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Manish Mittal, Chih-Hsiung E Wang, Abigail H Goben, Andrew D Boyd
INTRODUCTION: Reducing preventable readmissions among Medicare beneficiaries is an effective way to not only reduce the exorbitantly rising cost in healthcare but also as a measure to improve the quality of patient care. Many of the previous efforts in reducing readmission rate of patients have not been very successful because of ill-defined quality measures, improper data collection methods and lack of effective strategies based on data driven solutions. METHODS: In this study, we analyzed the readmission data of patients for six major diseases including acute myocardial infarction (AMI), heart failure (HF), coronary artery bypass graft (CABG), pneumonia (PN), chronic obstructive pulmonary disease (COPD), and total hip arthroplasty and/or total knee arthroplasty (THA/TKA) from the Center for Medicare and Medicaid Readmissions Reduction Program (HRRP) program for the period 2012-2015 in context with the ownership structure of the hospitals...
2018: PloS One
Kongyong Cui, Dongfeng Zhang, Shuzheng Lyu, Xiantao Song, Fei Yuan, Feng Xu, Min Zhang
The relative safety and efficacy of percutaneous coronary intervention (PCI) with drug-eluting stent (DES) and coronary artery bypass grafting (CABG) in patients with left ventricular (LV) systolic dysfunction remains controversial; therefore we conducted this meta-analysis to identify the optimal strategy for such cohorts. A comprehensive search of the electronic databases including PubMed, EMBASE, and Cochrane Library from January 1, 2003 to March 1, 2018 was performed to identify the eligible adjusted observational studies...
August 20, 2018: American Journal of Cardiology
Xia Dai, Zu-Chun Luo, Lu Zhai, Wen-Piao Zhao, Feng Huang
INTRODUCTION: In this analysis, we aimed to systematically compare percutaneous coronary intervention (PCI) versus coronary artery bypass surgery (CABG) in terms of adverse outcomes utilizing data from a recent (2015-2017) population of patients with type 2 diabetes mellitus (T2DM). METHODS: An electronic search of recent studies (2015-2017) was carried out using 'diabetes mellitus,' 'coronary artery bypass surgery,' and 'percutaneous coronary intervention' as the main search terms...
September 15, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Francisca A Saraiva, Nicolas Girerd, Rui J Cerqueira, João Pedro Ferreira, Noélia Vilas-Boas, Paulo Pinho, António Barros, Mário J Amorim, André P Lourenço, Adelino F Leite-Moreira
BACKGROUND: Most observational studies support long-term survival benefit after bilateral internal mammary artery (BIMA) compared with single internal mammary artery (SIMA) coronary artery bypass grafting (CABG) but data on females is scarce. We compared 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 in 2004-2013...
November 1, 2018: International Journal of Cardiology
Jill Jussli-Melchers, Bernd Panholzer, Christine Friedrich, Ole Broch, Katharina Huenges, Joachim Cremer, Assad Haneya
BACKGROUND:  Patients receiving arterial grafts have superior late survival after coronary artery bypass graft (CABG) surgery. The aim of our study was to evaluate the mid- and long-term results of total arterial (TA) revascularization in the elderly. METHODS:  Between January 2005 and December 2012, a retrospective study on age-, gender-, and EuroSCORE-matched patients aged 70 years and older was performed. Altogether, 356 patients who received isolated CABG were assigned to either TA group or control (CON) group...
September 15, 2018: Thoracic and Cardiovascular Surgeon
Tim Montrief, Alex Koyfman, Brit Long
INTRODUCTION: Coronary artery bypass graft (CABG) surgery remains a high-risk procedure, and many patients require emergency department (ED) management for complications after surgery. OBJECTIVE: This narrative review provides an evidence-based summary of the current data for the emergency medicine evaluation and management of post-CABG surgery complications. DISCUSSION: While there has been a recent decline in all cardiac revascularization procedures, there remains over 200,000 CABG surgeries performed in the United States annually, with up to 14% of these patients presenting to the ED within 30 days of discharge with post-operative complications...
September 8, 2018: American Journal of Emergency Medicine
Thomas A Schwann, Maroun B Yammine, Abdul-Karim M El-Hage-Sleiman, Milo C Engoren, Mark R Bonnell, Robert H Habib
INTRODUCTION: Incomplete coronary revascularization is associated with suboptimal outcomes. We investigated the long-term effects of Incomplete, Complete, and Supra-complete revascularization and whether these effects differed in the setting of single-arterial and multi-arterial coronary artery bypass graft (CABG). METHODS: We analyzed 15-year mortality in 7157 CABG patients (64.1 ± 10.5 years; 30% women). All patients received a left internal thoracic artery to left anterior descending coronary artery graft with additional venous grafts only (single-arterial) or with at least one additional arterial graft (multi-arterial) and were grouped based on a completeness of revascularization index (CRI = number of grafts minus the number of diseased principal coronary arteries): Incomplete (CRI ≤ -1 [N = 320;4...
