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off pump surgery

Kamales Kumar Saha, Saurab Goel, Ajay Kumar, Kakalee K Saha
A 64 years old male diabetic patient with ejection fraction of 16% and renal dysfunction underwent off-pump CABG using both in situ internal mammary artery grafts. Left internal mammary artery was used to bypass left anterior descending artery and right internal mammary artery was used as composite graft. Patient had uneventful recovery and left ventricular ejection fraction improved to 34% within 8 months after surgery. In presence of left ventricular dysfunction, both internal thoracic artery grafting should be preferred for better patency rate and flow reserve...
September 2016: Indian Heart Journal
Harinder Singh Bedi, Vivek Tewarson, Kamal Negi
We report a 55-year-old man who underwent off-pump bypass surgery and had diffuse oozing and bruising postoperatively. His hematological profile had been normal preoperatively and he had been off antiplatelets for a week prior to surgery. Postoperatively, a detailed talk revealed that he had been on dietary supplements containing fish oil and garlic - both of which are known to affect platelet function. It behooves the surgeon and anesthetist to screen all patients preoperatively for the possibility of intake of any dietary supplements taken by the patient...
September 2016: Indian Heart Journal
Krzysztof Wróbel, Katarzyna Kurnicka, Marcin Zygier, Wojciech Dyk, Ryszard Wojdyga, Dariusz Zieliński, Małgorzata Jarzębska, Zbigniew Juraszyński, Barbara Lichodziejewska, Piotr Pruszczyk, Andrzej Biederman, Giovanni Speziali, Uwe Kasten
BACKGROUND AND AIM: Artificial chordal implantation in order to repair flail or prolapse mitral valve leaflet requires open heart surgery and cardiopulmonary bypass. Transapical off-pump implantation of neochordae is a new surgical technique proposed to treat degenerative mitral valve regurgitation. The procedure is performed using the NeoChord DS1000 system (NeoChord, Inc., Eden Praire, MN), which facilitates both implantation and tension adjustment of the neochordae under transesophageal echocardiographic 2D and 3D guidance...
October 7, 2016: Kardiologia Polska
Deniz Çevirme, Taylan Adademir, Mehmet Aksüt, Tülay Örki, Kamil Cantürk Çakalağaoğlu, Mete Alp, Kaan Kirali
INTRODUCTION: Coronary artery bypass grafting (CABG) results in higher morbidity and mortality rates in end-stage renal disease (ESRD) patient populations than in patients with normal renal function. This study aimed to identify the early results of CABG performed on ESRD patients, and the factors that affected the mortality rates of those patients. METHODS: A retrospective evaluation of our hospital database revealed 84 haemodialysis-receiving patients who underwent CABG during the years 2006 to 2012...
July 22, 2016: Cardiovascular Journal of Africa
Igor D Gregoric, Rajko Radovancevic, Mehmet H Akay, Mateja K Jezovnik, Sriram Nathan, Manish Patel, Jayeshkumar A Patel, Elena Nedelcu, Nghia D Nguyen, Pranav Loyalka, Biswajit Kar
Implantation of left ventricular assist devices (LVAD) while avoiding cardiopulmonary bypass (CPB) may decrease bleeding and improve postoperative recovery. To understand the effectiveness of this approach, we reviewed the charts of 26 patients who underwent HeartWare left ventricular assist device (HVAD) implantation without use of CPB (off-CPB group) and 22 patients who had HVAD implanted with CPB (CPB group) with an emphasis on the 30-day postoperative period. Preoperatively, both groups had similar demographic, functional, and hemodynamic characteristics...
September 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Ali Sait Kavakli, Nilgun Kavrut Ozturk, Raif Umut Ayoglu, Mustafa Emmiler, Lutfi Ozyurek, Kerem Inanoglu, Sadik Ozmen
OBJECTIVES: Various minimally invasive surgical approaches have been used in mitral valve (MV) surgery. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive, alternative procedure for the treatment of degenerative mitral regurgitation. There are several special considerations for the anesthesiologist during the TOP-MINI procedure. The main purpose of this study was to present the anesthetic management of the TOP-MINI procedure...
June 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
T K Kim, K Nam, Y J Cho, J J Min, Y J Hong, K U Park, D M Hong, Y Jeon
The infusion of fluids to patients may affect tissue microcirculation and the endothelial glycocalyx. However, the effects of hydroxyethyl starch and crystalloid on endothelial glycocalyx degradation and microvascular reactivity have not been evaluated in detail. We hypothesised that hydroxyethyl starch may cause less endothelial glycocalyx degradation and better microvascular reactivity than that caused by crystalloid. We randomly allocated 120 patients undergoing off-pump coronary artery bypass graft surgery to receive up to 20 ml...
