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Bypass survival

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
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
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
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
Gustavo S Oderich, Rodrigo Macedo, David H Stone, Edward Y Woo, Jean M Panneton, Timothy Resch, Nuno V Dias, Björn Sonesson, Marc L Schermerhorn, Jason T Lee, Manju Kalra, Randall R DeMartino, Giuliano de A Sandri, Emanuel J Ramos Tenorio
OBJECTIVE: Retrograde open mesenteric stenting (ROMS) through laparotomy was introduced as an alternative to surgical bypass in patients with acute mesenteric ischemia (AMI). The purpose of this study was to evaluate the indications and outcomes of ROMS for treatment of AMI and chronic mesenteric ischemia. METHODS: We reviewed the clinical data and outcomes of all consecutive patients treated by ROMS in seven academic centers from 2001 to 2013. ROMS was performed through laparotomy with retrograde access into the target mesenteric artery and stent placement using a retrograde or antegrade approach...
March 13, 2018: Journal of Vascular Surgery
Chin L Poh, Edward Buratto, Marco Larobina, Rochelle Wynne, Michael O'Keefe, John Goldblatt, James Tatoulis, Peter D Skillington
OBJECTIVES: The Ross procedure has demonstrated excellent results when performed in patients with aortic stenosis or mixed aortic valve disease [aortic stenosis and aortic regurgitation (AR)]. However, due to its reported risk of late reoperation, it is not recommended under current guidelines for patients presenting with bicuspid aortic valve and pure AR. We have analysed our own results in light of this recommendation. METHODS: Between 1993 and 2016, 129 consecutive patients with a mean age of 34...
March 12, 2018: European Journal of Cardio-thoracic Surgery
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
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
Kangjun Shen, Xinmin Zhou, Ling Tan, Feng Li, Jun Xiao, Hao Tang
BACKGROUND: We hypothesized that the arch-first procedure without extra devices under moderate-to-mild systemic hypothermia during acute type A aortic dissection is safe and efficient and will improve patient outcome compared with the standard total arch replacement technique. METHODS: From December 2014 to February 2017, 89 patients were enrolled in this study, 52 of whom underwent conventional deep hypothermic circulatory arrest (DHCA, 24.2 ± 0.71°C) using the antegrade cerebral perfusion surgical procedure (Group A) and 37 of whom underwent the "arch-first" technique with moderate (27...
March 12, 2018: Journal of Cardiovascular Surgery
Erin Amanda Fender, Pranav Chandrashekar, Jackson J Liang, Priyank R Dhar, Terence T Sio, John M Stulak, Ryan J Lennon, Joshua P Slusser, Jonathan B Ashman, Robert C Miller, Joerg Herrmann, Abhiram Prasad, Gurpreet S Sandhu
Background and aim: Thoracic radiation therapy (XRT) for cancer is associated with the development of significant coronary artery disease that may require coronary artery bypass grafting surgery (CABG). Contemporary acute surgical outcomes and long-term postoperative survival of patients with prior XRT have not been well characterised. Methods: This was a retrospective, single-centre study of patients with a history of thoracic XRT who required CABG and who were propensity matched against 141 controls who underwent CABG over the same time period...
2018: Open Heart
Jared P Beller, Robert B Hawkins, J Hunter Mehaffey, Damien J LaPar, Irving L Kron, Leora T Yarboro, Gorav Ailawadi, Ravi K Ghanta
BACKGROUND: As a marker of myocardial injury, troponin level correlates with adverse outcomes following myocardial infarction (MI). We hypothesized that patients with higher preoperative troponin level would have increased morbidity and mortality following CABG. METHODS: A total of 1,272 patients underwent urgent or emergent, isolated CABG and had preoperative troponin measurements at our institution (2002-2016). Logistic regression assessed the risk-adjusted impact of peak troponin level on morbidity and mortality...
March 8, 2018: Annals of Thoracic Surgery
Lianfang Ni, Ligong Nie
Targeted therapy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKIs) has been the standard modality as first-line treatment of advanced EGFR-mutated non-small cell lung cancer (NSCLC). The third-generation EGFR-TKIs has been approved to overcome the EGFR T790M mutation in patients resistant to the first-or second-generation TKIs, which brings more survival benefits for patients with advanced NSCLC. Unfortunately, acquired resistance inevitably develops after application of approximately 10 months...
February 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Hallie E Baer-Bositis, Taylor D Hicks, Georges M Haidar, Matthew J Sideman, Lori L Pounds, Mark G Davies
OBJECTIVE: Tibial interventions for critical limb ischemia are now commonplace. Restenosis and occlusion remain barriers to durability after intervention. The aim of this study was to examine the patient-centered outcomes of open and endovascular reintervention for symptomatic recurrent disease after a primary isolated tibial endovascular intervention. METHODS: A database of patients undergoing isolated primary lower extremity tibial endovascular interventions between 2006 and 2016 was retrospectively queried...
