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coronary bypass anesthesia

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https://www.readbyqxmd.com/read/29778336/implementation-of-the-aortic-no-touch-technique-to-reduce-stroke-after-off-pump-coronary-surgery
#1
Alexander Albert, Jürgen Ennker, Yasser Hegazy, Sebastian Ullrich, Georgi Petrov, Payam Akhyari, Stefan Bauer, Eda Ürer, Ina Carolin Ennker, Artur Lichtenberg, Horst Priss, Alexander Assmann
OBJECTIVES: Despite substantial scientific effort, the relationship between stroke after coronary artery bypass grafting and the use of the aortic no-touch off-pump technique (anOPCAB) remains incompletely understood. The present study aimed to define the effect of anOPCAB on the occurrence and time point of stroke. METHODS: A total cohort of 15,042 consecutive patients underwent surgical myocardial revascularization at a single institution. After establishing anOPCAB as routine procedure, 4695 patients received surgery by 18 different surgeons using the anaortic approach...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#2
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29727370/effect-of-a-perioperative-intra-aortic-balloon-pump-in-high-risk-cardiac-surgery-patients-a-randomized-clinical-trial
#3
Graziela Santos Rocha Ferreira, Juliano Pinheiro de Almeida, Giovanni Landoni, Jean Louis Vincent, Evgeny Fominskiy, Filomena Regina Barbosa Gomes Galas, Fabio A Gaiotto, Luís Oliveira Dallan, Rafael Alves Franco, Luiz Augusto Lisboa, Luis Roberto Palma Dallan, Julia Tizue Fukushima, Stephanie Itala Rizk, Clarice Lee Park, Tânia Mara Strabelli, Silvia Helena Gelas Lage, Ligia Camara, Suely Zeferino, Jaquelline Jardim, Elisandra Cristina Trevisan Calvo Arita, Juliana Caldas Ribeiro, Silvia Moreira Ayub-Ferreira, Jose Otavio Costa Auler, Roberto Kalil Filho, Fabio Biscegli Jatene, Ludhmila Abrahao Hajjar
OBJECTIVES: The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN: A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING: Heart Institute of São Paulo University. PATIENTS: High-risk patients undergoing elective coronary artery bypass surgery. INTERVENTION: Patients were randomized to receive preskin incision intra-aortic balloon pump insertion after anesthesia induction versus no intra-aortic balloon pump use...
April 30, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#4
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628009/aprotinin-impacts-8-isoprostane-after-coronary-artery-bypass-grafting
#5
V Toikkanen, T Rinne, R Nieminen, E Moilanen, J Laurikka, H Porkkala, M Tarkka, A A Mennander
BACKGROUND AND AIMS: The lungs participate in the modulation of the circulating inflammatory factors induced by coronary artery bypass grafting. We investigated whether aprotinin-which has been suggested to interact with inflammation-influences lung passage of key inflammatory factors after coronary artery bypass grafting. MATERIAL AND METHODS: A total of 40 patients undergoing coronary artery bypass grafting were randomized into four groups according to aprotinin dose: (1) high dose, (2) early low dose, (3) late low dose, and (4) without aprotinin...
April 1, 2018: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29627158/kinetics-of-endocan-in-patients-undergoing-cardiac-surgery-with-and-without-cardiopulmonary-bypass
#6
Pierre-Alain Poinsot, Benoit Barrucand, Fiona Ecarnot, Philippe Lassalle, Guillaume Besch, Sidney Chocron, Andréa Perrotti
BACKGROUND: Endocan plays an important role in the processes of inflammation and infection. The use of cardiopulmonary bypass (CPB) during cardiac surgery can induce an inflammatory response. We aimed to describe the kinetics of endocan in patients undergoing cardiac surgery with and without the use of CPB. METHODS: Single-centre, observational study with retrospective analysis of prospectively collected data, to compare the kinetics of endocan in patients undergoing isolated coronary artery bypass graft (CABG) surgery...
