and-conventional-coronary-artery-bypass-grafting-implications-for-hybrid-revascularization
#5
Galina Leyvi, Kumar Vivek, Sankalp Sehgal, Adrienne Warrick, Kea Alexa Moncada, Nancy Shilian, Jonathan D Leff, Robert E Michler, Joseph J DeRose
OBJECTIVE: The inflammatory response elicited by robotically enhanced coronary artery bypass grafting (r-CABG) has not been well described. When r-CABG is performed as part of hybrid coronary revascularization, the inflammatory milieu and the timing of percutaneous coronary intervention may affect the stent patency negatively in the short and long term. The goal of this study was to describe the extent and time course of cytokine release after r-CABG compared with conventional CABG (c-CABG) and to elucidate the optimal timing for r-CABG in the setting of hybrid coronary revascularization for a future study...
April 26, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28807552/assessment-of-deformation-of-the-mitral-valve-complex-during-off-pump-coronary-artery-bypass-surgery-using-three-dimensional-echocardiography-in-a-porcine-model
#6
Takashi Igarashi, Masumi Iwai-Takano, Hiroki Wakamatsu, Mineyuki Haruta, Sadao Omata, Hitoshi Yokoyama
BACKGROUND: This study aimed to assess the deformation of the mitral valve complex during the displacement of the beating heart by using three-dimensional echocardiography in a porcine off-pump coronary artery bypass grafting (OPCAB) model. METHODS: In nine healthy swine, we positioned the beating heart as an OPCAB model, i.e. control, left anterior descending artery (LAD), right coronary artery (RCA), and left circumflex artery (LCX) positions. In each position, three-dimensional echocardiography was performed to assess the mitral valve complex with hemodynamic parameters...
August 11, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28806769/effects-of-statin-therapy-on-clinical-outcomes-after-acute-myocardial-infarction-in-patients-with-advanced-renal-dysfunction-a-propensity-score-matched-analysis
#7
Jin Sug Kim, Weon Kim, Ji Yoon Park, Jong Shin Woo, Tae Won Lee, Chun Gyoo Ihm, Yang Gyun Kim, Ju-Young Moon, Sang Ho Lee, Myung Ho Jeong, Kyung Hwan Jeong
OBJECTIVE: Lipid lowering therapy is widely used for the prevention of cardiovascular complications after acute myocardial infarction (AMI). However, some studies show that this benefit is uncertain in patients with renal dysfunction, and the role of statins is based on the severity of renal dysfunction. In this study, we investigated the impact of statin therapy on major adverse cardiac events (MACEs) and all-cause mortality in patients with advanced renal dysfunction undergoing percutaneous coronary intervention (PCI) after AMI...
2017: PloS One
https://www.readbyqxmd.com/read/28806185/graft-quality-verification-in-coronary-artery-bypass-graft-surgery-how-when-and-why
#8
Teresa M Kieser
PURPOSE OF REVIEW: The coronary artery bypass graft (CABG) operation is one of the few remaining operations/interventions on diseased arteries that are not routinely verified during or immediately after the procedure. This review answers the 'how', 'when' and 'why' of intraoperative CABG assessment. RECENT FINDINGS: More recent than new literature on this topic, is the increased interest in quality assurance of CABG. This is most likely due to reports in the last 5 years suggesting CABG superiority to percutaneous coronary intervention (PCI) for improved mid-term and long-term outcomes; for example, for patients with diabetes mellitus (Freedom Trial by Farkouh in 2012), and for patients with SYNTAX score ≥ 33 (SYNTAX Trial by Mohr in 2013)...
August 12, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28805755/-an-analysis-of-postoperative-cognitive-dysfunction-in-different-methods-of-coronary-artery-bypass
#9
G Yu Alekseevich, M V Rodikov, A V Marchenko, P A Myalyuk, G V Alekseevich
AIM: To evaluate changes in cognitive functions in patients with coronary heart disease before and after coronary artery bypass grafting (CABG) in a planned manner. MATERIAL AND METHODS: The study included 192 patients divided into 3 groups: in group 1 patients (n=88) underwent standard CABG; in group 2 (n=61) different methods of CABG were used; a control group consisted of 43 people. MMSE, FAB, Clock drawing test, Shultz tables, semantic verbal fluency, Wechsler adult intelligence scale were used for neurological testing...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28805455/the-effect-of-a-peer-support-intervention-on-early-recovery-outcomes-in-men-recovering-from-coronary-bypass-surgery-a-randomized-controlled-trial
#10
Tracey Jf Colella, Kathryn King-Shier
BACKGROUND AND AIM: Examine the effect of a professionally-guided telephone peer support intervention on recovery outcomes including depression, perceived social support, and health services utilization after coronary artery bypass graft surgery (CABG). METHODS: A randomized controlled trial was conducted with post-coronary artery bypass graft surgery men ( N=185) who were randomized before hospital discharge. The intervention arm received telephone-based peer support through weekly telephone calls from a peer volunteer over six weeks, initiated within 3-4 days of discharge...
