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https://www.readbyqxmd.com/read/29780070/chronic-obstructive-pulmonary-disease-and-off-pump-coronary-surgery
#1
Cengiz Ovalı, Aykut Şahin
PURPOSE: To determine to what extent chronic obstructive pulmonary disease (COPD) affects mortality and morbidity rates in patients treated with off-pump coronary artery bypass graft (CABG). METHODS: A total of 321 patients treated with off-pump CABG were included in the present study. Of the 321 patients, 46 patients had COPD and they were designated as Group 1 and the remaining 275 patients did not have COPD and they were considered as Group 2. We compared the data obtained from the patients in both groups...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29764035/-relationship-between-hyperuricemia-and-prognosis-in-patients-with-heart-failure-of-coronary-heart-disease-after-revascularization
#2
D Peng, S P Wang, D H Zhao, Q C Fan, J Shu, J H Liu
Objective: To explore the effect of hyperuricemia on prognosis in patients with heart failure of coronary heart disease (CHD) after revascularization. Methods: A single-center retrospective study of all subjects who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) as revascularization for CHD at Beijing Anzhen Hospital, Capital Medical University, between January 2005 and December 2014 was performed.Patients were divided into two groups by with or without hyperuricemia...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#3
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29758209/bilateral-internal-mammary-artery-utilization-in-diabetics-friend-or-foe
#4
Todd C Crawford, Xun Zhou, Charles D Fraser, J Trent Magruder, Alejandro Suarez-Pierre, Diane Alejo, Jennifer Bobbitt, Clifford E Fonner, Kurt Wehberg, Brad Taylor, Christopher Kwon, Michael Fiocco, John V Conte, Rawn Salenger, Glenn J Whitman
BACKGROUND: Bilateral internal mammary artery (BIMA) grafting in diabetic patients undergoing coronary artery bypass grafting (CABG) remains controversial. Our study compared morbidity and mortality between 1)diabetic and non-diabetic BIMA patients and 2)diabetic BIMA versus diabetic patients who underwent left internal mammary artery (LIMA) grafting only. METHODS: Patients who underwent isolated CABG from July 2011 - June 2016 at any of the 10 centers in Maryland were propensity scored across 16 variables...
May 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29753665/off-pump-versus-on-pump-coronary-artery-bypass-grafting-a-systematic-review-and-analysis-of-clinical-outcomes
#5
REVIEW
Shahzad Shaefi, Aaron Mittel, Dan Loberman, Harish Ramakrishna
Surgical coronary artery bypass grafting (CABG) is the standard of care for revascularization of left main or three-vessel coronary artery disease. The off-pump coronary artery bypass graft (OPCAB) procedure avoids the use of cardiopulmonary bypass. Theoretically, OPCAB may improve long-term outcomes by reducing the rates of perioperative myocardial injury, stroke, neurocognitive impairment, and cardiac-related mortality. Several high-quality clinical trials have been conducted since OPCAB became popular in the 1990s and have demonstrated no benefit of OPCAB over traditional CABG with respect to these outcomes despite favorable short-term reductions in transfusion requirements and other postoperative complications...
April 4, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29750254/clinical-significance-of-atrial-kick
#6
Vinod Namana, Sushilkumar Satish Gupta, Nitin Sabharwal, Gerald Hollander
A 68-year-old man with a history of diabetes mellitus type II, hypertension and active smoking was transferred to our hospital from a nearby hospital for coronary artery bypass graft (CABG) surgery after suffering a complicated inferior wall myocardial infarction (IWMI). Post the initial angioplasty, the patient developed in-stent thrombosis and became hypotensive with a systolic blood pressure < 90 mmHg. After hemodynamic stability was achieved he was transferred to our hospital. During his stay, the cardiac monitor showed fluctuations in his blood pressure with a drop in systolic blood pressure by 10 to 15 mmHg and diastolic blood pressure by 10 mmHg when he developed atrioventricular (AV) dissociation during an idioventricular rhythm...