April 4, 2018: Cytokine
https://www.readbyqxmd.com/read/29602472/local-anesthesia-for-percutaneous-endovascular-abdominal-aortic-aneurysm-repair-is-associated-with-fewer-pulmonary-complications
#7
Kathryn Van Orden, Alik Farber, Marc L Schermerhorn, Philip P Goodney, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Percutaneous endovascular aneurysm repair (EVAR) can be performed with general anesthesia (GA) or local anesthesia (LA). Our goal was to assess perioperative outcomes comparing anesthesia type in percutaneous EVAR. METHODS: The Vascular Quality Initiative database was queried for all exclusively percutaneous EVAR procedures. Univariable analysis was used to compare which patients were offered LA. Multivariable analysis was used to determine the independent effect of anesthesia type...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29602249/the-first-transapical-transcatheter-aortic-valve-in-valve-implantation-using-the-j-valve-system-into-a-failed-biophysio-aortic-prosthesis-in-a-patient-with-high-risk-of-coronary-obstruction
#8
Jian Ye, Arthur J Lee, Philipp Blanke, John Webb
We report the first successful valve-in-valve (ViV) implantation into a failed Edwards Biophysio surgical prosthesis (Edwards Lifesciences, Irvine, CA) and also the first use of the J-Valve system (Jie Cheng Medical Technologies, Suzhou, China) in a ViV configuration. A 77-year old male had symptomatic severe aortic stenosis secondary to failure of a 25 mm Biophysio bioprosthetic valve implanted 11 years previously, along with concomitant coronary artery bypass grafting. Transthoracic echocardiography (TTE) revealed calcified leaflets, a mean aortic gradient of 50 mm Hg, and an estimated valve area of 0...
March 30, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29559262/integration-of-simulation-components-enhances-team-training-in-cardiac-surgery
#9
David L Joyce, Brian D Lahr, Simon Maltais, Sameh M Said, John M Stulak, Gregory A Nuttall, Lyle D Joyce
OBJECTIVES: Simulation in resident medical education has traditionally focused on isolated components of a surgical procedure. We hypothesized that incorporating an interdisciplinary team into a high-fidelity simulation laboratory would enhance the modeling of real-world challenges during cardiac surgery. METHODS: Simulation exercises were performed with staffing by surgeons, anesthesiologists, perfusionists, surgical assistants, and operating room technicians. Twelve accredited cardiothoracic surgical residents were divided into 3 teams...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29544418/brom-aortoplasty-for-supravalvular-aortic-stenosis
#10
Michael C Mongé, Osama M Eltayeb, John M Costello, Joyce T Johnson, Andrada R Popescu, Cynthia K Rigsby, Carl L Backer
BACKGROUND: Controversy remains regarding the optimal surgical approach for children with supravalvular aortic stenosis (SVAS). METHODS: Since 1997 we have used Brom three-patch aortoplasty for patients with SVAS. We prefer computed tomography (CT) imaging for preoperative evaluation rather than cardiac catheterization as it avoids the well-known morbidity of general anesthesia. The purpose of this study was to present our intermediate-term results of this strategy...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29540661/assessment-of-renal-and-hepatic-tissue-protective-effects-of-n-acetylcysteine-via-ammonia-metabolism-a-prospective-randomized-study
#11
Didem Onk, Fatih Özçelik, Oruç Alper Onk, Murat Günay, Tülin Akarsu Ayazoğlu, Ethem Ünver
BACKGROUND The present study sought to assess the renal and liver protective effect of N-acetylcysteine through NH3 and urea metabolism in patients with chronic obstructive pulmonary disease who were scheduled for coronary artery bypass grafting surgery. MATERIAL AND METHODS Patients with chronic obstructive pulmonary disease (COPD) who were scheduled for coronary artery bypass grafting were divided into 2 groups so as to receive (Group 1, n=35) or not receive (Group 2, n=35) 900 mg/day of n-acetylcysteine for 7 days before the operation starting from their admission to the service by a pulmonologist with the purpose of treating COPD until the day of surgery...
