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https://www.readbyqxmd.com/read/28445858/the-impact-of-minor-blood-transfusion-on-the-outcome-after-coronary-artery-bypass-grafting
#1
Eeva-Maija Kinnunen, Marco Zanobini, Francesco Onorati, Debora Brascia, Giovanni Mariscalco, Ilaria Franzese, Vito G Ruggieri, Karl Bounader, Andrea Perrotti, Francesco Musumeci, Giuseppe Santarpino, Daniele Maselli, Saverio Nardella, Helmut Gulbins, Riccardo Gherli, Antonino S Rubino, Carmelo Mignosa, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Antonio Salsano, Magnus Dalén, Matteo Saccocci, Daniel Reichart, Giuseppe Faggian, Tiziano Gherli, Francesco Nicolini, Fausto Biancari
PURPOSE: To investigate the impact of minor perioperative bleeding requiring transfusion of 1-2 red blood cell (RBC) units on the outcome after coronary artery bypass grafting (CABG). METHODS: Sixteen cardiac surgical centers contributed to the prospective European CABG registry (E-CABG). 1014 patients receiving 1-2 RBC units during or after isolated CABG were compared to 2264 patients not receiving RBCs. RESULTS: In 827 propensity score matched pairs, transfusion of 1-2 RBC units did not affect the risk of in-hospital/30-day death (p=0...
April 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28444175/predictive-value-of-telomere-length-on-outcome-following-acute-myocardial-infarction-evidence-for-contrasting-effects-of-vascular-vs-blood-oxidative-stress
#2
Marios Margaritis, Fabio Sanna, George Lazaros, Ioannis Akoumianakis, Sheena Patel, Alexios S Antonopoulos, Chloe Duke, Laura Herdman, Costas Psarros, Evangelos K Oikonomou, Cheerag Shirodaria, Mario Petrou, Rana Sayeed, George Krasopoulos, Regent Lee, Dimitris Tousoulis, Keith M Channon, Charalambos Antoniades
Aims: Experimental evidence suggests that telomere length (TL) is shortened by oxidative DNA damage, reflecting biological aging. We explore the value of blood (BTL) and vascular TL (VTL) as biomarkers of systemic/vascular oxidative stress in humans and test the clinical predictive value of BTL in acute myocardial infarction (AMI). Methods and results: In a prospective cohort of 290 patients surviving recent AMI, BTL measured on admission was a strong predictor of all-cause [hazard ratio (HR) [95% confidence interval (CI)]: 3...
April 24, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28442067/meta-analysis-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#3
Abdur R Khan, Harsh Golwala, Avnish Tripathi, Haris Riaz, Arnav Kumar, Michael P Flaherty, Deepak L Bhatt
Despite the increase in use of percutaneous coronary intervention (PCI) in left main coronary disease, its efficacy compared with coronary artery bypass grafting (CABG) is unclear. We performed a meta-analysis of randomized controlled trials to assess the optimal revascularization strategy. Our search yielded 8 studies reporting relevant outcomes that were pooled using the inverse variance method, and the hazard ratio (HR) was calculated. The primary outcome was all-cause mortality, myocardial infarction (MI), or stroke (major adverse cardiac events [MACE]), and the secondary outcome was death/MI/stroke/repeat revascularization (expanded MACE)...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28439849/aortic-valve-replacement-after-coronary-artery-bypass-grafting-with-the-in-situ-right-gastroepiploic-artery-to-the-occluded-right-coronary-artery-using-a-temporary-vein-graft-for-cardioplegia
