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coronary bypass surgery

Corey Joseph, Marie Garrubba, Julian A Smith, Angela Melder
Pulmonary artery catheters (PACs) were introduced in 1970. Since then, their use has steadily increased. However, there have been questions raised regarding their efficacy for multiple clinical scenarios. The purpose of this systematic review was to determine the safety and effectiveness of routine use of PACs post cardiac surgery on mortality, complications, days in intensive care unit, days in hospital, and costs in patients undergoing cardiac surgery, or patients who end up in an intensive care unit. METHODS: Medline, All EBM, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched using predetermined search terms...
February 21, 2018: Heart, Lung & Circulation
Zhifeng Gao, Jeffrey Bortman, Faraz Mahmood, John Mitchell, Feroze Mahmood, Robina Matyal
OBJECTIVE: To test the feasibility and reliability of using a vendor-neutral platform to evaluate right ventricular (RV) strain. Reliability was determined by comparing intra- and inter-observer variability between RV strain assessments. The secondary objective was to assess strain's correlation with conventional RV functional parameters to evaluate its feasibility as a RV systolic functional assessment tool. DESIGN: This is a retrospective study. SETTING: Tertiary hospital...
February 9, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Akshat Saxena, Sohaib A Virk, Sebastian Bowman, Lionel Chan, Richmond Jeremy, Paul G Bannon
No abstract text is available yet for this article.
April 2018: Journal of Thoracic and Cardiovascular Surgery
Steven Maximus, Jeffrey C Milliken, Beate Danielsen, Richard Shemin, Junaid Khan, Joseph S Carey
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) procedures were introduced in 2011. Initially, procedures were limited to patients who were not surgical candidates, but subsequently high-risk surgical candidates were considered for TAVR. The influence on aortic valve surgery in California is unknown. METHODS: The California Office of Statewide Health Planning and Development hospitalized patient discharge database was queried for the years 2009 through 2014...
April 2018: Journal of Thoracic and Cardiovascular Surgery
Morgan L Cox, Brian C Gulack, Dylan P Thibault, Xia He, Matthew L Williams, Vinod H Thourani, Jeffery P Jacobs, J Matthew Brennan, Mani A Daneshmand, Deepak Acharya
OBJECTIVES: Previous studies have demonstrated a 20% mortality rate among patients undergoing isolated coronary artery bypass grafting (CABG) for cardiogenic shock. However, outcomes following CABG for cardiogenic shock in patients who are neurologically unresponsive preoperatively are unknown. METHODS: Utilizing the Society of Thoracic Surgeons Adult Cardiac Surgery Database between July 2011 and December 2013, patients undergoing urgent or emergent CABG within 7 days of an acute myocardial infarction complicated by cardiogenic shock were identified...
March 14, 2018: European Journal of Cardio-thoracic Surgery
Melissa Rochon, Julian We Jarman, Joseph Gabriel, Lisa Butcher, Carlos Morais, Martin Still, Ishtiaq Ahmed, Mario Petrou, Richard Trimlett, Anthony DeSouza, Rashmi Yadav, Shahzad G Raja
Background: Previously, we reported that the Brompton Harefield Infection Score (BHIS) accurately predicts surgical site infection (SSI) after coronary artery bypass grafting (CABG). The BHIS was developed using two-centre data and stratifies SSI risk into three groups based on female gender, diabetes or HbA1c > 7.5%, body mass index ≥ 35, left ventricular ejection fraction < 45% and emergency surgery. The purpose of this study was to prospectively evaluate BHIS internally as well as externally...
March 2018: Journal of Infection Prevention
Alexander Kulik, Amy M Abreu, Viviana Boronat, Nicholas T Kouchoukos, Marc Ruel
RATIONALE: Saphenous vein graft disease remains a major limitation of coronary artery bypass graft surgery (CABG). Up to 20% of vein grafts will occlude within the first year after CABG despite standard aspirin antiplatelet therapy. However, more potent postoperative platelet inhibition with ticagrelor may improve graft patency. The goal of this study will be to evaluate the efficacy of ticagrelor, as compared to aspirin, for the prevention of saphenous vein graft occlusion following CABG...
