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https://www.readbyqxmd.com/read/29223418/should-diabetes-be-a-contraindication-to-bilateral-internal-mammary-artery-grafting
#1
Alexander Iribarne, Benjamin M Westbrook, David J Malenka, Joseph D Schmoker, Jock N McCullough, Bruce J Leavitt, Paul W Weldner, Joseph DeSimone, Robert S Kramer, Reed D Quinn, Elaine M Olmstead, John D Klemperer, Gerald L Sardella, Cathy S Ross, Anthony W DiScipio
BACKGROUND: This study evaluates the influence of bilateral internal mammary artery (BIMA) versus single internal mammary artery (SIMA) grafting on postoperative morbidity and long-term survival among diabetic patients undergoing coronary artery bypass grafting (CABG). METHODS: A multicenter, retrospective analysis of 47,984 consecutive CABGs performed from 1992 to 2014 at 7 medical centers was conducted. Among the study population, 1,482 CABGs with BIMA were identified, and 1,297 BIMA patients were propensity-matched to 1,297 SIMA patients...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29102303/national-trends-and-geographic-variation-in-bilateral-internal-mammary-artery-use-in-the-united-states
#2
Alexander Iribarne, Philip P Goodney, Alyssa M Flores, Joseph DeSimone, Anthony W DiScipio, Andrea Austin, Jock N McCullough
BACKGROUND: The goal of this study was to characterize the adoption rate and regional variation in bilateral internal mammary artery (BIMA) use during coronary artery bypass grafting (CABG) in the United States. METHODS: Observational study of 100% sample of fee-for-service Medicare beneficiaries aged 65 years or older, continuously enrolled in Parts A and B from 2009 to 2014 (n = 162,860,439). Rates of beneficiaries receiving a BIMA versus single internal mammary artery (SIMA) during CABG are expressed per 1,000 beneficiaries and aggregated by Hospital Referral Region (HRR)...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29029008/complete-arterial-revascularization-using-bilateral-internal-mammary-artery-in-t-graft-technique-for-multivessel-coronary-artery-disease-in-on-or-off-pump-approach-does-gender-lose-its-historical-impact-on-clinical-outcome
#3
Friedrich-Christian Rieß, Christian-Alexander Behrendt, Wagma Amin, Stefan Heller, Lorenz Hansen, Stephan Winkel, Jan Stripling, Henrik Christian Rieß
OBJECTIVES: Higher rates of mortality and morbidity have been reported in women undergoing coronary artery bypass grafting (CABG) compared with men. Different revascularization techniques (on-pump and off-pump) might influence this outcome. METHODS: We retrospectively analysed 3445 consecutively recruited patients (all comers) undergoing complete arterial CABG (CACABG) at a single centre between January 2000 and December 2012. CACABG was performed in all patients using bilateral skeletonized internal mammary artery in T-graft technique, either on-pump (n = 2216) or off-pump (n = 1229)...
November 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28690951/coronary-artery-bypass-graft-in-a-young-man
#4
Stella Pak
Currently, there are no explicit guidelines on the management of acute myocardial infarction (MI) in young adults under the age of 30. The lack of published literature to guide clinicians in the care of young adults with MI has prompted us to report a case exemplary for the successful treatment with coronary artery bypass graft (CABG). A 25-year-old man developed acute MI and underwent on-pump five quintuple CABG using bilateral internal mammary arteries and left greater saphenous vein. This appropriate and timely intervention may have helped to prevent cardiac death and maintain the quality of life...
June 5, 2017: Curēus
https://www.readbyqxmd.com/read/28450552/one-year-costs-of-bilateral-or-single-internal-mammary-grafts-in-the-arterial-revascularisation-trial
#5
RANDOMIZED CONTROLLED TRIAL
Alastair M Gray, Jacqueline Murphy, Douglas G Altman, Umberto Benedetto, Helen Campbell, Marcus Flather, Stephen Gerry, Belinda Lees, David P Taggart
OBJECTIVE: Coronary artery bypass grafting (CABG) using bilateral internal mammary arteries (BIMA) may improve survival over CABG using single internal mammary arteries (SIMA), but may be surgically more complex (and therefore costly) and associated with impaired sternal wound healing. We report, for the first time, a detailed comparison of healthcare resource use and costs over 12 months, as part of the Arterial Revascularisation (ART) Trial. METHODS: 3102 patients in 28 hospitals in seven countries were randomised to CABG surgery using BIMA (n=1548) or SIMA (n=1554)...