September 26, 2016: Anaesthesia
Juan M Vrancic, Fernando Piccinini, Mariano Camporrotondo, Juan C Espinoza, Juan I Camou, Francisco Nacinovich, Pablo Fernandez Oses, Daniel Navia
BACKGROUND: There is controversy about the risk of mediastinitis associated with the use of both internal thoracic arteries (ITA). METHODS: We performed a case-control study of patients operated on at a single institution from January 2003 to December 2014. A total of 3,118 consecutive patients undergoing isolated coronary artery bypass graft surgery were included; 81.3% (n = 2,533) underwent bilateral ITA (BITA) grafts exclusively and constitute the BITA group, and 18...
September 19, 2016: Annals of Thoracic Surgery
Ghulam Hussain, Hammad Azam, Mirza Ahmad Raza Baig, Naseem Ahmad
OBJECTIVES: To see the early post-operative outcomes of off-pump versus on-pump coronary artery bypass graft surgery. METHODS: This retrospective analytical study was conducted at Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Our Primary outcome variables were; necessity of inotropic support, nonfatal myocardial infarction, ICU stay, nonfatal stroke, new renal failure requiring dialysis and death within 30 days after operation. There were two groups of patients; Group-I (On-pump group) and Group-II (Off-pump Group)...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Ali Sait Kavakli, Raif Umut Ayoglu, Nilgun Kavrut Ozturk, Omer Haldun Tekinalp, Zehra Erkal, Kerem Inanoglu, Mustafa Emmiler
Elderly patients with severe hematological malignancies may require cardiac surgery. The combined impact of cardiopulmonary bypass (CPB) and surgical trauma is a potent inflammatory activator and is increased by intraoperative and postoperative complications. To avoid the adverse effects of CPB, minimally invasive off-pump techniques may be used in these patients. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive technique for mitral valve repair, which makes it possible to avoid the risks of CPB in selected patients, such as elderly, cancer or immunosuppressive patients...
September 19, 2016: Journal of Anesthesia
Wojciech Szychta, Franciszek Majstrak, Grzegorz Opolski, Krzysztof J Filipiak
INTRODUCTION: Strict glucose control is an everyday practice in the perioperative period. Elevated glucose level has a deleterious impact on clinical results, but a therapeutic target has not been stated yet. AIM: To determine a glucose concentration range affecting long-term outcomes after coronary artery bypass surgery (CABG). MATERIAL AND METHODS: This study is a retrospective evaluation of consecutive patients treated in a university hospital in Poland from 2004 to 2008...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Hong Chul Oh, Jung Wook Han, Jae-Woong Choi, Yong Han Kim, Ho Young Hwang, Ki-Bong Kim
BACKGROUND: Reports on concomitant cardiac and non-cardiovascular surgeries have noted disadvantages in the use of extracorporeal circulation. We assessed the results of concomitant off-pump coronary artery bypass (OPCAB) and non-cardiovascular surgery, and compared them with isolated OPCAB results. METHODS: Of 2,439 patients who underwent OPCAB between 1999 and 2014, 115 patients underwent concomitant OPCAB and non-cardiovascular surgery. Combined non-cardiovascular diseases included 63 malignant and 52 benign diseases...
August 2016: Journal of Thoracic Disease
Xuchen Ma, Fangjiong Huang, Zhitai Zhang, Feiqiang Song, Songlei Ou
BACKGROUND: To assess the safety and efficacy of combined surgery for patients with concurrent lung cancer and severe coronary heart disease (CHD). METHODS: Between 2003 and 2014, 34 patients with stage I or II lung cancer and simultaneous severe CHD underwent combined off-pump coronary artery bypass (OPCAB) grafting and lung resection. Surgically, myocardial revascularization was performed first and followed by lobectomies through the same or a second incision...