March 15, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29517675/effects-of-shenmai-injection-on-the-values-of-co-sv-and-ef-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-a-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Qingxue Liu, Haiyan Wu, Jianjuan Wang, Xi-Ming Li
BACKGROUND: To explore the effects of Shenmai (SM) injection on the values of cardiac output (CO), stroke volume (SV), and the ejection fraction (EF) in patients treated with off-pump coronary artery bypass graft (OPCABG). METHODS: Forty patients undergoing OPCABG were randomly divided into SM group (n = 20) and the 5% glucose (G) group (n = 20). The control liquids were injected from the beginning of the operation to the start of coronary artery bypass graft (CABG)...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29459111/a-trial-of-two-anesthetic-regimes-for-minimally-invasive-mitral-valve-repair
#13
Marco Moscarelli, Nora Terrasini, Anna Nunziata, Prakash Punjabi, Gianni Angelini, Marco Solinas, Alba Buselli, Paolo Del Sarto, Dorela Haxhiademi
OBJECTIVE: Minimally invasive mitral valve repair may be associated with prolonged cardioplegic arrest times and ischemic reperfusion injury. Intravenous (propofol) and volatile (sevoflurane) anesthesia are used routinely during cardiac surgery and are thought to provide cardioprotection; however, the individual contribution of each regimen to cardioprotection is unknown. Therefore, the authors sought to compare the cardioprotective effects of propofol and sevoflurane anesthesia in patients undergoing minimally invasive mitral valve repair...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29430523/plasma-catecholamine-levels-on-the-morning-of-surgery-predict-post-operative-atrial-fibrillation
#14
Ethan J Anderson, Jimmy T Efird, Andy C Kiser, Patricia B Crane, Wesley T O'Neal, T Bruce Ferguson, Hazaim Alwair, Kendal Carter, J Mark Williams, Anil K Gehi, Alan P Kypson
OBJECTIVES: This study sought to determine whether plasma catecholamines and monoamine oxidase-B (MOA-B) are associated with post-operative atrial fibrillation (POAF) in patients undergoing elective cardiac surgery. BACKGROUND: Although intra- and post-operative adrenergic tone has been demonstrated to be an causative factor for POAF, the role and association of pre-operative plasma catecholamines remains unclear. METHODS: Prior to administration of anesthesia on the morning of surgery, blood samples were obtained from 324 patients undergoing nonemergent coronary artery bypass graft and/or aortic valve surgery with cardiopulmonary bypass at East Carolina Heart Institute...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29390270/anesthetic-management-of-off-pump-simultaneous-coronary-artery-bypass-grafting-and-lobectomy-case-report-and-literature-review
#15
REVIEW
Xian Zhao, Yuhong Li, Hai-Ying Kong, Lin Zhang, Xiao-Hong Wen
RATIONALE: Survey data show approximately 10% patients with lung cancer may present concomitant coronary heart disease. Simultaneous surgery is a challenge for anesthetist. We review our experience in the anesthesia with 5 patients who required simultaneous off-pump coronary artery bypass grafting (OPCABG) and pulmonary resection for lung cancer. PATIENT CONCERNS: Between 2014 and 2016, 5 patients with ASA (American Society of Anesthesiologists) grade II or III, underwent combined OPCABG and lung resection in the first Affiliated Hospital, Zhejiang University School of Medicine...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29342431/comparison-of-access-type-on-perioperative-outcomes-after-endovascular-aortic-aneurysm-repair
#16
Jeffrey J Siracuse, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Gheorghe Doros, Salvatore T Scali, Marc L Schermerhorn
OBJECTIVE: Endovascular aneurysm repair (EVAR) can be performed through percutaneous or surgical access. Our goal was to assess the difference in perioperative outcomes based on access type in a real-world setting. METHODS: The Vascular Quality Initiative (VQI) database was queried for EVAR. Univariable analysis and multivariable analysis were used to determine the independent effect of access type. RESULTS: There were 8340 (64%) and 4747 (36%) EVAR procedures performed through percutaneous and surgical access (3395 [72%] transverse and 1352 [28%] vertical incisions)...