#4
Yoshifumi Fuke, Toru Yasutsune, Masato Sakamoto
BACKGROUND: The operation of aortic valve replacement (AVR) after CABG is a technically challenging procedure in respect to dissection of living grafts from its surrounding tissue, myocardial protection, and so on, especially that procedure to patients with living in situ functional arterial grafts to occluded native coronary arteries has a special problem in regard to myocardial protection because myocardial blood supply originates from various arteries including the left internal thoracic artery (LITA), the right internal thoracic artery (RITA), and the right gastroepiploic artery (GEA); hence, adequate myocardial protection should be fastidiously considered...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28439192/bedside-vein-mapping-for-conduit-size-in-coronary-artery-bypass-surgery
#5
Frank Manetta, Pey-Jen Yu, Allan Mattia, John C Karaptis, Alan R Hartman
BACKGROUND AND OBJECTIVES: The greater saphenous vein has been used in coronary artery bypass grafting (CABG) for more than 50 years. Endoscopic vein harvesting has greatly reduced the morbidity associated with obtaining the vein, but the quality of the vein could not be assessed before its was exposed surgically or after the endoscopic procedure had been performed. This study was conducted to evaluate the accuracy of preoperative mapping of the greater saphenous vein at the bedside in assessing suitable conduit size for use in CABG...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28438354/coronary-artery-bypass-graft-surgery-versus-percutaneous-coronary-intervention-with-drug-eluting-stents-for-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#6
Alessandro Putzu, Michele Gallo, Enrico Antonio Martino, Enrico Ferrari, Giovanni Pedrazzini, Tiziano Moccetti, Tiziano Cassina
BACKGROUND: Despite several clinical studies, efficacy of coronary artery bypass grafting (CABG) surgery versus percutaneous coronary intervention (PCI) in patients with left main (LM) disease remains controversial. The objective of this meta-analysis of randomized trials was to evaluate the clinical outcome of CABG versus PCI with drug-eluting stents in LM coronary disease. METHODS: We systematically searched online databases up to March 2017 for randomized trials comparing CABG to PCI with drug-eluting stents...
April 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#7
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28433995/effect-of-prophylactic-dialysis-on-morbidity-and-mortality-in-non-dialysis-dependent-patients-after-coronary-artery-bypass-grafting-a-pilot-study
#8
Roghayeh Borji, Seyyed Hossein Ahmadi, Khosrow Barkhordari, Ali Pasha Meysami, Abbas Ali Karimi, Seyedeh Hamideh Mortazavi, Parinaaz Dadlani, Farah Ayatollah Zadeh Esfahani, Seyyed Mohammad Reza Khatami
BACKGROUND/AIMS: Coronary artery bypass grafting (CABG) is associated with an increased risk of morbidity and mortality in patients with pre-existing renal dysfunction. Numerous measures have been implemented to overcome this problem; however, no improvement in outcomes has been achieved. This study was aimed at investigating the effects of prophylactic dialysis on mortality and morbidity in these patients. METHODS: This randomized-controlled clinical trial enrolled 88 non-dialysis-dependent patients with chronic kidney disease awaiting CABG surgery...