May 10, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29733924/thirteen-year-experience-with-universal-staphylococcus-aureus-nasal-decolonisation-prior-to-cardiac-surgery-a-quasi-experimental-study
#7
Adrien Lemaignen, Laurence Armand-Lefevre, Gabriel Birgand, Guillaume Mabileau, Isabelle Lolom, Walid Ghodbane, Pierre Dilly Marie, Patrick Nataf, Jean-Christophe Lucet
INTRODUCTION: Sternal wound infection (SWI) after cardiac surgery is a severe complication. Among preventive measures, pre-operative decolonisation of nasal carriage of Staphylococcus aureus has recently been shown to be beneficial. In this quasi-experimental study, we assessed the effect of decolonisation on the incidence of S. aureus-associated SWI during 19-year prospective surveillance. METHODS: We analysed by segmented negative binomial regression the change over time of the incidence of S...
May 4, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29730991/feasibility-of-cardiovascular-magnetic-resonance-to-detect-oxygenation-deficits-in-patients-with-multi-vessel-coronary-artery-disease-triggered-by-breathing-maneuvers
#8
Kady Fischer, Kyohei Yamaji, Silvia Luescher, Yasushi Ueki, Bernd Jung, Hendrik von Tengg-Kobligk, Stephan Windecker, Matthias G Friedrich, Balthasar Eberle, Dominik P Guensch
BACKGROUND: Hyperventilation with a subsequent breath-hold has been successfully used as a non-pharmacological vasoactive stimulus to induce changes in myocardial oxygenation. The purpose of this pilot study was to assess if this maneuver is feasible in patients with multi-vessel coronary artery disease (CAD), and if it is effective at detecting coronary artery stenosis > 50% determined by quantitative coronary angiography (QCA). METHODS: Twenty-six patients with coronary artery stenosis (QCA > 50% diameter stenosis) underwent a contrast-free cardiovascular magnetic resonance (CMR) exam in the time interval between their primary coronary angiography and a subsequent percutaneous coronary intervention (PCI, n = 24) or coronary artery bypass (CABG, n = 2) revascularization procedure...
May 7, 2018: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29730345/hemiarch-reconstruction-vs-clamped-aortic-anastomosis-for-concomitant-ascending-aortic-aneurysm
#9
Ibrahim Sultan, Valentino Bianco, Ibrahim Yajzi, Arman Kilic, Keith Dufendach, Arturo Cardounel, Andrew D Althouse, Ahmad Masri, Forozan Navid, Thomas G Gleason
BACKGROUND: Deep hypothermic circulatory arrest (DHCA) is often avoided in patients with concomitant ascending aortic pathology when treating other cardiac disease to avoid increased risk of morbidity and mortality. We hypothesized that the use of DHCA with retrograde cerebral perfusion (RCP) does not add incremental risk to ascending aortic replacement alone in the setting of concomitant cardiac surgery. METHODS: 408 ascending aortic ± hemiarch replacements and aortic (root)/mitral/tricuspid valve(s), CABG, or MAZE procedures were performed for concomitant cardiac disease...
