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Multivessel coronary artery disease

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https://www.readbyqxmd.com/read/29681566/off-pump-coronary-artery-bypass-grafting-with-mini-sternotomy-in-the-treatment-of-triple-vessel-coronary-artery-disease
#1
Pixiong Su, Song Gu, Yan Liu, Xitao Zhang, Jun Yan, Xiangguang An, Jie Gao, Yue Xin, Jian Zhou
We have developed off-pump coronary artery bypass approach with lower distal mini-sternotomy (TM-OPCAB) for multivessel coronary revascularization. The aim of this retrospective study is to provide evidence for the feasibility and safety of this technique in the treatment of triple-vessel diseases.Two hundred eighty-eight patients with triple-vessel coronary artery disease who underwent TM-OPCAB or standard off-pump coronary artery bypass surgery (S-OPCAB) were included in this study after propensity-score matching...
April 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29680218/hybrid-coronary-revascularization-in-selected-patients-with-multivessel-disease-5-year-clinical-outcomes-of-the-prospective-randomized-pilot-study
#2
Mateusz Tajstra, Tomasz Hrapkowicz, Michał Hawranek, Krzysztof Filipiak, Marek Gierlotka, Marian Zembala, Mariusz Gąsior, Michael Oscar Zembala
OBJECTIVES: This study aimed to investigate the 5-year clinical follow-up of the Hybrid Revascularization for Multivessel Coronary Artery Disease (HYBRID) trial. BACKGROUND: HYBRID trial, the only randomized study involving thorough analysis of outcome after the 2 procedures, suggested that hybrid coronary revascularization (HCR) is feasible in selected patients with multivessel coronary disease referred for conventional coronary artery bypass grafting (CABG). There are currently no long-term outcome data from randomized trials in this setting...
April 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29661343/reduced-forced-expiratory-volume-in-1-second-percentage-predicted-is-associated-with-diffuse-coronary-atherosclerosis-in-hospitalized-patients-undergoing-coronary-angiography
#3
Ying Liang, Meng Wang, Xinye Xu, Nan Li, Qingtao Zhou, Bei He
BACKGROUND: Reduced forced expiratory volume in 1 second percentage (FEV1%) predicted is closely related to cardiovascular mortality. However, evidence regarding the correlation between FEV1% predicted and the severity of coronary atherosclerosis observed on coronary angiography is still limited. We aimed to explore whether a decline in FEV1% predicted was associated with diffuse coronary atherosclerosis in hospitalized patients. METHODS: A cross-sectional study enrolling hospitalized patients with cardiovascular symptoms undergoing both coronary angiography and lung function testing was conducted...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29661004/percutaneous-versus-surgical-revascularization-for-left-main-or-multivessel-coronary-artery-disease-results-from-a-large-scale-meta-analysis-in-the-era-of-drug-eluting-stents
#4
Monica Verdoia, Lucia Barbieri, Elvin Kedhi, Harry Suryapranata, Giuseppe De Luca
The best treatment options for left main (LM) or multivessel coronary disease (MVD) are still debated. We performed a meta-analysis of randomized trials comparing percutaneous versus surgical revascularization for LM or MVD. Primary end point was overall mortality. Secondary end points were major adverse cardiovascular events, recurrent myocardial infarction, repeated revascularization, or stroke. A total of 8 randomized trials were included, involving 8694 patients, 50% undergoing percutaneous coronary intervention (PCI)...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29626068/clinical-benefit-of-evolocumab-by-severity-and-extent-of-coronary-artery-disease-an-analysis-from-fourier
#5
Marc S Sabatine, Gaetano M De Ferrari, Robert P Giugliano, Kurt Huber, Basil S Lewis, Jorge Ferreira, Julia F Kuder, Sabina A Murphy, Stephen D Wiviott, Christopher E Kurtz, Narimon Honarpour, Anthony C Keech, Peter S Sever, Terje R Pedersen
Background -The FOURIER trial recently showed that the PCSK9 inhibitor evolocumab significantly reduced major vascular events in patients with stable atherosclerotic cardiovascular disease, including patients with prior MI. Within the broad group of patients with prior MI, we hypothesized that readily ascertainable features would identify subsets that derive greater clinical risk reduction with evolocumab. Methods -The 22,351 patients with a prior MI were characterized based on time from most recent MI, number of prior MIs, and presence of residual multivessel coronary artery disease (≥40% stenosis in ≥2 large vessels)...
