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Coronary artery bypass and angioplasty

Giuseppe Tarantini, Francesco Saia, Piera Capranzano, Bernardo Cortese, Marco Mojoli, Giacomo Boccuzzi, Andrea Cuculo, Salvatore Geraci, Alessio Mattesini, Jacopo Oreglia, Francesco Summaria, Luca Testa, Sergio Berti, Giovanni Esposito, Alessio La Manna, Ugo Limbruno, Alfredo Marchese, Ciro Mauro, Fabio Tarantino, Alessandro Salvi, Gennaro Santoro, Ferdinando Varbella, Roberto Violini, Giuseppe Musumeci
Drug-eluting stents (DES) are the current gold standard for percutaneous treatment of coronary artery disease. However, DES are associated with a non-negligible risk of long-term adverse events related to persistence of foreign material in the coronary artery wall. In addition, DES implantation causes permanent caging of the native vessel, thus impairing normal vasomotricity and the possibility of using non-invasive coronary imaging or preforming subsequent bypass surgery. On the contrary, coronary bioresorbable stents (BRS) may provide temporary mechanical support to coronary wall without compromising the subsequent recovery of normal vascular physiology, and have the potential to prevent late adverse events related to permanent elements...
October 2016: Giornale Italiano di Cardiologia
Timo H Mäkikallio, Juhani Junttila, Antti Kiviniemi, Sudhir Kurl, Kari Ylitalo, Jarkko Magga, Vesa Jokinen, Olli-Pekka Piira, Kari Kervinen, Matti Niemelä, Jari A Laukkanen
No abstract text is available yet for this article.
September 28, 2016: International Journal of Cardiology
Iu I Kazakov, I B Lukin, N Iu Sokolova, M A Strakhov
Analysed herein are both immediate and remote results of surgical treatment of 93 patients presenting with chronic atherosclerotic occlusion of the femoral-popliteal-tibial segment in the stage of critical ischaemia. The patients were subjected to autovenous femoropopliteal bypass grafting to the isolated arterial segment or balloon angioplasty with stenting of the superficial femoral artery. While choosing the method of arterial reconstruction we assessed concomitant diseases, primarily lesions of the coronary and cerebral circulation...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Mohammadhossien Soltani, Masoud Mirzaei, Ahmad Amin, Mahmoud Emami, Reza Aryanpoor, Farimah Shamsi, Mohammadtaghi Sarebanhassanabadi
BACKGROUND: Chest pain is a common symptom for referring patients to emergency departments (ED). Among those referred, some are admitted to hospitals with a definite or tentative diagnosis of acute coronary syndrome and some are discharged with primary diagnosis of non-cardiac chest pain. This study aimed at investigating 30 days' adverse outcomes of patients discharged from ED of a major heart center in Iran. METHODS: Out of 1638 chest pain admissions to the centre during 2010-2011, 962 patients (mean age= 50...
July 2016: Ethiopian Journal of Health Sciences
Rafael Cavalcante, Yohei Sotomi, Cheol W Lee, Jung-Min Ahn, Vasim Farooq, Hiroki Tateishi, Erhan Tenekecioglu, Yaping Zeng, Pannipa Suwannasom, Carlos Collet, Felipe N Albuquerque, Yoshinobu Onuma, Seung-Jung Park, Patrick W Serruys
BACKGROUND: Currently available randomized data on the comparison between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for the treatment of unprotected left main coronary disease (LMD) lacks statistical power due to low numbers of patients enrolled. OBJECTIVES: This study assessed long-term outcomes of PCI and CABG for the treatment of LMD in specific subgroups according to disease anatomic complexity. METHODS: We conducted a pooled analysis of individual patient-level data of the LMD patients included in the PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease) and SYNTAX (Synergy Between PCI With TAXUS and Cardiac Surgery) trials...
September 6, 2016: Journal of the American College of Cardiology
Eric J Shiroma, Nancy R Cook, JoAnn E Manson, M V Moorthy, Julie E Buring, Eric B Rimm, I-Min Lee
PURPOSE: To examine the association of strength training with incident type 2 diabetes and cardiovascular disease risk. METHODS: We followed 35 754 healthy women (mean age, 62.6 years, range 47.0 - 97.8) from the Women's Health Study, who responded to a health questionnaire that included physical activity questions in 2000; assessing health outcomes through annual health questionnaire through 2014 (average (SD) follow-up = 10.7 (3.7) years). Incident type 2 diabetes (N cases = 2120) and cardiovascular disease (N cases = 1742) were confirmed on medical record review...