May 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29730070/exercise-prehabilitation-in-elective-intra-cavity-surgery-a-role-within-the-eras-pathway-a-narrative-review
#10
REVIEW
Samuel T Orange, Matthew J Northgraves, Phil Marshall, Leigh A Madden, Rebecca V Vince
The Enhanced Recovery after Surgery (ERAS) model integrates several elements of perioperative care into a standardised clinical pathway for surgical patients. ERAS programmes aim to reduce the rate of complications, improve surgical recovery, and limit postoperative length of hospital stay (LOHS). One area of growing interest that is not currently included within ERAS protocols is the use of exercise prehabilitation (PREHAB) interventions. PREHAB refers to the systematic process of improving functional capacity of the patient to withstand the upcoming physiological stress of surgery...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29726986/propensity-matched-analysis-of-a-side-clamp-versus-an-anastomosis-assist-device-in-cases-of-isolated-coronary-artery-bypass-grafting
#11
Aya Saito, Hiraku Kumamaru, Minoru Ono, Hiroaki Miyata, Noboru Motomura
OBJECTIVES: The use of an anastomosis assist device during coronary artery bypass grafting (CABG) is considered less invasive for the ascending aorta than the use of a side-biting clamp (Side-clamp) and to possibly be associated with a lower incidence of postoperative stroke. However, this benefit has not yet been clearly demonstrated. This study was to evaluate whether the use of an anastomosis assist device will minimize the postoperative stroke and other complications in patients undergoing off-pump CABG in comparison with the use of the Side-clamp...
May 2, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29726596/cost-implications-of-intraprocedural-thrombotic-events-and-bleeding-in-percutaneous-coronary-intervention-results-from-the-champion-phoenix-economics-study
#12
Hector Tamez, Philip Généreux, Robert W Yeh, Amit P Amin, Weihong Fan, Harvey D White, Ajay J Kirtane, Gregg W Stone, C Michael Gibson, Robert A Harrington, Deepak L Bhatt, Duane S Pinto
BACKGROUND: Despite improvements in percutaneous coronary intervention (PCI), intraprocedural thrombotic events (IPTE) and bleeding complications occur and are prognostically important. These have not been included in prior economic studies. METHODS: PHOENIX ECONOMICS was a substudy of the CHAMPION PHOENIX trial, evaluating cangrelor during PCI. Hospital bills were reviewed from 1,171 patients enrolled at 22 of 63 US sites. Costs were estimated using standard methods including resource-based accounting, hospital billing data, and the Medicare fee schedule...
May 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29706372/preoperative-anemia-versus-blood-transfusion-which-is-the-culprit-for-worse-outcomes-in-cardiac-surgery
#13
Damien J LaPar, Robert B Hawkins, Timothy L McMurry, James M Isbell, Jeffrey B Rich, Alan M Speir, Mohammed A Quader, Irving L Kron, John A Kern, Gorav Ailawadi
BACKGROUND: Reducing blood product utilization after cardiac surgery has become a focus of perioperative care as studies have suggested improved outcomes. The relative impact of preoperative anemia versus packed red blood cells (PRBC) transfusion on outcomes remains poorly understood, however. In this study, we investigated the relative association between preoperative hematocrit (Hct) level and PRBC transfusion on postoperative outcomes after coronary artery bypass grafting (CABG) surgery...
April 4, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29701394/ascending-aorta-aneyrysms-over-70mm
#14
Jorge Pinheiro Santos, Álvaro Laranjeira, António Cruz Tomás, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Current guidelines suggest that patients with aortic diameter over 55-60 mm should undergo ascending aorta replacement, depending on associated valve pathology and other comorbidities. Studies show that the risk of aortic rupture over 60 mm is over 30%. Even though, we still receive in our practice patients that present with aneurysms of greater dimensions. The aim of our study is to evaluate the surgical outcomes of patients presenting with ascending aorta with diameter larger than 70 mm...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701390/ascending-aorta-aneurysms-in-octogenarians
#15
