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https://www.readbyqxmd.com/read/28698347/carbon-dioxide-surgical-field-flooding-and-aortic-no-touch-off-pump-coronary-artery-bypass-grafting-to-reduce-neurological-injuries-after-surgical-coronary-revascularisation-canon-protocol-for-a-randomised-controlled-investigator-and-patient-blinded-single
#1
Szwed Krzysztof, Pawliszak Wojciech, Serafin Zbigniew, Kowalewski Mariusz, Tomczyk Remigiusz, Perlinski Damian, Szwed Magdalena, Tomaszewska Marta, Anisimowicz Lech, Borkowska Alina
INTRODUCTION: Neurological injuries remain a major concern following coronary artery bypass grafting (CABG) that offsets survival benefit of CABG over percutaneous coronary interventions. Among numerous efforts to combat this issue is the development of off-pump CABG (OPCABG) that obviates the need for extracorporeal circulation and is associated with improved neurological outcomes. The objective of this study is to examine whether the neuroprotective effect of OPCABG can be further pronounced by the use of two state-of-the-art operating techniques...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28606279/-long-term-outcomes-of-off-pump-coronary-artery-bypass-grafting
#2
G P Liu, L Shang, C S Xiao, Y Wu, R Wang, Z Y Gong, J L Yan, C Q Gao
Objective: To investigate the long-term outcomes of off-pump coronary artery bypass grafting (OPCABG). Methods: Clinical data of 1 129 consecutive patients ( 937 males and 192 females) with coronary artery disease receiving OPCABG at Department of Cardiovascular Surgery, Chinese PLA General Hospital between January 2000 and December 2015 was retrospectively analyzed.The age of patients ranged from 29 to 83 years, with a mean age of (62.0±9.6) years. The follow-up data of the patients, including the graft patency and repeated revascularization rate, were analyzed...
June 13, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28549672/rotational-thromboelastometry-predicts-increased-bleeding-after-off-pump-coronary-bypass-surgery
#3
Sarah Soh, Young-Lan Kwak, Jong-Wook Song, Kyung-Jong Yoo, Hee-Jung Kim, Jae-Kwang Shim
BACKGROUND: We aimed to investigate the ability of rotational thromboelastometry (ROTEM) thresholds for coagulopathy to predict increased perioperative blood loss in off-pump coronary artery bypass graft surgery (OPCABG) and its association with transfusion requirement. METHODS: The data of 303 patients undergoing OPCABG were retrospectively analyzed. Perioperative blood loss and transfusion requirement were compared according to the presence of abnormal ROTEM thresholds, which were tested after anesthesia induction and heparin reversal...
May 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28533097/distal-anastomosis-support-for-coronary-artery-bypass-grafting-a-new-surgical-technique-and-current-outcomes
#4
Junfeng Yang, Liangshan Wang, Haitao Li, Changcheng Liu, Bo Li, Hui Li, Rui Liu, Chengxiong Gu
BACKGROUND: Saphenous vein graft (SVG) failure remains the Achilles' heel of coronary artery bypass grafting (CABG) and grafts performed on the right coronary artery (RCA) system always have the worst patency compared with those performed on the left coronary system. The aim of this study was to introduce the distal anastomoses support (DAS) procedure and investigate the effect of DAS on the mid-term graft patency of SVG-PDA. METHODS: Between May and September 2013, 100 patients with an RCA severe lesion who underwent isolated OPCABG (CABG alone group, n=50) or CABG with DAS for anastomoses of SVG-PDA (CABG plus DAS group, n=50) were evaluated retrospectively...
November 30, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28454490/ct-perfusion-in-predicting-the-morbidity-and-prognosis-of-hypoxic-ischemic-encephalopathy-after-off-pump-coronary-artery-bypass-grafting
#5
Di Luo, James Yip, Zhe Song, Baolei Xu, Qi Bi
OBJECTIVE: To investigate the perfusion parameters of computed tomography (CT) in hypoxicischemic encephalopathy (HIE) after off-pump coronary artery bypass grafting (OPCABG), and its potential in predicting the occurrence and prognosis of hypoxic-ischemic encephalopathy. METHODS: We selected 830 patients. The patients were grouped into: HIE and no HIE. HIE patients were further divided into two groups: poor prognosis and better prognosis. RESULTS: (1) Patients with HIE, who had a history of stroke and hypertension, showed more severe stenosis on CTA and more perfusion abnormalities compared to non-HIE patients (p < 0...