August 2016: Journal of Thoracic Disease
Aya G Elmarsafawi, Maggie M Abbassi, Sameh Elkaffas, Hassan M Elsawy, Nirmeen A Sabry
OBJECTIVES: Comparing different perioperative statin regimens for the prevention of post-coronary artery bypass grafting adverse events. DESIGN: A randomized, prospective study. SETTING: Cardiothoracic surgical units in a government hospital. PARTICIPANTS: The study comprised 94 patients scheduled for elective, isolated on- or off- pump coronary artery bypass grafting. INTERVENTIONS: Patients were assigned randomly to 1 of the following 3 treatment groups: group I (80 mg of atorvastatin/day for 2 days preoperatively), group II (40 mg of atorvastatin/day for 5-9 days preoperatively), or group III (80 mg of atorvastatin/day for 5-9 days preoperatively)...
May 31, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Andreas Beckmann, Anne-Katrin Funkat, Jana Lewandowski, Michael Frie, Markus Ernst, Khosro Hekmat, Wolfgang Schiller, Jan F Gummert, Armin Welz
On the basis of a long-standing voluntary registry, which was founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), well-defined data of all heart, thoracic, and vascular surgery procedures performed in 78 German heart surgery departments during 2015 are analyzed. In 2015, a total of 103,967 heart surgery procedures (implantable cardioverter defibrillator, pacemaker, and extracardiac procedures without ECC excluded) were submitted to the database. Approximately 14.8% of the patients were at least 80 years old, resulting in an increase of 0...
September 2016: Thoracic and Cardiovascular Surgeon
Carlos Junior Toshiyuki Karigyo, Felipe Batalini, Alexandre Noboru Murakami, Rogério Toshio Teruya, Francisco Gregori Júnior
A 76-year-old man with situs inversus totalis underwent a successful off-pump three-vessel coronary artery bypass surgery. The postoperative course was uneventful, and the patient was discharged 8 days later. At 9-month follow-up a coronary computed tomography angiography confirmed the viability of all of the grafts, and one year after the operation the patient remained asymptomatic. It comprises the fifth Brazilian case of a coronary surgery in a patient with situs inversus totalis and the first one of the country of a coronary artery bypass surgery without the use of the cardiopulmonary bypass in this condition...
April 2016: Brazilian Journal of Cardiovascular Surgery
Mehmet Özülkü, Fatih Aygün
OBJECTIVE: We investigated the effects of pedicled and semiskeletonized left internal mammary artery (LIMA) harvesting techniques on postoperative drainage in patients subjected to off-pump CABG, ignoring other advantages or disadvantages of those techniques. METHODS: The present study comprises a total of 160 subjects that underwent coronary artery bypass surgery in our clinic. Data were collected consecutively and retrospectively. An attempt was made to have similar groups in terms of demographic characteristics...
April 2016: Brazilian Journal of Cardiovascular Surgery
Paulo Roberto L Prates, Judson B Williams, Rajendra H Mehta, Susanna R Stevens, Laine Thomas, Peter K Smith, L Kristin Newby, Renato A K Kalil, John H Alexander, Renato D Lopes
INTRODUCTION: Antiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario. OBJECTIVE: Identify predictors of clopidogrel following CABG. METHODS: We evaluated 5404 patients who underwent CABG between 2000 and 2009 at Duke University Medical Center. We excluded patients undergoing concomitant valve surgery, those who had postoperative bleeding or death before discharge...
April 2016: Brazilian Journal of Cardiovascular Surgery
Ashok Tholpady, Arthur W Bracey, Kelty R Baker, Ross M Reul, Alice J Chen
Cold hemagglutinin disease with broad thermal amplitude and high titers presents challenges in treating cardiac-surgery patients. Careful planning is needed to prevent the activation of cold agglutinins and the agglutination of red blood cells as the patient's temperature drops during surgery. We describe our approach to mitigating cold agglutinin formation in a 77-year-old man with severe cold hemagglutinin disease who underwent off-pump coronary artery bypass surgery without the use of preoperative plasmapheresis...
August 2016: Texas Heart Institute Journal
Dirk Wilhelm, Alissa Jell, Hubertus Feussner, Roland M Schmid, Monther Bajbouj, Valentin Becker
AIM: Diagnosis of laryngopharyngeal reflux (LPR) has dramatically increased over the last years. For diagnosis of gastroesophageal reflux, a newly designed pharyngeal probe (Dx-pH) was recently introduced. It is also recommended to guide therapy decision in antireflux surgery. However, diagnostic results are questionable. Therefore, we establish a reliable reference group with asymptomatic patients after total gastrectomy and, thus, complete extinction of gastric acid production. METHODS: Pharyngeal pH monitoring was performed in 10 consecutive patients with history of total gastrectomy...
August 2016: United European Gastroenterology Journal
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