April 6, 2018: Circulation
https://www.readbyqxmd.com/read/29607197/kawasaki-disease-multiple-giant-coronary-aneurysms-intervention-and-pacemaker-implantation-due-to-complete-heart-block-a-case-report
#6
Chunping Liu, Junxia Li, Zhenshuang Cui, Lili Niu, Junyu Cui, Xinli Tian, Yujie Shi
Early intravenous immunoglobulin (IVIG) is the standard treatment for Kawasaki disease (KD) to reduce the incidence of coronary aneurysms. Patients with atypical presentation or who live in a rural area are less likely to receive treatment in the early stage of presentation and are more likely to develop severe complications. There is little consensus on how to treat coronary aneurysms effectively in the acute or subacute stage especially when giant aneurysms develop that compromise cardiac function. This case study is of a 19-month-old girl who initially was not treated as KD and developed multivessel giant coronary artery aneurysms (CAAs) (>8 mm), acute myocardial infarction, and complete heart block despite late intravenous IVIG administration...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29605639/multivessel-analysis-of-progressive-vascular-aging-in-the-rat-asynchronous-vulnerability-among-vascular-territories
#7
Mariam El Assar, Argentina Fernández, Alberto Sánchez-Ferrer, Javier Angulo, Leocadio Rodríguez-Mañas
Aging induces vascular dysfunction, representing the major risk factor for cardiovascular disease. Our aim was to ascertain specific vulnerability of vascular territories to aging by evaluating the progressive impact of aging on vascular function in four different vascular beds: aorta, mesenteric artery (MA), coronary artery (CA), and penile corpus cavernosum (CC) from 3, 6, 9, 12, 20 or 24 months-old male rats. Contractile/relaxant responses were evaluated in organ chambers (A/CC) and wire myographs (MA/CA)...
March 29, 2018: Mechanisms of Ageing and Development
https://www.readbyqxmd.com/read/29602582/relationship-between-cha-2-ds-2-vasc-score-coronary-artery-disease-severity-residual-platelet-reactivity-and-long-term-clinical-outcomes-in-patients-with-acute-coronary-syndrome
#8
Fernando Scudiero, Chiara Zocchi, Elena De Vito, Giuseppe Tarantini, Rossella Marcucci, Renato Valenti, Angela Migliorini, David Antoniucci, Niccolò Marchionni, Guido Parodi
BACKGROUND: The CHA2 DS2 -VASc score predicts stroke risk in patients with atrial fibrillation, but recently has been reported to have a prognostic role even in patients with ACS. We sought to assess the ability of the CHA2 DS2 -VASc score to predict the severity of coronary artery disease, high residual platelet reactivity and long-term outcomes in patients with acute coronary syndrome (ACS). METHODS: Overall, 1729 consecutive patients with ACS undergoing invasive management were included in this prospective registry...
March 20, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29593837/is-complete-revascularisation-mandated-for-all-patients-with-multivessel-coronary-artery-disease
#9
Carlo De Innocentiis, Marco Zimarino, Raffaele De Caterina
In multivessel coronary artery disease (MVCAD), myocardial revascularisation can be achieved by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), with complete revascularisation on all diseased coronary segments or with incomplete revascularisation on selectively targeted lesions. Complete revascularisation confers a long-term prognostic benefit, but is associated with a higher rate of periprocedural events compared with incomplete revascularisation. In most patients with MVCAD, the main advantage of CABG over PCI is conferred by the achievement of more extensive revascularisation...