September 14, 2018: Journal of Cardiac Surgery
Ebrahim Hassani, Alireza Mahoori, Nazli Karami, Asma Hassani, Leila Hassani
Background: Chronic use of renin-angiotensin system (RAS) antagonists (angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor antagonists (ARAS)) can cause hypotension during anesthesia. In some studies hemodynamic instability, including hypotension and its effects on the clinical outcome in patients treated with these drugs during coronary artery bypass graft (CABG) and need to excessive vasoactive drugs in these patient population, has been described. The aim of this study was to evaluate the effect of chronic consumption of ACEIs and ARAS on blood pressure and inotrope consumption during coronary artery bypass graft under cardiopulmonary bypass...
June 2018: Anesthesiology and Pain Medicine
Fardin Yousefshahi, Mohammadali Boroumand, Katayoun Haryalchi, Jayran Zebardast, Azin Ghajar, Ehsan Bastan Hagh
Background: Applying the cardiopulmonary pump produces inflammatory responses and induces leukocytosis. White Blood Cell (WBC) count has a diagnostic value for detecting different infections. In this study, we want to redefine the normal value reference intervals of WBC count in Coronary Artery Bypass Graft (CABG) patients, to prevent misdiagnose leukocytosis as a sign of infection. Methods: In an observational study, 140 patients who underwent on - pump CABG were enrolled to find out normal values of the reference interval...
June 2018: Anesthesiology and Pain Medicine
Rakan I Nazer, Mohammed F Abalhassan, Khalid A Alburikan
Background: Metformin is an oral antidiabetic agent belonging to the biguanide class of antidiabetics. Possible novel applications for metformin in cardiovascular disease might exist. The aim of this study was to verify a possible association between pre-operative metformin administration and protection against ischemia-induced liver injury in diabetic patients undergoing coronary artery bypass grafting (CABG) surgery. Methods: A retrospective case-control series was conducted at a single center...
August 2018: Cardiovascular Diagnosis and Therapy
Jan Gunnar Dale, Elin Midthus, Bjørg Dale
Background: Patients who have undergone a coronary artery bypass graft (CABG) surgery are exposed to physical and mental problems after discharge from the specialist hospital and are often in need of post-discharge support and follow-up. Aim: This study aimed to explore the attitudes of CABG patients toward using information and communication technology (ICT) during the first year of recovery after discharge from hospital. Methods: A cross-sectional design utilizing an electronic survey was employed...
2018: Journal of Multidisciplinary Healthcare
John C Moscona, Jason D Stencel, Gregory Milligan, Christopher Salmon, Rohit Maini, Paul Katigbak, Qusai Saleh, Ryan Nelson, Sudesh Srivastav, Owen Mogabgab, Rohan Samson, Thierry Le Jemtel
Background: An accurate diagnostic assessment of coronary artery disease is crucial for patients undergoing coronary artery bypass grafting (CABG). Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) to guide complete revascularization have not been adequately studied in patients prior to CABG. We compared an anatomic to a physiologic assessment of moderate coronary lesions (40-70% stenosis) in patients referred for CABG. Methods: We retrospectively reviewed 109 medical records of patients who underwent CABG at Tulane Medical Center from 2014 to 2016...
August 2018: Annals of Translational Medicine
Sang Eun Lee, Hae-Young Lee, Hyun-Jai Cho, Won-Seok Choe, Hokon Kim, Jin Oh Choi, Eun-Seok Jeon, Min-Seok Kim, Kyung-Kuk Hwang, Shung Chull Chae, Sang Hong Baek, Seok-Min Kang, Dong-Ju Choi, Byung-Su Yoo, Kye Hun Kim, Myeong-Chan Cho, Jae-Joong Kim, Byung-Hee Oh
OBJECTIVE: Myocardial ischaemia is a leading cause of acute heart failure (AHF). However, optimal revascularisation strategies in AHF are unclear. We aimed to compare two revascularisation strategies, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), in patients with AHF. METHODS: Among 5625 consecutive patients enrolled prospectively in the Korean Acute Heart Failure registry from March 2011 to February 2014, 717 patients who received CABG or PCI during the index hospitalisation for AHF were included in this analysis...