June 2017: Neurological Research
https://www.readbyqxmd.com/read/28441848/-short-term-clinical-outcomes-and-risk-factors-associated-with-in-hospital-mortality-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#6
K Hua, J J Sheng, R Dong
Objective: To explore short-term clinical outcomes and risk factors associated with in-hospital mortality in patients undergoing off-pump coronary artery bypass grafting (OPCABG) and establish a prediction model for in-hospital mortality. Methods: The clinical data of patients undergoing OPCABG in Beijing Anzhen Hospital between January 2014 and January 2016 was retrospectively studied. Univariate analysis and logistic regression were applied to determine the potential risk factors, and then a prediction model for mortality was confirmed...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28420471/-mixed-venous-arterial-carbon-dioxide-difference-combined-with-passive-leg-raising-in-guiding-volume-management-for-patients-post-off-pump-coronary-artery-bypass-grafting
#7
Likun Huo, Peijun Li, Chang Xie, Chenglei Yan, Jie Li
OBJECTIVE: To investigate whether mixed venous-arterial carbon dioxide difference (Pv-aCO2) combined with passive leg raising (PLR) could better guide volume management for patients post off-pump coronary artery bypass grafting (OPCABG). METHODS: Eighty patients experienced OPCABG, and admitted to Tianjin Chest Hospital from June 1st to October 1st in 2016 were enrolled. They were randomly divided into two groups: observation group given Pv-aCO2 combined with PLR directed therapy and control group given central venous pressure (CVP) directed therapy, 40 cases in each group...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28299332/relationship-between-angiotensin-converting-enzyme-apelin-and-new-onset-atrial-fibrillation-after-off-pump-coronary-artery-bypass-grafting
#8
Shu Xu, Jian Zhang, Yin-Li Xu, Hai-Bo Wu, Xiao-Dong Xue, Hui-Shan Wang
It has been shown that inflammation and oxidative stress are important factors in postoperative atrial fibrillation (POAF). Angiotensin converting enzyme (ACE) and apelin have a close relationship with inflammation and oxidative stress. The effect of ACE and apelin on POAF after off-pump coronary artery bypass grafting (OPCABG) remains a question. The concentrations of serum ACE, angiotensin II (Ang II), apelin, bradykinin (BK), malondialdehyde (MDA), and C reactive protein (CRP) were measured in the perioperative period of OPCABG...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28148891/feasibility-and-efficacy-of-simultaneous-off-pump-coronary-artery-bypass-grafting-and-esophagectomy-in-elderly-patients
#9
Ban Liu, Chang Gu, Yuliang Wang, Xiaowei Wang, Wen Ge, Lingtong Shan, Yujian Wei, Xiaohan Xu, Yangyang Zhang
INTRODUCTION: To analyze the outcomes of off-pump coronary artery bypass grafting (OPCABG) and esophagectomy simultaneously for patients with coronary artery disease (CAD) and coexisting esophageal cancer. METHODS: Twenty-two patients with CAD and coexisting esophageal cancer underwent combined surgical interventions were subjected to the study. OPCABG was performed first, followed by esophagectomy. All the corresponding data including clinicopathological characteristics and postoperative outcomes were all investigated...
July 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28109568/one-or-two-internal-thoracic-grafts-long-term-follow-up-of-957-off-pump-coronary-bypass-surgeries
#10
Dmitry Pevni, Yanai Ben-Gal, Rephael Mohr, Amir Ganiel, Yosef Paz, Amir Kramer, Nahum Nesher
BACKGROUND: The potential survival benefit of bilateral internal thoracic artery (BITA) grafting in patients undergoing off-pump coronary artery bypass graft surgery (OPCABG) is controversial owing to the technical complexity of these operations. Our objective was to compare the outcome of patients undergoing OPCABG with BITA to the outcome of patients undergoing OPCABG with a single internal thoracic artery (SITA) and saphenous vein grafts or radial artery. METHODS: Five hundred and thirty-five consecutive patients who underwent OPCABG BITA at our institute between 2000 and 2008 were compared with 422 patients who underwent OPCABG with SITA...