March 8, 2018: Journal of Vascular Surgery
Douglas W Jones, Philip P Goodney, Jens Eldrup-Jorgensen, Marc L Schermerhorn, Jeffrey J Siracuse, Jeanwan Kang, Jesse A Columbo, Bjoern D Suckow, David H Stone
OBJECTIVE: Performing lower extremity bypass (LEB) in actively smoking claudicants remains controversial. Whereas some surgeons advocate a strict nonoperative approach to active smokers, citing perceived inferior outcomes, others will proceed with surgical bypass if the patient is anatomically suited and medical management has failed. The purpose of this study was to determine the impact of active smoking on LEB outcomes among claudicants. METHODS: All patients undergoing infrainguinal LEB for claudication in the Vascular Study Group of New England from 2003 to 2016 were analyzed...
March 6, 2018: Journal of Vascular Surgery
S Chris Malaisrie, Patrick M McCarthy, Jane Kruse, Roland Matsouaka, Adin-Cristian Andrei, Maria V Grau-Sepulveda, Daniel J Friedman, James L Cox, J Matthew Brennan
BACKGROUND: This study compares early and late outcomes in patients undergoing coronary artery bypass grafting with and without preoperative atrial fibrillation in a contemporary, nationally representative Medicare cohort. METHODS: In the Medicare-Linked Society of Thoracic Surgeons database, 361,138 patients underwent isolated coronary artery bypass from 2006 to 2013, of whom 37,220 (10.3%) had preoperative atrial fibrillation; 13,161 (35.4%) were treated with surgical ablation and were excluded...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Colette Pickard, Rachel Thomas, Isabell Robertson, Angus Macdonald
PURPOSE: The purpose of this study was to review our experience with palliative ostomy surgery in patients with bowel obstruction and advanced stage colorectal cancer. DESIGN: A descriptive, retrospective review of data from a prospectively collected clinical database. SUBJECTS AND SETTING: The sample comprised 86 patients (55 male) who underwent palliative surgery between October 1998 and January 2009. METHODS: All patients undergoing palliative stoma formation without resection for colorectal carcinoma were identified from a prospectively compiled colorectal cancer database...
March 7, 2018: Journal of Wound, Ostomy, and Continence Nursing
Laura Mercer-Rosa, Okan U Elci, Nelangi M Pinto, Ronn E Tanel, Elizabeth Goldmuntz
Deletion of 22q11.2 (del22q11) is associated with adverse outcomes in patients with tetralogy of Fallot (TOF). We sought to investigate its contribution to perioperative outcome in patients with a severe form of TOF characterized by pulmonary atresia (PA) or severe pulmonary stenosis (PS) and major aortopulmonary collateral arteries (MAPCAS). We conducted a retrospective review of patients with TOF/MAPCAS who underwent staged surgical reconstruction between 1995 and 2006. Groups were compared according to 22q11...
March 8, 2018: Pediatric Cardiology
Rachel Morris, Cheong Jun Lee
Angiosarcoma is an exceedingly rare and aggressive neoplasm. Due to early metastasis even in low-grade tumors, it is associated with poor survival. We report a late development of an angiosarcoma in a saphenous vein graft following a femoral artery to above knee popliteal artery bypass performed for disabling claudication. Chronic inflammation, lymphatic disruption and thrombosis of the graft may have contributed to the malignant transformation, similar to cases described occurring after arteriovenous fistulae creation...
March 5, 2018: Annals of Vascular Surgery
Stephanie C Casey, Virginie Baylot, Dean W Felsher
The MYC proto-oncogene is a gene product that coordinates the transcriptional regulation of a multitude of genes that are essential to cellular programs required for normal as well as neoplastic cellular growth and proliferation, including cell cycle, self-renewal, survival, cell growth, metabolism, protein and ribosomal biogenesis, and differentiation. Here we propose that MYC regulates these programs in a manner that is coordinated with a global influence on the host immune response. MYC had been presumed to contribute to tumorigenesis through tumor cell intrinsic influences...
March 7, 2018: Blood
Jianzhou Liu, Mei Liang, Guotao Ma, Xingrong Liu, Ninghai Cheng, Dongyan Cao, Chunhua Yu, Shunda Du, Qi Miao, Chaoji Zhang
OBJECTIVES: There are few published studies on the rare disorder of intravenous-cardiac leiomyomatosis (IVCL). This study aimed to propose an individualized strategy for surgical treatment of IVCL. METHODS: In this retrospective study, we reviewed 50 patients who had undergone IVCL removal from November 2002 to October 2017 in our hospital. IVCL was classified as Type A-E according to the extent and size, with Type E being the most severe. Clinical manifestations, surgical features and follow-up data were analysed...
March 3, 2018: European Journal of Cardio-thoracic Surgery
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