Jorge Pinheiro Santos, Álvaro Laranjeira, António Cruz Tomás, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Older age is often regarded as a relative contraindication for open surgery for aortic aneurysms. These individuals often have a greater comorbidity burden that predispose them for development of postoperative complications. The aim of our study is to evaluate the surgical outcomes of selected octogenarians after open aortic surgery. METHODS: We performed a retrospective observational study. We collected data from patients operated on by our team between January of 2012 to September of 2017...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701336/cabg-to-cbp-or-not-to-cbp-a-propensity-score-matched-survival
#16
Pedro Magro, Sérgio Boshoff, José Calquinha, Miguel Sousa Uva, José Neves
INTRODUCTION: Over the past 3 decades two main strategies have been employed for surgical coronary revascularization (CABG): on- pump CABG with cardioplegia (ONCAB) and off-pump CABG (OPCAB). The objective of this study is to evaluate the short-term and long-term survival of the two strategies. METHODS: This study consists of 8-year cohort, retrospective single-center analysis with an intention-to-treat design. 2954 patients underwent CABG (OPCAB n=2123; ONCAB= 831) for CAD...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701335/survival-after-bilateral-internal-mammary-artery-in-coronary-artery-bypass-grafting-are-women-at-risk
#17
Francisca A Saraiva, Nicolas Girerd, Rui J Cerqueira, João P Ferreira, Noélia Vilas-Boas, Paulo Pinho, António Barros, Mário J Amorim, André Lourenço, Adelino F Leite-Moreira
INTRODUCTION: To compare survival and safety of BIMA versus SIMA CABG between males and females at our tertiary care center. METHODS: Single-center retrospective cohort including consecutive patients with at least 2 left coronary system (LCS) vessel disease who underwent isolated CABG with at least 1 IMA conduit and a minimum of 2 conduits targeting the LCS between 2004 and 2013. All-cause mortality was the primary outcome, secondary outcomes were in-hospital mortality and reoperation due to sternal wound complications (SWC)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696108/comparing-the-effectiveness-of-patient-control-analgesia-pump-and-bolus-morphine-in-controlling-pain-after-cardiopulmonary-bypass-graft-surgery
#18
Vali Imantalab, Ali Mirmansouri, Ali Mohammadzadeh Jouryabi, Bahram Naderi Nabi, Gholamreza Kanani, Nassir Nassiri Sheikhani, Zahra Atrkarroushan, Samaneh Ghazanfar Tehran, Nastaran Samadpour
Background: Postoperative pain is a complex process commonly caused by surgical trauma. It is one of the major concerns of patients undergoing heart surgery. Despite new techniques and modern analgesic treatments, postoperative pain is still one of the most important controversial issues. Methods: 68 patients scheduled for elective CABG with CPB were included in a prospective, double-blind clinical trial. They were randomly divided into two groups. One group received PCA pump including morphine (group P) with underlying infusion of 0...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29691626/the-disparities-of-coronary-artery-bypass-grafting-surgery-outcomes-by-insurance-status-a-retrospective-cohort-study-2007-2014
#19
Timothy M Connolly, Robert S White, Dahniel L Sastow, Licia K Gaber-Baylis, Zachary A Turnbull, Lisa Q Rong
BACKGROUND: Coronary artery bypass grafting (CABG) surgery is the gold standard treatment for complex coronary artery disease. Social determinants of health, including primary payer status, are disproportionately associated with adverse outcomes following surgical operations. We sought to examine associations between insurance status, in particular having Medicaid public insurance, and postoperative outcomes following isolated CABG surgeries. METHODS: A retrospective review was performed using Florida, California, New York, Maryland, and Kentucky State Inpatient Databases (2007-2014) for isolated CABG patients ≥ 18 years...
April 24, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29686717/preoperative-blood-morphology-and-incidence-of-acute-kidney-injury-after-on-pump-coronary-artery-bypass-grafting-a-single-center-preliminary-report
#20
Bartłomiej Perek, Dawid Maison, Szymon Budnick, Kinga Gębala, Veronica Casadei, Daniela Dadej, Artur Chmielewski, Marcin Ligowski, Piotr Buczkowski, Anna Perek, Marek Jemielity
Introduction: Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) performed in cardiopulmonary bypass (CPB) may complicate the postoperative course and has a negative impact on outcome. In some cases, postoperative AKI develops in spite of normal baseline creatinine concentration and estimated glomerular filtration rate (eGFR). Aim: To examine whether there is any association between the preoperative blood morphology and incidence of post-operative AKI...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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