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https://www.readbyqxmd.com/read/28828765/fast-track-extubation-in-adult-patients-on-pump-open-heart-surgery-at-a-tertiary-care-hospital
#1
Mohammad Irfan Akhtar, Hasanat Sharif, Mohammad Hamid, Khalid Samad, Fazal Hameed Khan
Background: Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. Methods: The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28826902/comparison-of-the-frequency-of-acute-kidney-injury-in-patients-with-renal-transplant-who-underwent-percutaneous-coronary-intervention-versus-coronary-artery-bypass-graft-surgery
#2
Siva Sagar Taduru, Madhuri Ramakrishnan, Reem A Mustafa, Paramdeep S Baweja
Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) are established modalities of coronary revascularization. Choosing between the two requires taking into consideration not only disease severity, patient characteristics, and expected outcomes but also adverse effects. One such adverse effect is acute kidney injury (AKI), especially when considering coronary revascularization in patients with renal transplant (RT). We searched the National Inpatient Sample from 2008 to 2014 using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for patients with RT (V42...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28826745/does-continuous-infusion-of-local-anaesthesia-improve-pain-control-and-walking-distance-after-coronary-artery-bypass-graft-surgery-a-randomised-controlled-trial
#3
Serena S Hong, Jennifer A Alison, Maree A Milross, Kristy Robledo, Rebecca Dignan
OBJECTIVES: To evaluate the effects of continuous infusion of ropivacaine compared to sham infusion or usual care on pain scores before and after physiotherapy treatment, distance walked and time to discharge from physiotherapy, after coronary artery bypass graft (CABG) surgery. DESIGN: Prospective, randomised, double blind controlled trial. SETTING AND PARTICIPANTS: Seventy-five participants who underwent CABG surgery with left internal mammary artery grafts were allocated, to the ropivacaine group (n=26), the sham group (n=25), or usual care group (n=24)...
February 21, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28823011/guidelines-versus-reality-is-coronary-stent-application-in-three-vessel-disease-standard-or-the-exception
#4
Roland Linder, J Zeidler, F Verheyen, J-M Graf von der Schulenburg, A Haverich, T Schilling
The national guidelines for treatment of chronic coronary heart disease (CHD) recommend surgical coronary aortic bypass grafting (CABG) rather than percutaneous coronary intervention (PCI) for patients with a coronary three-vessel disease. The epidemiology of three-vessel CHD and data about the application of different revascularisation strategies raise suspicion of deviation from the guidelines in the treatment of those patients. Claims data containing records of almost 10 million patients of the largest German statutory health insurance fund (Techniker Krankenkasse) were utilised to measure adherence to the guidelines for treatment of groups of patients with one-, two-, and three-vessel CHD, respectively...
August 19, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28822518/clinical-outcomes-of-patients-with-coronary-artery-disease-who-underwent-ffr-evaluation-of-intermediate-coronary-lesions-coffrs-study
#5
Srinivasa Prasad, S Harikrishnan, G Sanjay, S P Abhilash, S Bijulal, M Krishna Kumar, Jaganmohan Tharakan, V K Ajit Kumar
BACKGROUND: We undertook this study to validate the impact of FFR-guided coronary interventions among Indian patients, which is not readily available as of date. Our patients differ from their western counterparts, both in terms of risk profile (younger, more metabolic syndrome, lipid rich diet) as well as their coronary size. METHODS: We retrospectively evaluated 282 patients with intermediate stenosis in their coronary arteries, who underwent FFR to assess the functional severity of the lesion...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28822513/frequency-and-predictors-of-non-adherence-to-lifestyle-modifications-and-medications-after-coronary-artery-bypass-grafting-a-cross-sectional-study
#6
Muhammad Armughan Ali, Javeria Yasir, Rida Noor Sherwani, Marium Fareed, Fizza Arshad, Fareeha Abid, Ramsha Arshad, Safana Ismail, Sarim Ahmed Khan, UroojJamal Siddiqui, Marium Gul Muhammad, Kaneez Fatima
BACKGROUND: Non-adherence to dietary recommendations, exercise and prescribed drug regimens, in coronary heart disease (CHD) patients following coronary artery bypass grafting (CABG), is a major health care issue worldwide. AIMS AND OBJECTIVES: The primary objective of this study was to investigate the frequency and predictors of non-adherence to lifestyle changes and medication among CHD patients after undergoing CABG surgery. METHOD: The sample of this cross sectional descriptive study was 265 patients who underwent isolated primary CABG...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28821262/pre-operative-serum-vcam-1-as-a-biomarker-of-atrial-fibrillation-after-coronary-artery-bypass-grafting
#7
Leanne Harling, Jonathan Lambert, Hutan Ashrafian, Ara Darzi, Nigel J Gooderham, Thanos Athanasiou
OBJECTIVE: Systemic inflammation is a recognised contributory factor in the pathogenesis of de novo post-operative atrial fibrillation after cardiac surgery. This study aims to determine whether serum soluble vascular endothelial cell adhesion molecule (sVCAM-1) may predict the onset of POAF in patients under going coronary artery bypass grafting. METHODS: 34 patients undergoing non-emergent, on-pump CABG were prospectively recruited. Plasma was obtained at 24 h pre-operatively and at 48 and 96 h post-operatively...
August 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#8
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28816101/measurement-of-total-hemoglobin-reduces-red-cell-transfusion-in-hospitalized-patients-undergoing-cardiac-surgery-a-retrospective-database-analysis
#9
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
#10
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/28813212/changing-the-discussion-about-on-pump-versus-off-pump-cabg
#11
EDITORIAL
Eugene H Blackstone, Joseph F Sabik
New England Journal of Medicine, Volume 377, Issue 7, Page 692-693, August 2017.
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
#12
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/28806769/effects-of-statin-therapy-on-clinical-outcomes-after-acute-myocardial-infarction-in-patients-with-advanced-renal-dysfunction-a-propensity-score-matched-analysis
#13
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
#14
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
#15
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
#16
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/28805032/improving-outcomes-after-cabg-and-pci
#17
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
#18
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/28804232/acute-beneficial-effects-of-muscular-counterpulsation-in-patients-with-coronary-heart-diseases
#19
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/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#20
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
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