August 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28805102/favourable-long-term-outcome-after-coronary-artery-bypass-grafting-in-a-nationwide-cohort
#11
Hera Johannesdottir, Linda O Arnadottir, Jonas A Adalsteinsson, Tomas A Axelsson, Martin I Sigurdsson, Solveig Helgadottir, Dadi Helgason, Helga R Gardarsdottir, Steinthor A Marteinsson, Arnar Geirsson, Gudmundur Thorgeirsson, Tomas Gudbjartsson
OBJECTIVES: In a nationwide cohort, we analyzed long-term outcome following coronary artery bypass grafting, using the combined strategy of left internal mammary artery to the left anterior descending artery and saphenous vein as secondary graft to other coronary targets. METHODS: 1,507 consecutive patients that underwent myocardial revascularization during 2001-2012 in Iceland. Mean follow-up was 6.8 years. Major adverse cardiac and cerebrovascular events were depicted using the Kaplan-Meier method...
August 13, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28805032/improving-outcomes-after-cabg-and-pci
#12
EDITORIAL
Robert D Safian
Within 1 year of coronary artery bypass surgery , 64% of percutaneous coronary interventions were performed for graft failure and 36% for native vessel disease. Predictors of graft failure were small diameter of the graft and native vessel, poor distal run-off, and disease distal to the graft. In the near future, cardiac computed tomography angiography (CCTA) and fractional flow reserve by CT (FFRct) will incorporate accurate determination of coronary anatomy and the presence and extent of myocardial ischemia...
August 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28804239/iatrogenic-great-cardiac-vein-anastomosis-during-coronary-artery-bypass-surgery
#13
Alireza Bagherli, Hilary Bews, Minh Vo, John Ducas, Davinder S Jassal, Amir Ravandi
Inadvertent anastomosis of the left internal mammary artery (LIMA) or a saphenous vein graft (SVG) to the great cardiac vein (GCV) is a rare complication of coronary artery bypass grafting (CABG). We present two cases with a LIMA to GCV and a SVG to GCV anastomosis, respectively, resulting in angina and dyspnea in the postoperative state. As an alternative to repeat CABG, both patients underwent percutaneous coronary intervention with percutaneous coil embolization or implantation of an Amplatzer vascular plug within the bypass graft to GCV conduit...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28804238/percutaneous-closure-of-the-aorto-ostial-origin-of-a-coronary-artery-saphenous-bypass-graft-with-a-large-pseudoaneurysm-using-the-amplatzer-muscular-ventricular-septal-defect-occluder
#14
Nicolas W Shammas, Majid Z Chammas, Jon Robken, Dale Geiss
We report the case of a 76-year-old male patient with a history of coronary artery bypass graft surgery presented with a large pseudoaneurysm emerging from a previously occluded saphenous bypass graft (SVG). A largely contained hematoma is seen in the mediastinum on computed tomography angiography (CTA) of the chest. Flow was seen from the ascending aorta into the pseudoaneurysm through the aorto-ostial opening of the bypass graft. Closure of the aorto-ostial origin of the graft was performed using the AMPLATZER muscular ventricular septal defect (VSD) occluder (St Jude's Medical, St...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28804232/acute-beneficial-effects-of-muscular-counterpulsation-in-patients-with-coronary-heart-diseases
#15
Larry V Lapanashvili, Michael D Alshibaya, Julia Veselova, Leo A Bockeria
This prospective pilot study was designed to investigate the acute hemodynamic effects and clinical applicability of muscular counterpulsation (MCP), a one-shot procedure for biomechanical circulatory support. The study included 17 consecutive patients with coronary artery disease (CAD) and impaired ejection fraction (EF ≤45%) who underwent elective coronary artery bypass grafting (CABG). Patients were divided into control ( n  = 7) and treatment ( n  = 10) groups. MCP was applied through adhesive skin electrodes to the thighs and calves with a battery-powered, portable, ECG-triggered device for 15 minutes prior to general anesthesia...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28802789/cytochrome-c-in-patients-undergoing-coronary-artery-bypass-grafting-a-post-hoc-analysis-of-a-randomized-trial
#16
Lars W Andersen, Xiaowen Liu, Sophia Montissol, Mathias J Holmberg, Bjørn K Fabian-Jessing, Michael W Donnino
PURPOSE: To establish whether plasma cytochrome c is detectable in patients undergoing cardiac surgery, whether cytochrome c levels are associated with lactate/inflammatory markers/cellular oxygen consumption, and whether cytochrome c levels are associated with clinical outcomes. MATERIALS AND METHODS: This was an observational sub-study of a randomized trial comparing thiamine to placebo in patients undergoing coronary artery bypass grafting. Patients had blood drawn before, after, and again 6h after surgery...