August 30, 2016: Medicine and Science in Sports and Exercise
Leszek Wrotniak, Anna Kabłak-Ziembicka, Agnieszka Rosławiecka, Piotr Musiałek, Paweł Bogacki, Mariusz Trystuła, Krzysztof Żmudka, Tadeusz Przewłocki
OBJECTIVE: A minor part of patients with subclavian or innominate artery occlusive disease (subclavian artery stenosis [SAS]) experience symptoms of vertebrobasilar insufficiency, upper extremity exertional ischemia (UEEI), or cardiac ischemia owing to subclavian-coronary steal (SCS) in some instances. The study aimed to assess the impact of percutaneous transluminal angioplasty (PTA) of symptomatic SAS on symptom resolution and to determine factors related with SAS recurrence. METHODS: Symptom resolution and incidence of restenosis (RS) were evaluated for up to 15 years in patients who had undergone successful PTA of SAS...
September 2016: Journal of Vascular Surgery
G S Stergiou, A Margetaki, N Boubouchairopoulou, A Mastrokostas, A Vantarakis, G Chlouverakis, G Rachiotis, G Trypsianis, P Voulgari, I Alamanos, A Karakosta, G Touloumi
OBJECTIVE: To date no nationwide epidemiological study of cardiovascular disease has been performed in the general population in Greece. This study evaluated the prevalence of coronary heart disease and stroke in individuals with hypertension in a randomly selected general population sample of adults in Greece. DESIGN AND METHOD: The EMENO survey (National Morbidity and Risk Factors Survey) supported by the European Social Fund and national funds, is currently performed in Greece, aiming to include 6,000 adults aged > = 18 years...
September 2016: Journal of Hypertension
Agnus M Kim, Jong Heon Park, Sungchan Kang, Kyosang Hwang, Taesik Lee, Yoon Kim
OBJECTIVES: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. METHODS: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period...
July 2016: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
Mark D Danese, Michelle Gleeson, Lucie Kutikova, Robert I Griffiths, Ali Azough, Kamlesh Khunti, Sreenivasa Rao Kondapally Seshasai, Kausik K Ray
OBJECTIVES: To characterise the costs to the UK National Health Service of cardiovascular (CV) events among individuals receiving lipid-modifying therapy. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records from 2006 to 2012 to identify individuals with their first and second CV-related hospitalisations (first event and second event cohorts). Within-person differences were used to estimate CV-related outcomes. SETTING: Patients in the UK who had their first CV event between January 2006 and March 2012...
2016: BMJ Open
Yohei Sotomi, Rafael Cavalcante, David van Klaveren, Jung-Min Ahn, Cheol Whan Lee, Robbert J de Winter, Joanna J Wykrzykowska, Yoshinobu Onuma, Ewout W Steyerberg, Seung-Jung Park, Patrick W Serruys
OBJECTIVES: The study sought to validate the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II mortality prediction model after percutaneous coronary intervention (PCI) or coronary artery bypass grafting in a large pooled population of patients with multivessel coronary disease (MVD) and/or unprotected left main disease (UPLMD) enrolled in the PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease) and BEST (Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) randomized controlled trials...
August 8, 2016: JACC. Cardiovascular Interventions
Marcus Eng Hock Ong, Ying Hao, Susan Yap, Pin Pin Pek, Terrance Siang Jin Chua, Faith Suan Peng Ng, Swee Han Lim
OBJECTIVES: The new Vancouver Chest Pain (VCP) Rule recommends early discharge for chest pain patients who are at low risk of developing acute coronary syndrome (ACS), and thus can be discharged within 2 hours of arrival at the emergency department (ED). This study aimed to assess the performance of the new VCP Rule for Asian patients presenting with chest pain at the ED. METHODS: This prospective cohort study involved patients attended to at the ED of a large urban centre...
July 27, 2016: CJEM
Sung Hye Byun, Jonghoon Lee, Jong Hae Kim
BACKGROUND: Patients on antiplatelet therapy following percutaneous coronary intervention can become coagulopathic due to infection. Performing regional anesthesia for bilateral surgery in such cases is challenging. We report a case of successful combined inguinal femoral and subgluteal sciatic nerve blocks (CFSNBs) for simultaneous bilateral below-knee amputations in a coagulopathic patient on antiplatelet therapy. METHODS: A 70-year-old male patient presented with pain in both feet due to diabetic foot syndrome...
July 2016: Medicine (Baltimore)
Majed S Faden, Natalie Bottega, Alice Benjamin, Richard N Brown
OBJECTIVE: Spontaneous coronary artery dissection (SCAD) is a rare and potentially lethal cause of myocardial infarction (MI). The purpose of our study was to estimate the prevalence and maternal outcomes of pregnancies complicated by SCAD. MATERIALS AND METHODS: A population-based cohort study on all births identified in the Healthcare Cost and Utilization Project from 2008 to 2012. Disease prevalence was calculated and logistic regression was used to estimate the adjusted odds ratio (aOR) for risk factors and different maternal complications...