January 2018: Interventional Cardiology
https://www.readbyqxmd.com/read/29588736/unprotected-left-main-coronary-artery-disease-management-in-the-post-noble-and-excel-era
#10
Nyal Borges, Samir R Kapadia, Stephen G Ellis
The optimal management of unprotected left main coronary artery (ULMCA) disease is currently a debated topic. Percutaneous coronary intervention (PCI) has seen an increased adoption for the management of ULMCA disease after numerous small-scale randomised trials and cohort studies showed equipoise with coronary artery bypass grafting (CABG) for low complexity lesions. The recently published NOBLE and EXCEL trials are two of the largest international randomised clinical trials comparing PCI and CABG in patients with ULMCA disease...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29579209/does-minimally-invasive-coronary-artery-bypass-improve-outcomes-compared-to-off-pump-coronary-bypass-via-sternotomy-in-patients-undergoing-coronary-artery-bypass-grafting
#11
Daniel S Florisson, Joshua A DeBono, Reece A Davies, Andrew E Newcomb
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'In patients undergoing off-pump coronary artery bypass grafting, for single or multivessel disease, does minimally invasive direct coronary artery bypass (MIDCAB) or off-pump coronary artery bypass (OPCAB) provide the superior outcome including a reduction in morbidity and mortality?'. A total of 187 papers were found using the reported search, of which 12 represented the best evidence to answer the clinical question...
March 22, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29572680/syntax-score-and-outcomes-of-coronary-revascularization-in-diabetic-patients
#12
REVIEW
Amartya Kundu, Partha Sardar, Kevin O'Day, Saurav Chatterjee, Theophilus Owan, J Dawn Abbott
PURPOSE OF REVIEW: This review describes the dynamic relationship between diabetes mellitus (DM) and coronary artery disease (CAD) with respect to different revascularization strategies and how angiographic tools such as the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score can supplement clinical decision-making. RECENT FINDINGS: The SYNTAX score characterizes the anatomical extent of CAD in terms of the number of lesions, functional importance, and complexity...
March 23, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29571730/hybrid-coronary-revascularization-versus-on-pump-coronary-artery-bypass-grafting
#13
Vincenzo Giambruno, Philip Jones, Feras Khaliel, Michael W Chu, Patrick Teefy, Kumar Sridhar, Cristina Cucchietti, Rebecca Barnfield, Bob Kiaii
BACKGROUND: Hybrid coronary revascularization (HCR) is an evolving coronary revascularization strategy for the treatment of multivessel coronary artery disease. We provide a comparative analysis to conventional on-pump coronary artery bypass graft surgery (CABG) with long-term follow-up. METHODS: We included all double on-pump CABG (n = 682) and HCR (147 robotic-assisted minimally invasive bypass grafts of the left internal thoracic artery to the left anterior descending coronary artery and percutaneous coronary intervention to one of the non-left anterior descending coronary artery vessels) performed in our institution between March 2004 and November 2015...
March 20, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29568331/impact-of-diabetes-mellitus-on-ischemic-cardiomyopathy-five-year-follow-up-revision-dm-trial
#14
Thiago Hueb, Mauricio S Rocha, Sergio F Siqueira, Silvana Angelina D Orio Nishioka, Giselle L Peixoto, Marcos M Saccab, Eduardo Gomes Lima, Rosa Maria Rahmi Garcia, José Antonio F Ramires, Roberto Kalil Filho, Martino Martinelli Filho
Background: Patients with ischemic cardiomyopathy and severe left ventricular dysfunction have a worse survival prognosis than patients with preserved ventricular function. The role of diabetes in the long-term prognosis of this patient group is unknown. This study investigated whether the presence of diabetes has a long-term impact on left ventricular function. Methods: Patients with coronary artery disease who underwent coronary artery bypass graft surgery, percutaneous coronary intervention, or medical therapy alone were included...
2018: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/29561966/short-term-and-mid-term-clinical-outcomes-following-hybrid-coronary-revascularization-versus-off-pump-coronary-artery-bypass-a-meta-analysis
#15
Li Dong, Yi-Kun Kang, Xiang-Guang An
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) is one of the standard treatments for coronary artery disease (CAD) while hybrid coronary revascularization (HCR) represents an evolving revascularization strategy. However, the difference in outcomes between them remains unclear. OBJECTIVE: We performed a meta-analysis to compare the short-term and mid-term outcomes of HCR versus OPCAB for the treatment of multivessel or left main CAD. METHODS: We searched the PubMed, EMBASE, Web of Science and Cochrane databases to identify related studies and a routine meta-analysis was conducted...