April 22, 2017: Nephron
https://www.readbyqxmd.com/read/28433221/c-reactive-protein-predicts-acute-kidney-injury-and-death-after-coronary-artery-bypass-grafting
#9
Seung Seok Han, Dong Ki Kim, Sejoong Kim, Ho Jun Chin, Dong-Wan Chae, Ki Young Na
BACKGROUND: A better prediction of postoperative acute kidney injury (AKI) is worthwhile in patients undergoing coronary artery bypass grafting (CABG) because AKI is associated with high rates of morbidity and mortality. The present study was performed to investigate whether preoperative C-reactive protein (CRP) predicted AKI and the long-term rate of mortality in CABG. METHODS: This retrospective cohort study included 1,656 patients whose high-sensitivity CRPs were measured before CABG at two tertiary referral centers from 2004 to 2010...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433215/meta-analysis-of-randomized-controlled-trials-of-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#10
Aakash Garg, Sunil V Rao, Sahil Agrawal, Kleanthis Theodoropoulos, Marco Mennuni, Abhishek Sharma, Lohit Garg, Giuseppe Ferrante, Omar A Meelu, Davit Sargsyan, Bernhard Reimers, Marc Cohen, John B Kostis, Giulio G Stefanini
Few randomized controlled trials (RCTs) and observational studies had shown acceptable short-term efficacy and safety of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) in selected patients with left main coronary artery disease (LMCAD). We aimed to evaluate long-term outcomes of PCI using DES compared with CABG in patients with LMCAD. On November 1, 2016, we searched available databases for published RCTs directly comparing DES PCI with CABG in patients with LMCAD...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28431717/chronic-periaortitis-of-ascending-aorta-with-bilateral-ostial-coronary-stenosis-in-a-young-female
#11
Gauranga Majumdar, Aditya Kapoor, Surendra K Agarwal, Navneet Srivastava, Ram Nawal Rao, Neetu Soni
An 18-year-old woman without any risk factors for coronary artery disease or systemic vasculitis and infection presented with recurrent angina at rest. Coronary angiography revealed 100% occlusion of the ostial left main coronary artery and severe ostial right coronary artery stenosis. She underwent successful coronary artery bypass graft surgery. At surgery, the external surface of the ascending aorta was covered with a soft-tissue thickened mass; histopathology of the mass revealed chronic nonspecific inflammatory aortitis...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28431047/impact-of-the-syntax-scores-i-and-ii-in-patients-with-diabetes-and-multivessel-coronary-disease-a-pooled-analysis-of-patient-level-data-from-the-syntax-precombat-and-best-trials
#12
Rafael Cavalcante, Yohei Sotomi, Massimo Mancone, Cheol Whan Lee, Jung-Min Ahn, Yoshinobu Onuma, Pedro A Lemos, Robert-Jan van Geuns, Seung-Jung Park, Patrick W Serruys
Aims: To assess the impact of the SYNTAX scores I and II in outcomes after percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for patients with diabetes and multivessel disease (MVD). Methods and Results: We performed a patient-level pooled analysis of three large randomized trials of patients with MVD. The impact of coronary anatomic complexity as measured by the SYNTAX score in the differences in outcomes following PCI and CABG was assessed at a median follow-up of 5 years...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430311/effect-of-hemodialysis-access-blood-flow-on-cardiac-events-after-coronary-artery-bypass-grafting-using-an-internal-thoracic-artery
#13
Leonid Feldman, Ilia Beberashvili, Ahmad Abu Tair, Shai Efrati, Oleg Gorelik, Walter G Wasser, Eitan Heldenberg, Igor Rabin
BACKGROUND: The possibility of coronary steal through an arteriovenous fistula (AVF) in hemodialysis (HD) patients with coronary artery bypass grafts (CABGs) using an ipsilateral internal thoracic artery (ITA) has been suggested. In order to define the significance of such a possibility, we analyzed cardiac events and mortality risk in patients in relation to AVF flow. METHODS: A retrospective cohort study was performed on prevalent HD patients from a single center...
April 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28430307/the-incidence-and-risk-factors-of-coronary-steal-after-ipsilateral-avf-in-patients-with-a-coronary-artery-bypass-graft
#14
Sanghyun Ahn, Ahram Han, Song-Yi Kim, Chanjoong Choi, Sang-Il Min, Jongwon Ha, Ho Young Hwang, Ki-Bong Kim, Seung-Kee Min
OBJECTIVE: Ipsilateral arteriovenous fistula (AVF) may cause symptoms of coronary steal in patients who had undergone coronary artery bypass graft (CABG) using internal thoracic artery. The purpose of this study was to evaluate the adverse effects of ipsilateral AVF to CABG, including the incidence of coronary steal, and to analyze the risk factors for coronary steal. METHODS: Between 2000 and 2013, a total of 25 patients undergoing hemodialysis via upper extremity AVF, ipsilateral to the preexisting CABG, were reviewed retrospectively...