November 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28388767/treatment-of-coronary-artery-disease-randomized-trials-on-myocardial-revascularization-and-complete-arterial-bypass-grafting
#6
Ardawan J Rastan
Friedrich Wilhelm Mohr from the very beginning of his career as a cardiac surgeon was involved in the refinements of coronary artery bypass grafting (CABG). At the Leipzig Heart Center, his spirit of early adapting to new technologies inspired the entire team and led to a matchless scientific atmosphere to find solutions to improve almost all fields of cardiac surgery, including CABG. In combination with a tremendous number of patients with indications for isolated coronary artery bypass Prof. Mohr as the surgical principle investigator and the Leipzig Heart Center were able to include patients in the Synergy between PCI [percutaneous coronary intervention] with Taxus and Cardiac Surgery (SYNTAX) trial, the first randomized trials comparing CABG and PCIs using the drug-eluting stents...
April 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28063673/-coronary-artery-bypass-graft-surgery-with-bilateral-internal-mammary-artery-short-term-results
#7
Josías Caleb Ríos Ortega, Paul Castañeda Castillo, Luisa Talledo Paredes, Franz Soplopuco Palacios, Necemio Aranda Pretell, Yemmy Pérez Valverde, Julio Morón Castro, Andrés Reyes Torres
INTRODUCTION: Coronary artery bypass graft (CABG) surgery remains the reference standard in the treatment of multivessel coronary disease. Several studies have shown that CABG with bilateral internal mammary arteries (BIMA) has better results in long-term survival. METHODOLOGY: A retrospective study was conducted on CABG surgeries with BIMA from January 2012 to December 2015 in the National Cardiovascular Institute, INCOR, EsSalud, Peru. The objectives were to determine the mortality and major cardiovascular events at 30 days follow-up...
January 5, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/27959712/randomized-trial-of-bilateral-versus-single-internal-thoracic-artery-grafts
#8
RANDOMIZED CONTROLLED TRIAL
David P Taggart, Douglas G Altman, Alastair M Gray, Belinda Lees, Stephen Gerry, Umberto Benedetto, Marcus Flather
BACKGROUND: The use of bilateral internal thoracic (mammary) arteries for coronary-artery bypass grafting (CABG) may improve long-term outcomes as compared with the use of a single internal-thoracic-artery plus vein grafts. METHODS: We randomly assigned patients scheduled for CABG to undergo single or bilateral internal-thoracic-artery grafting in 28 cardiac surgical centers in seven countries. The primary outcome was death from any cause at 10 years. The composite of death from any cause, myocardial infarction, or stroke was a secondary outcome...
December 29, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27928145/glycated-hemoglobin-and-risk-of-sternal-wound-infection-after-isolated-coronary-surgery
#9
MULTICENTER STUDY
Giuseppe Gatti, Andrea Perrotti, Daniel Reichart, Luca Maschietto, Francesco Onorati, Sidney Chocron, Magnus Dalén, Peter Svenarud, Giuseppe Faggian, Giuseppe Santarpino, Theodor Fischlein, Aniello Pappalardo, Daniele Maselli, Carmelo Dominici, Saverio Nardella, Antonino S Rubino, Marisa De Feo, Francesco Santini, Francesco Nicolini, Riccardo Gherli, Giovanni Mariscalco, Tuomas Tauriainen, Eeva-Maija Kinnunen, Vito G Ruggieri, Matteo Saccocci, Fausto Biancari
BACKGROUND: Glycated hemoglobin (HbA1c) is a suspected risk factor for sternal wound infection (SWI) after CABG.Methods and Results:Data on preoperative HbA1c and SWI were available in 2,130 patients undergoing isolated CABG from the prospective E-CABG registry. SWI occurred in 114 (5.4%). Baseline HbA1c was significantly higher in patients with SWI (mean, 54±17 vs. 45±13 mmol/mol, P<0.0001). This difference was also observed in patients without a diagnosis of diabetes (P=0.027), in insulin-dependent diabetic (P=0...