March 15, 2018: Contemporary Clinical Trials
Joseph P DeSimone, David J Malenka, Paul W Weldner, Alexander Iribarne, Bruce J Leavitt, Jock N McCullough, Reed D Quinn, Joseph D Schmoker, Robert S Kramer, Yvon Baribeau, John D Klemperer, Gerald L Sardella, Elaine M Olmstead, Cathy S Ross, Anthony W DiScipio
BACKGROUND: Coronary artery bypass graft surgery (CABG) arterial conduits are preferred to venous conduits because of longer patency. A single internal mammary artery (SIMA) is used routinely. Bilateral internal mammary arteries (BIMA) are used less frequently. We sought to determine if BIMA were superior to SIMA. METHODS: From our regional registry of consecutive open heart surgery, we identified 47,984 patients who underwent isolated CABG from 1992-2014. Of the 1,482 BIMA patients, 1,297 were propensity matched to a cohort of SIMA patients...
March 14, 2018: Annals of Thoracic Surgery
Prateek Bhatnagar, Shubhi Bhatnagar
Mesocardia is an extremely rare congenital cardiac anomaly of counter clockwise rotation of the heart. We report here a case of coronary artery bypass grafting in mesocardia, which has not been described in medical literature earlier. A 52 years male suffered an anterior wall myocardial infarction. Chest X Ray, 2 D Echocardiography and computed tomography of chest confirmed the presence of mesocardia. Off pump total arterial revascularization was done. Exposure of aorta and right atrium through the standard median sternotomy is very difficult in mesocardia due to cardiac rotation and should be kept in mind in this surgery...
March 13, 2018: Annals of Thoracic Surgery
Justyna Bartoszko, Duminda N Wijeysundera, Keyvan Karkouti, Jeannie Callum, Vivek Rao, Mark Crowther, Hilary P Grocott, Ruxandra Pinto, Damon C Scales, Blaine Achen, Sukhpal Brar, Doug Morrison, David Wong, Jean S Bussières, Tonya de Waal, Christopher Harle, Étienne de Médicis, Charles McAdams, Summer Syed, Diem Tran, Terry Waters
BACKGROUND: Research into major bleeding during cardiac surgery is challenging due to variability in how it is scored. Two consensus-based clinical scores for major bleeding: the Universal definition of perioperative bleeding and the European Coronary Artery Bypass Graft (E-CABG) bleeding severity grade, were compared in this substudy of the Transfusion Avoidance in Cardiac Surgery (TACS) trial. METHODS: As part of TACS, 7,402 patients underwent cardiac surgery at 12 hospitals from 2014 to 2015...
March 15, 2018: Anesthesiology
Judit Karacsonyi, Ehrin J Armstrong, Huu Tam D Truong, Ryan Tsuda, Damianos G Kokkinidis, Jose Roberto Martinez-Parachini, Aya J Alame, Barbara A Danek, Aris Karatasakis, Michele Roesle, Houman Khalili, Imre Ungi, Subhash Banerjee, Emmanouil S Brilakis, Bavana V Rangan
BACKGROUND: The contemporary use and outcomes of excimer laser coronary atherectomy (ELCA) in percutaneous coronary intervention (PCI) are not well described. METHODS: We examined the baseline clinical and angiographic characteristics and procedural outcomes of 130 target lesions in 121 consecutive PCIs (n = 116 patients) in which ELCA was performed at three United States Department of Veterans Affairs (VA) medical centers between 2008 and 2016. RESULTS: Mean age was 68...
March 15, 2018: Journal of Invasive Cardiology
Sarah Soo-Hoo, Samantha Nemeth, Onur Baser, Michael Argenziano, Paul Kurlansky
Objective: To explore the impact of racial and ethnic diversity on the performance of cardiac surgical risk models, the Chinese SinoSCORE was compared with the Society of Thoracic Surgeons (STS) risk model in a diverse American population. Methods: The SinoSCORE risk model was applied to 13 969 consecutive coronary artery bypass surgery patients from twelve American institutions. SinoSCORE risk factors were entered into a logistic regression to create a 'derived' SinoSCORE whose performance was compared with that of the STS risk model...