September 12, 2018: Heart: Official Journal of the British Cardiac Society
Harold L Lazar
No abstract text is available yet for this article.
September 11, 2018: Journal of Cardiac Surgery
Giseppe Santarpino, Francesco Nicolini, Marisa De Feo, Magnus Dalén, Theodor Fischlein, Andrea Perrotti, Daniel Reichart, Giuseppe Gatti, Francesco Onorati, Ilaria Franzese, Giuseppe Faggian, Ciro Bancone, Sideny Chocron, Sorosh Khodabandeh, Antonino S Rubino, Daniele Maselli, Saverio Nardella, Riccardo Gherli, Antonio Salsano, Marco Zanobini, Matteo Saccocci, Karl Bounader, Stefano Rosato, Tuomas Tauriainen, Giovanni Mariscalco, Juhani Airaksinen, Vito G Ruggieri, Fausto Biancari
OBJECTIVES: The aim of this study was to evaluate the prognostic impact of untreated asymptomatic carotid artery stenosis (CS) in patients undergoing isolated coronary artery bypass grafting (CABG). METHODS: This was a post hoc analysis of data from a prospective multicentre observational study. Patients without history of stroke or transient ischaemic attack from the multicentre E-CABG registry who were screened for CS before isolated CABG were included. RESULTS: Among 2813 patients screened by duplex ultrasound and who did not undergo carotid intervention for asymptomatic CS, 11...
September 6, 2018: European Journal of Vascular and Endovascular Surgery
Mahmoud Diab, Gloria Färber, Christoph Sponholz, Raphael Tasar, Thomas Lehmann, Sophie Tkebuchava, Marcus Franz, Torsten Doenst
OBJECTIVE:  Coronary artery bypass grafting (CABG) using bilateral internal thoracic artery (BITA) is associated with the best long-term survival. However, using BITA increases the risk of sternal wound infections with conventional sternotomy. We describe here our initial results of minimally invasive CABG (MICS-CABG) using BITA. METHODS:  Patients were operated through an incision similar to that of standard minimally invasive direct CABG. All operations were performed off-pump...
September 7, 2018: Thoracic and Cardiovascular Surgeon
Jakub Rychlik, Ivan Hornacek, Miloslav Tejc, Erik Petrikovits, Zdenek Klimsa
OBJECTIVES: The aim of this study was to analyse the consequence of radial or femoral access during coronary interventions to radiation dose, fluorography time and a number of pseudoaneurysms following each type of intervention. BACKGROUND: According to the results of many recent studies (RIVAL, RIFLE-STEACS, STEMI RADIAL), current guidelines favour radial over femoral access during coronary intervention for safety, especially in cases of acute coronary syndromes...
September 7, 2018: Acta Cardiologica
Aylin Hatice Yamac, Mustafa Ahmet Huyut, Emre Yilmaz, Ilke Celikkale, Ahmet Bacaksiz, Yusuf Demir, Ali Riza Demir, Mehmet Erturk, Nijad Bakhshaliyev, Ramazan Ozdemir, Ulkan Kilic
BACKGROUND The cardioprotective protein SIRT1 is elevated in patients with coronary artery disease (CAD) to compensate for the disease-related adverse effects, but less is known about the prognostic role of SIRT 1 regulating microRNAs in patients after coronary artery bypass graft (CABG) surgery. MATERIAL AND METHODS The expression of the SIRT 1-specific microRNAs miR-199a and miR-195 was analyzed using real-time PCR in 68 patients referred for CABG surgery and 34 control patients undergoing heart valve surgery...
September 7, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Sonya K Hui, Emma Lindale, Louise Sun, Marc Ruel
PURPOSE OF REVIEW: Patients with multivessel coronary artery disease (CAD) may undergo revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). This review will discuss the use of polygenic risk scores for risk-stratification of patients with multivessel CAD in order to guide the choice of revascularization. RECENT FINDINGS: A 57-single nucleotide polymorphism (SNP)-polygenic risk score can accurately risk-stratify patients with CAD and identify those who will receive greater benefit from statin therapy...
September 3, 2018: Current Opinion in Cardiology
Ding Peng, Jing-Hua Liu
OBJECTIVE: This study aimed to explore the predictive factors for left ventricular ejection fraction (LVEF) improvement after revascularization. METHODS: This real-world study examined 993 patients with ischemic HFrEF who had received revascularization (PCI or CABG), had survived at least 90 days and had undergone an echocardiography review. Based on the change in the LVEF, we divided the patients into two groups. RESULT: We obtained 454 patients with ≥10% improvement and 539 with <10% improvement or deterioration...
September 5, 2018: Journal of Interventional Cardiology
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