December 22, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27751328/anaortic-off-pump-bilateral-internal-mammary-grafting-in-severe-left-ventricular-dysfunction-case-report
#10
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
https://www.readbyqxmd.com/read/27547690/coronary-artery-bypass-surgery-in-diabetic-patients-risk-factors-for-sternal-wound-infections
#11
Kristina Lenz, Michael Brandt, Sandra Fraund-Cremer, Jochen Cremer
The incidence of sternal wound infections (SWI) after coronary artery bypass surgery (CABG) as reported worldwide is low. However, it is associated with significant increase of postoperative mortality and treatment costs. The major risk factors discussed are diabetes mellitus and bilateral IMA harvesting of the internal mammary artery. This study analyses data of 590 patients receiving CABG concerning the risk factors for SWI. Sternal wound infections occur significantly more often in diabetic patients, one crucial and significant additional risk factor is obesity...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/27326347/potential-risk-factors-for-surgical-site-infection-after-isolated-coronary-artery-bypass-grafting-in-a-bahrain-cardiac-centre-a-retrospective-case-controlled-study
#12
Ahmed Abdulaziz Abuzaid, Mahmood Zaki, Habib Al Tarief
OBJECTIVE: The purposes of this study were to determine the incidence of surgical site infections (SSI) and associated risk factors in patients undergoing isolated coronary artery bypass grafting (CABG) in our cardiac center during a 2-year period. MATERIALS AND METHODS: Retrospective case-control analysis for 80 patients who underwent isolated cardiac surgery CABG. These patients were divided into the SSI study group (n = 40) and the noninfected control group (n = 40)...
July 2015: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/27229669/bilateral-mammary-artery-grafting-increases-postoperative-mediastinitis-without-survival-benefit-in-obese-patients
#13
Emmeline Ruka, François Dagenais, Siamak Mohammadi, Vincent Chauvette, Paul Poirier, Pierre Voisine
OBJECTIVES: The prevalence of obesity has risen in the last decade, increasing the percentage of obese patients who undergo cardiac surgery. Deep sternal wound infection (DSWI) is a rare but devastating postoperative complication, more often encountered in the obese population. DSWI is also associated with the use of bilateral internal mammary artery (BIMA), particularly in this high-risk population. The aim of this study is to determine the short-term and long-term outcomes following BIMA revascularization in obese patients...
December 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27084197/complete-myocardial-revascularization-using-only-bilateral-internal-thoracic-arteries-provides-a-low-risk-and-durable-10-year-clinical-outcome
#14
David Glineur, Spiridon Papadatos, Juan B Grau, Richard E Shaw, Cyrus E Kuschner, Gaby Aphram, Yves Mairy, Christophe Vanbelighen, Pierre Yves Etienne
OBJECTIVES: Bilateral internal thoracic artery (BITA) bypass provides long-term survival benefits over strategies that use single internal mammary arteries during coronary artery bypass grafting (CABG). However, the rate of adoption of this strategy remains very low. Moreover, optimal BITA configuration and the use of cardiopulmonary bypass still remain a matter of debate. We investigated the long-term results of a coronary revascularization strategy, utilising exclusively BITA-Y composite grafts using off-pump platform and sequential anastomoses...