2018: Heart Asia
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
Taku Omori, Ryuji Okamoto, Hajime Fujimoto, Jun Masuda, Tetsu Kobayashi, Eitaro Fujii, Yoshiyuki Takei, Masaaki Ito
No abstract text is available yet for this article.
March 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Kyokun Uehara, Hitoshi Matsuda, Jiro Matsuo, Yosuke Inoue, Atsushi Omura, Yoshimasa Seike, Hiroaki Sasaki, Junjiro Kobayashi
AIM: To evaluate the surgical outcomes and midterm results of patients under 50 years old with acute type A aortic dissection (AAAD). METHODS: The study population included 51 patients who underwent AAAD repair between 2003 and 2016. Of these 51 patients, 46 (90.1%) were males and 14 (27.5%) had connective tissue disorders. Twenty-five patients (49.0%) had a body mass index >25.0 kg/m2 and two patients were pregnant. Total arch replacement was performed in 39 patients (76...
March 13, 2018: Journal of Cardiac Surgery
Irene Papanicolas, Liana R Woskie, Ashish K Jha
Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations...
March 13, 2018: JAMA: the Journal of the American Medical Association
Sigita Glaveckaite, Egle Uzdavinyte-Gateliene, Zaneta Petrulioniene, Darius Palionis, Nomeda Valeviciene, Gintaras Kalinauskas, Pranas Serpytis, Aleksandras Laucevicius
OBJECTIVES: We aimed to evaluate (i) the effectiveness of combined surgery (coronary artery bypass grafting with restrictive mitral valve annuloplasty) and (ii) the late gadolinium enhancement cardiovascular magnetic resonance-based predictors of ischaemic mitral regurgitation (IMR) recurrence. METHODS: The prospective analysis included 40 patients with multivessel coronary artery disease, IMR >II° and left ventricular (LV) dysfunction undergoing combined surgery...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Jonathan Rilinger, Claudia Heilmann, Ulrich Beitinger, Christoph B Olivier, Philipp Diehl, Friedhelm Beyersdorf, Matthias Siepe
BACKGROUND: Ischemic mitral regurgitation (IMR) is a frequent complication of coronary artery heart disease and is associated with increased mortality. Controversies exists whether patients with moderate IMR may benefit from a combined procedure with coronary artery bypass grafting (CABG) and treatment of mitral regurgitation. METHODS: 451 patients with moderate IMR (grade 2) receiving either CABG alone (CABG only) or additional mitral valve repair or replacement (CABG+MV) were included in this observational single-centre study...
March 12, 2018: Journal of Cardiovascular Surgery
Paolo Nardi, Calogera Pisano, Fabio Bertoldo, Sara R Vacirca, Guglielmo Saitto, Antonino Costantino, Emanuele Bovio, Antonio Pellegrino, Giovanni Ruvolo
We retrospectively analyzed early results of coronary artery bypass grafting (CABG) surgery using two different types of cardioplegia for myocardial protection: antegrade intermittent warm blood or cold crystalloid cardioplegia. From January 2015 to October 2016, 330 consecutive patients underwent isolated on-pump CABG. Cardiac arrest was obtained with use of warm blood cardioplegia (WBC group, n  = 297) or cold crystalloid cardioplegia (CCC group, n  = 33), according to the choice of the surgeon. Euroscore II and preoperative characteristics were similar in both groups, except for the creatinine clearance, slightly lower in WBC group (77...
December 2018: Cell Death Discovery
David R Dobies, Kimberly R Barber
Evidence-based medicine (EBM) provides clinicians with beneficial information. Nonetheless, study findings are often arbitrary, speculative or provisional. The current state of misleading evidence exists in all applications, including those for guideline recommendations. We conductedan appraisal of the American College of Cardiologyand European Society of Cardiology Guidelines for revascularisation of complex coronary anatomy to determine the veracity of the evidence that recommendations were based on. Study-specific critical appraisals were conducted by the authors on the 5-year Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and future revascularisation evaluation in patients with diabetes mellitus: optimal management of multivessel disease (FREEDOM) Trials...
2018: Open Heart
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