August 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28802735/incidence-of-cardiovascular-events-and-vascular-interventions-in-patients-with-type-2-diabetes
#17
Suzanne E Engelen, Yolanda van der Graaf, Manon C Stam-Slob, Diederick E Grobbee, Maarten J Cramer, L Jaap Kappelle, Gert J de Borst, Frank L J Visseren, Jan Westerink
OBJECTIVE: Diabetes mellitus is associated with an increased risk for cardiovascular morbidity and mortality. The vascular burden in terms of incidence of cardiovascular events (CVE) and vascular interventions is however poorly quantified. In this study we evaluated the incidence rates of CVE and vascular interventions in patients with type 2 diabetes (T2DM) with and without cardiovascular disease (CVD) in comparison to patients without type 2 diabetes. RESEARCH DESIGN AND METHODS: In a cohort of 9...
July 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28802533/bifurcation-culprit-lesions-in-st-segment-elevation-myocardial-infarction-procedural-success-and-5-year-outcome-compared-with-nonbifurcation-lesions
#18
Pablo Salinas, Hernán Mejía-Rentería, Raúl Herrera-Nogueira, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Iván Javier Núñez-Gil, Nieves Gonzalo, María Del Trigo, María José Pérez-Vizcayno, Alicia Quirós, Javier Escaned, Carlos Macaya, Antonio Fernández-Ortiz
INTRODUCTION AND OBJECTIVES: We assessed short- and long-term outcomes of primary angioplasty in ST-segment elevation myocardial infarction by comparing bifurcation culprit lesions (BCL) with non-BCL. METHODS: Observational study with a propensity score matched control group. Among 2746 consecutive ST-segment elevation myocardial infarction patients, we found 274 (10%) patients with BCL. The primary outcome was a composite endpoint including all-cause death, myocardial infarction, coronary artery bypass grafting or target vessel revascularization, assessed at 30-days and 5-years...
August 9, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28800983/gastrointestinal-complications-after-cardiac-surgery-a-nationwide-population-based-analysis-of-morbidity-and-mortality-predictors
#19
Rabail Chaudhry, John Zaki, Robert Wegner, Greesha Pednekar, Alex Tse, Roy Sheinbaum, George W Williams
OBJECTIVE: The authors aimed to evaluate the incidence, risk factors, and outcomes of gastrointestinal (GI) complications in cardiac and aortic surgery using recent versions of the National (Nationwide) Inpatient Sample (NIS) to provide clinicians with a better understanding of these uncommon but potentially serious complications. DESIGN: Population-based study. SETTING: NIS database 2010-2012. PARTICIPANTS: Patients undergoing cardiac and aortic aneurysm repair surgeries...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28799701/drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease
#20
Hisato Takagi, Tomo Ando, Takuya Umemoto
OBJECTIVES: To compare follow-up outcomes after percutaneous coronary intervention with drug-eluting stents (DES-PCI) versus coronary artery bypass grafting (CABG) for left-main coronary artery disease (LMCAD), we performed a meta-analysis of randomized controlled trials (RCTs) and observational studies with propensity-score analysis. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through November 2016. Eligible studies were RCTs or observational studies with propensity-score analysis of DES-PCI versus CABG enrolling patients with LMCAD and reporting ≥ 6-month mortality, myocardial infarction (MI), stroke, or repeat revascularization (RRV)...
August 11, 2017: Catheterization and Cardiovascular Interventions
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