July 13, 2016: Heart: Official Journal of the British Cardiac Society
Akihiro Yoshitake, Takashi Hachiya, Kazuma Okamoto, Hiroto Kitahara, Shinji Kawaguchi, Seishi Nakatsuka, Masanori Inoue, Masahiro Jinzaki, Hideyuki Shimizu
OBJECTIVES: This study aimed to analyze the perioperative stroke rate, stroke lesions, outcome, risk factors, and stroke prevention following debranching with thoracic endovascular aortic repair (TEVAR). DESIGN: Retrospective study. METHODS: Between February 2011 and February 2015, 74 consecutive patients underwent debranching with TEVAR at our institution. Of these, the TEVAR proximal landing zone was "zone 0' in 23 patients, "zone 1" in 28, and "zone 2" in 23...
July 8, 2016: Annals of Vascular Surgery
Allie Massaro, Steven R Messé, Michael A Acker, Scott E Kasner, Jose Torres, Molly Fanning, Tania Giovannetti, Sarah J Ratcliffe, Michel Bilello, Wilson Y Szeto, Joseph E Bavaria, Emile R Mohler, Thomas F Floyd
BACKGROUND AND PURPOSE: Stroke is a potentially devastating complication of cardiac surgery. Identifying predictors of radiographic infarct may lead to improved stroke prevention for surgical patients. METHODS: We reviewed 129 postoperative brain magnetic resonance imagings from a prospective study of patients undergoing surgical aortic valve replacement. Acute infarcts were classified as watershed or embolic using prespecified criteria. RESULTS: Acute infarct on magnetic resonance imaging was seen in 79 of 129 patients (61%), and interrater reliability for stroke pathogenesis was high (κ=0...
August 2016: Stroke; a Journal of Cerebral Circulation
Adam J Buntaine, Binita Shah, Jeffrey D Lorin, Steven P Sedlis
Patients with diabetes mellitus (DM) have more severe CAD and higher mortality in acute coronary syndrome (ACS) than patients without DM. The optimal mode of revascularization-coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)-remains controversial in this setting. For patients with DM and ST-segment elevation myocardial infarction, prompt revascularization of the culprit artery via PCI is generally preferable. In non-ST-elevation ACS, the decision on mode of revascularization is more challenging...
August 2016: Current Cardiology Reports
A V Sevastyanov, A M Chernyavsky, M A Chernyavsky, A G Edemsky, A S Nesmachnyi, A R Tarkova
Presented in the article is a clinical case report regarding successfully used hybrid technology in combined lesions of the coronary arteries and the first segment of the left subclavian artery. The patient was subjected to simultaneous hybrid operation, i. e., transaortic angioplasty with stenting of the left subclavian artery by means of the Assurant stent accompanied by coronary artery bypass grafting. The early postoperative period turned out uneventful. The patient was discharged with no complications and in a satisfactory condition...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Robert Wolk, Marnie Bertolet, Prachi Singh, Maria M Brooks, Richard E Pratley, Robert L Frye, Arshag D Mooradian, Martin K Rutter, Andrew D Calvin, Bernard R Chaitman, Virend K Somers
OBJECTIVE: To evaluate the cardiovascular (CV) prognostic value of adipokines in a large prospective cohort of patients participating in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial. PATIENTS AND METHODS: The effects of the adipokine levels at baseline and change from baseline on the composite outcome (CV death, myocardial infarction, and stroke) were analyzed using unadjusted and fully adjusted Cox models in 2330 patients with type 2 diabetes and coronary artery disease who had participated in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial (from January 1, 2001, through December 1, 2008)...
July 2016: Mayo Clinic Proceedings
Balakumaran Jeyakumaran, Ajay Raj, Bhagya Narayan Pandit, Tarun Kumar, Surender Deora
Iatrogenic left main coronary artery (LMCA) dissection is a rare complication and may have devastating consequences if not immediately intervened. The management includes urgent revascularization mostly with percutaneous coronary intervention (PCI) with bail-out stenting and rarely requires coronary artery bypass graft (CABG) surgery. In clinically and hemodynamically stable patients, a conservative approach may be preferred. Here, we present a rare case of iatrogenic retrograde LMCA dissection due to pin-hole rupture of angioplasty balloon that was managed conservatively...
June 9, 2016: Acute Cardiac Care
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