January 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28062681/dialyzer-based-cell-salvage-system-a-superior-alternative-to-conventional-cell-salvage-in-off-pump-coronary-artery-bypass-grafting
#11
Amber Malhotra, Pankaj Garg, Arvind Kumar Bishnoi, Pranav Sharma, Vivek Wadhawa, Komal Shah, Sanjay Patel, Umesh Kumar Ahirwar, Dayesh Rodricks, Himani Pandya
Objectives: Our goal was to test the hypothesis that the use of a dialyzer-based cell salvage system during off-pump coronary artery bypass grafting (OPCABG) reduces requirements for homologous blood transfusions (HBT) and improves postoperative haemtochemical parameters. Methods: Data were prospectively collected for 222 patients who had OPCABG using 3 different cell salvage techniques: (1) dialyzer-based cell salvage (DBCS) ( n  = 75), (2) conventional cell salvage (CCS) ( n  = 73) and (3) without cell salvage (WCS) ( n  = 74)...
April 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27942402/off-pump-coronary-artery-bypass-grafting-opcabg-a-personal-european-perspective
#12
David P Taggart
Although popularised over two decades ago off-pump coronary artery bypass grafting (OPCABG) has seen a decrease in utilisation especially over the last decade. This has been due to publication of a number of trials which suggested inferior outcomes with OPCABG. However, the validity of the findings in these trials has been questioned on the basis of doubts over operator experience as witnessed by large numbers of cross-overs. Two more recent large randomised trials have shown very similar outcomes between on and off-pump surgery up to 1- and 5-year outcomes are imminently due...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27939574/effect-of-perioperative-pregabalin-on-postoperative-quality-of-recovery-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting-opcabg-a-prospective-randomized-double-blind-trial
#13
Deepak Prakash Borde, Savani Sameer Futane, Balaji Asegaonkar, Pramod Apsingekar, Sujeet Khade, Bapu Khodve, Manish Puranik, Antony George, Shreedhar Joshi
OBJECTIVES: Use of pregabalin is increasing in cardiac surgical patients. However, studies using comprehensive scoring systems are lacking on the drug's impact on postoperative recovery. The authors tested the hypothesis that perioperative oral pregabalin improves the postoperative quality of recovery as assessed using the Quality of Recovery (QoR-40) questionnaire in patients undergoing off-pump coronary artery bypass grafting (OPCABG). DESIGN: This was a randomized, double-blind, placebo-controlled study...
September 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27780561/minimally-invasive-extracorporeal-circulation-circuit-is-not-inferior-to-off-pump-coronary-artery-bypass-grafting-meta-analysis-using-the-bayesian-method
#14
REVIEW
Bernhard Winkler, Paul P Heinisch, Brigitta Gahl, Soheila Aghlmandi, Hans Jörg Jenni, Thierry P Carrel
The pathophysiologic side effects of cardiopulmonary bypass have already been identified. Minimally invasive extracorporeal circulation technologies (MiECT) and off-pump coronary artery bypass graft surgery (OPCABG) aim to reduce these problems. This meta-analysis provides a comparison of MiECT and OPCABG in randomized and observational studies. A fully probabilistic, Bayesian approach of primary and secondary endpoints was conducted. MiECT does not give inferior results when compared with OPCABG. However, there is a trend to borderline significantly higher blood loss in this group in randomized controlled trials...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27760636/-safety-and-efficacy-of-off-pump-coronary-artery-bypass-grafting-in-octogenarians
#15
T S Liu, B T Chen, R Dong, Y Li, Y Zhao, K Hua
Objective: To discuss the clinical safety and efficacy about off-pump coronary artery bypass grafting (OPCABG) in octogenarians. Methods: From June 2005 to July 2014, 252 patients (male 208, female 44, with a mean age of 81.7 years old) underwent OPCABG in Beijing Anzhen Hospital who were aged 80 years or older were enrolled. Results: Eight (3.2%) patients were diagnosed as single vessel coronary artery disease (CAD), 29 cases (11.5%) were diagnosed as bifurcation vessel CAD, and 215 cases (85.3%) were multivessel CAD...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27320248/association-of-ct-perfusion-and-postoperative-cognitive-dysfunction-after-off-pump-coronary-artery-bypass-grafting
#16
Zhe Song, Paul Fu, Mingying Chen, Qi Bi
OBJECTIVE: To investigate the relationship between an abnormal CT perfusion scan and postoperative cognitive dysfunction, as measured by changes in MoCA and MMSE scores, after off-pump coronary artery bypass grafting (OPCABG). METHODS: Eight hundred and thirteen patients were selected who underwent OPCABG between August 2010 and September 2013. Cognitive function was assessed before operation and at seven days post-op. CT perfusion scan was obtained preoperatively and was used to divide patients into two groups: abnormal perfusion and normal perfusion groups...