March 19, 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29557990/vascular-restenosis-in-coronary-artery-bypass-grafting-might-be-associated-with-vegf-c-vegfr-3-signaling-pathway
#16
Zuzanna Podemska-Jedrzejczak, Agnieszka Malinska, Patrycja Sujka-Kordowska, Michal Nowicki, Mateusz Puslecki, Marek Jemielity, Bartlomiej Perek
The vascular endothelial growth factor (VEGF) family of peptides and caveolins (CAVs) are reported to contribute, in early graft failure in patients, a coronary artery bypass grafting (CABG). To investigate the possible association of ultimate luminal occlusion to VEGFs and CAVs expression, a functional analysis (based on the molecular biology, bioinformatics, histology, and clinical studies) was performed. Twenty-four hundred and sixty-eight CABG patients diagnosed with multivessel stable coronary artery disease (CAD) were enrolled into prospective study and assigned to two subgroups: double- and triple-vessel CAD subjects...
March 20, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29554237/real-life-characteristics-and-outcomes-of-patients-who-undergo-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease-data-from-the-prospective-multi-vessel-coronary-artery-disease-multicad-israeli-registry
#17
Eilon Ram, Ilan Goldenberg, Yigal Kassif, Amit Segev, Jacob Lavee, Michal Einhorn-Cohen, Ehud Raanani
OBJECTIVES: Left main coronary artery involvement in patients with multivessel coronary artery disease provides a poor prognosis. Although the main strategy for revascularization is by coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI) is being used with increased frequency. METHODS: This prospective, 3-year follow-up study included 1063 consecutive patients with multivessel coronary artery disease enrolled between January and April 2013 from all 22 hospitals in Israel that perform coronary angiography and PCI...
March 15, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29551541/current-trends-in-bilateral-internal-thoracic-artery-use-for-coronary-revascularization-extending-benefit-to-high-risk-patients
#18
Nishant Saran, Chaim Locker, Sameh M Said, Richard C Daly, Simon Maltais, John M Stulak, Kevin L Greason, Alberto Pochettino, Hartzell V Schaff, Joseph A Dearani, Lyle D Joyce, Brian D Lahr, David L Joyce
BACKGROUND: We sought to identify the trends in bilateral internal thoracic artery use and determine the degree to which the survival advantage of bilateral internal thoracic artery revascularization persists among perceived "high-risk" patients, compared with the use of left internal thoracic artery alone. METHODS: A retrospective review was conducted of patients who underwent isolated coronary artery bypass grafting for multivessel coronary artery disease at the Mayo Clinic between January 2000 and December 2015...
February 23, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29551055/a-score-for-decision-making-during-percutaneous-coronary-intervention-in-acute-myocardial-infarction-patients-with-multivessel-disease
#19
Hae Chang Jeong, Joon Ho Ahn, Min Chul Kim, Doo Sun Sim, Keun Ho Park, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Ki-Bae Seung, Kiyuk Chang, Youngkeun Ahn
Background/Aims: The optimal percutaneous coronary intervention (PCI) strategy in patients with acute myocardial infarction (AMI) with multivessel disease (MVD) is uncertain. This study was designed to develop a novel and simple tool for assessing an individualized and optimized PCI strategy in AMI patients with MVD. Methods: In total, 5,025 patients with AMI from nine centers at two universities were enrolled in the prospective Convergent Registry of Catholic and Chonnam University for Acute Myocardial Infarction (COREA-AMI) registry from January 2004 through December 2009...
March 20, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29546745/definitions-and-clinical-impact-of-revascularization-completeness
#20
Cristina Aurigemma, Francesco Burzotta, Giulio Russo, Leonardo Previ, Carlo Trani
The Completeness of Revascularization in patients with multivessel coronary artery disease (CAD) remains an unanswered question. Despite 20 years of investigation there are still major doubts in this topic, reaching as far as to the lack of a standardized definition. The employment of different definition and the multiplicity of confounding variables that in general favor patients who receive a complete revascularization (CR) are the reason of difficult comparisons between studies. The complexity of coronary anatomy diseases and the clinical features play important role in the revascularization strategy...
March 15, 2018: Minerva Cardioangiologica
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