April 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28428447/comparison-of-mid-term-graft-patency-between-on-pump-and-off-pump-coronary-artery-bypass-grafting
#15
Tatsuya Seki, Toshihito Yoshida
BACKGROUND: Multiple studies have compared on-pump coronary artery bypass (ONCAB) grafting with off-pump coronary artery bypass (OPCAB) grafting, but the optimal surgical strategy has yet to be established. Furthermore, there is limited evidence regarding mid-term graft patency rates. METHODS: Between April 2001 and March 2014, 365 consecutive patients underwent isolated coronary artery bypass grafting (CABG; male: 75%; mean age: 69 ± 10 years). After propensity-score-matched analysis, we assessed the results of 67 patients in each group (ONCAB: group A, OPCAB: group B)...
April 19, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28427580/quality-of-life-after-surgery-or-des-in-patients-with-3-vessel-or-left-main-disease
#16
Mouin S Abdallah, Kaijun Wang, Elizabeth A Magnuson, Ruben L Osnabrugge, A Pieter Kappetein, Marie-Claude Morice, Friedrich A Mohr, Patrick W Serruys, David J Cohen
BACKGROUND: In the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, patients with 3-vessel or left main coronary artery disease (CAD) had improved long-term outcomes with coronary artery bypass graft (CABG) surgery compared with percutaneous coronary intervention (PCI) with drug-eluting stents (DES), improvements driven mainly by differences in myocardial infarction and repeat revascularization. OBJECTIVES: This study compared the long-term quality-of-life benefits of DES-PCI versus CABG for patients with 3-vessel or left main CAD...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427403/preoperative-carbohydrate-load-and-intraoperatively-infused-omega-3-polyunsaturated-fatty-acids-positively-impact-nosocomial-morbidity-after-coronary-artery-bypass-grafting-a-double-blind-controlled-randomized-trial
#17
Gibran Roder Feguri, Paulo Ruiz Lúcio de Lima, Danilo de Cerqueira Borges, Laura Ramos Toledo, Larissa Nadaf Batista, Thaís Carvalho E Silva, Neuber José Segri, José Eduardo de Aguilar-Nascimento
BACKGROUND: A strategy of limited preoperative fasting, with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA), has seldom been tried in cardiovascular surgery. Brief fasting, followed by CHO intake 2 h before anesthesia, may improve recovery from CABG procedures and lower perioperative vasoactive drug requirements. Infusion of ω-3 PUFA may reduce occurrences of postoperative atrial fibrillation (POAF) and shorten hospital stays...
April 20, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#18
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#19
Richard Issitt, Tim James, Bronagh Walsh, David Voegeli
BACKGROUND: Acute kidney injury (AKI) following cardiopulmonary bypass affects 5% of patients, representing significant postoperative morbidity and mortality. Animal models have shown an increased uptake of lipid microemboli (LME) into the renal vasculature, potentially indicating ischaemic causation. This study tested a new lipid filtration system (RemoweLL) against a conventional system with no lipid-depleting capacity to determine the efficacy of the filtration system and its effects on renal function...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28423123/n-acetylcysteine-versus-dopamine-to-prevent-acute-kidney-injury-after-cardiac-surgery-in-patients-with-preexisting-moderate-renal-insufficiency
#20
Omer Faruk Savluk, Fusun Guzelmeric, Yasemin Yavuz, Deniz Cevirme, Emre Gurcu, Halide Ogus, Tulay Orki, Tuncer Kocak
Objective: Acute kidney injury after cardiac surgery is associated with mortality and morbidity. Therefore, strategies to prevent acute kidney injury are very important. The aim of this placebo-controlled randomized double-blind study was to compare the prophylactic efficacy of N-Acetylcysteine and dopamine administration in patients with pre-existing moderate renal insufficiency who were undergoing cardiopulmonary bypass. Methods: This study included 135 patients with pre-existing moderate renal insufficiency who were scheduled for coronary artery bypass grafting surgery...
January 2017: Brazilian Journal of Cardiovascular Surgery
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