June 2016: Neurological Research
https://www.readbyqxmd.com/read/27241767/the-effects-of-on-pump-and-off-pump-coronary-artery-bypass-surgery-on-metabolic-profiles-in-the-early-postoperative-period
#17
Filippo Sanfilippo, Federica Chiarenza, Cesare Cassisi, Cristina Santonocito, Theodoros Tsoutsouras, Marialena Trivella, Stephen Gerry, Marinella Astuto, Shane George, David P Taggart
OBJECTIVE: Hyperlactatemia and base deficit (BD) are markers of adverse outcome after cardiac surgery, and their derangement can be influenced by the use of extracorporeal circulation. The authors hypothesized a better postoperative metabolic profile in off-pump coronary artery bypass grafting (OPCABG) compared with "on-pump" coronary artery bypass grafting (ONCABG). DESIGN: This was a retrospective study, with consecutive data collected for 1 year from electronic medical records...
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27162701/concomitant-off-pump-coronary-artery-bypass-grafting-and-total-thyroidectomy-for-a-large-retrosternal-goitre-a-case-report-and-review-of-the-literature
#18
Savvas Lampridis, Man Chi Lau, Peter Mhandu, Haralabos Parissis
A 76-year-old male presented with angina and a large retrosternal goitre causing marked dyspnoea. Coronary angiography revealed triple vessel disease and moderately impaired left ventricular function. CT imaging demonstrated a substantial multinodular goitre extending into the posterior mediastinum to the level of the carina, with associated compression of the trachea and oesophagus. Preoperative thyroid function tests showed euthyroid state. The patient subsequently underwent off-pump coronary artery bypass grafting (OPCABG) ×2 with concomitant total thyroidectomy...
May 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27052062/monitoring-diastolic-dysfunction-using-a-simplified-algorithm-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting-surgery
#19
Deepak Prakash Borde, Balaji Asegaonkar, Pramod Apsingekar, Sujeet Khade, Savni Futane, Bapu Khodve, Mahesh Kedar, Anand Deodhar, Unmesh Takalkar, Antony George, Shreedhar Joshi
CONTEXT: Left ventricle diastolic dysfunction (LVDD) is gaining importance as useful marker of mortality and morbidity in cardiac surgical patients. Different algorithms have been proposed for the intraoperative grading of DD. Knowledge of the particular grade of DD has clinical implications with the potential to modify therapy, but there is a paucity of literature on the role of diastolic function evaluation during off-pump coronary artery bypass grafting (OPCABG) surgery. AIMS: The aim of this study was to monitor changes in LVDD using simplified algorithm proposed by Swaminathan et al...
April 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/26888744/is-off-pump-technique-a-safer-procedure-for-coronary-revascularization-a-propensity-score-analysis-of-20-years-of-experience
#20
Paula Carmona, Federico Paredes, Eva Mateo, Armando V Mena-Durán, Fernando Hornero, Juan Martínez-León
OBJECTIVES: We aim to describe our experience in coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass by comparing intraoperative and postoperative outcomes. METHODS: From January 1993 to June 2013, 3097 patients underwent consecutive emergency and scheduled CABG surgery. A total of 1770 patients underwent on-pump CABG (ONCABG) and 1327 off-pump CABG (OPCABG). A propensity score matching was performed to identify appropriate matched-pair patients; univariable and multivariable logistic regression analyses were performed to assess significant predictors of hospital and 30-day morbidity and mortality composite end-points...
May 2016: Interactive Cardiovascular and Thoracic Surgery
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