January 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29336389/a-randomized-controlled-trial-comparing-the-myocardial-protective-effects-of-isoflurane-with-propofol-in-patients-undergoing-elective-coronary-artery-bypass-surgery-on-cardiopulmonary-bypass-assessed-by-changes-in-n-terminal-brain-natriuretic-peptide
#17
Balaji Kuppuswamy, Kirubakaran Davis, Raj Sahajanandan, Manickam Ponniah
OBJECTIVE: The objective of the study is to compare the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass (CPB), the cardio protection been assessed by changes in N-terminal brain natriuretic peptide (NT proBNP). Methodology and Design: This study is designed as a participant blinded, prospective randomized clinical trial. SETTING: Christian Medical College Hospital, Vellore, India...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29235056/separating-arterial-pressure-increases-and-decreases-in-assessing-cardiac-baroreflex-sensitivity-via-sequence-and-bivariate-phase-rectified-signal-averaging-techniques
#18
Beatrice De Maria, Vlasta Bari, Marco Ranucci, Valeria Pistuddi, Giovanni Ranuzzi, Anielle C M Takahashi, Aparecida M Catai, Laura Dalla Vecchia, Sergio Cerutti, Alberto Porta
Cardiac baroreflex (cBR) is activated by both arterial pressure (AP) increases and decreases. Sequence method, a widely utilized tool assessing cBR sensitivity (cBRS) from spontaneous heart period (HP) and systolic AP (SAP) variations, allows the separated computation of cBRS from positive and negative SAP variations. The recently proposed phase-rectified signal averaging (PRSA) method has the same feature but it has been applied so far solely to positive SAP variations. We adapted the PRSA method to compute cBRS over negative SAP variations and we compared the results with those derived from sequence method over two protocols: (i) graded head-up tilt (HUT) at 15, 30, 45, 60, and 75° in 19 healthy subjects and (ii) general anesthesia induction in 118 patients undergoing coronary artery bypass graft surgery...
December 13, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29151335/comparison-of-tidal-volume-and-deep-breath-preoxygenation-techniquesundergoing-coronary-artery-bypass-graft-surgery-effects-of-hemodynamicresponse-and-arterial-oxygenation
#19
Zafer Taş, Tülay Hoşten, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Ahmet Arıkan, Zeynep Mine Solak
Background/aim: Different techniques exist for the preoxygenation of patients that will be operated on under general anesthesia. Preoxygenation with the deep breath (DB) method may affect cardiovascular stability, which is crucial for coronary artery bypass graft (CABG) patients. In this study, we aimed to compare the effects of the 3 min TVB preoxygenation technique and 1 min 8DBs technique on hemodynamic response and arterial oxygenation in patients with normal ejection fraction that were scheduled for elective CABG surgery...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29151310/comparison-of-the-cardioprotective-effects-of-dexmedetomidineand-remifentanil-in-cardiac-surgery
#20
Mediha Türktan, Yasemin Güneş, Hafize Yalınız, Selçuk Matyar, Zehra Hatipoğlu, Ersel Güleç, Uğur Göçen, Atakan Atalay
Background/aim: Myocardial protection is an important factor of open heart surgery and biological biomarkers (lactate, CKMB, cardiac troponin I, and pyruvate) are used to assess myocardial damage. This study compares the effects of dexmedetomidine and remifentanil on myocardial protection during coronary artery bypass grafting (CABG) surgery. Materials and methods: Patients scheduled for elective CABG surgery (n = 60) were included in this study. Anesthesia induction was introduced with propofol, fentanyl, and vecuronium bromide...
November 13, 2017: Turkish Journal of Medical Sciences
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