October 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27005979/comparison-of-logistic-euroscore-and-euroscore-ii-in-predicting-operative-mortality-of-1125-total-arterial-operations
#15
MULTICENTER STUDY
Teresa M Kieser, M Sarah Rose, Stuart J Head
OBJECTIVES: The purpose of this study was to compare effectiveness of the 1999 logistic EuroSCORE (LES) and of the 2012 EuroSCORE II (ESII) in a real-world patient population of 1125 patients undergoing total arterial grafting (TAG) coronary artery bypass graft (CABG) surgery. METHODS: The performance of the two risk scores was compared using (i) discrimination (accuracy of discriminating non-survivors from survivors), (ii) calibration (assessment of agreement between the predicted/observed outcomes) and (iii) agreement between the two scores...
September 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/26687889/hybrid-coronary-revascularization-versus-coronary-artery-bypass-surgery-with-bilateral-or-single-internal-mammary-artery-grafts
#16
COMPARATIVE STUDY
Joshua M Rosenblum, Ralf E Harskamp, Niels Hoedemaker, Patrick Walker, Henry A Liberman, Robert J de Winter, Thomas A Vassiliades, John D Puskas, Michael E Halkos
OBJECTIVE: Hybrid coronary revascularization (HCR) combines minimally invasive left internal mammary artery (LIMA)-left anterior descending artery (LAD) bypass with percutaneous intervention of non-LAD vessels. The purpose of this study was to compare outcomes of HCR to conventional coronary artery bypass graft (CABG) surgery with single internal mammary artery (SIMA) or bilateral internal mammary artery (BIMA) grafting. METHODS: Between October 2003 and September 2013, 306 consecutive patients who underwent HCR were compared with 8254 patients who underwent CABG with SIMA (7381; 89...
April 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26576749/impact-of-the-radial-artery-as-an-additional-arterial-conduit-during-in-situ-bilateral-internal-mammary-artery-grafting-a-propensity-score-matched-study
#17
Siamak Mohammadi, François Dagenais, Pierre Voisine, Eric Dumont, Eric Charbonneau, Mohamed Marzouk, Andreas Paramythiotis, Dimitri Kalavrouziotis
BACKGROUND: Bilateral internal mammary artery (BIMA) grafting has been associated with improved long-term outcomes after CABG. We sought to evaluate the early results and long-term survival among coronary artery bypass graft patients who underwent in-situ BIMA grafting with the radial artery (RA) as an additional arterial conduit compared with those who underwent BIMA with additional saphenous vein graft (SVG). METHODS: Between 1991 and 2013, 1,750 consecutive patients with triple-vessel disease or left main plus right coronary system disease underwent primary isolated in-situ BIMA grafting with at least one internal mammary artery to the left anterior descending artery...
March 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26507423/bilateral-internal-thoracic-artery-composite-y-grafts-analysis-of-464-angiograms-in-296-patients
#18
Benjamin M Robinson, Hugh S Paterson, Rishendran Naidoo, Vikrant Dhurandhar, A Robert Denniss
BACKGROUND: The use of bilateral internal thoracic arteries (BITA) in coronary artery bypass graft surgery improves patient survival. The optimum BITA graft configuration is unknown. This study evaluates outcomes after the use of bilateral internal mammary Y grafting as the primary grafting strategy. METHODS: Patients who underwent BITA composite Y grafting (n = 1,011) between October 1994 and March 2009 were identified from a cardiac surgical database. Follow-up (mean 12 years) was obtained by cross-reference with the state death registry and local cardiology databases...
March 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26354634/minimally-invasive-coronary-artery-bypass-grating-using-bilateral-in-situ-internal-thoracic-arteries
#19
Keita Kikuchi, Dai Une, Yoshiki Endo, Takayoshi Matsuyama, Yasuhisa Fukada, Atsushi Kurata
When performing minimally invasive coronary artery bypass grafting (MICS CABG), it is difficult to access the right internal thoracic artery (ITA) under direct vision. We successfully performed off-pump MICS CABG using the bilateral in situ ITAs through a 8-cm left thoracotomy under direct vision for a 76-year-old man. His postoperative course was uneventful and all the grafts were patent. This novel, minimally invasive approach safely preserves the sternum and delivers the benefits of bilateral in situ ITA grafting, providing an alternative to conventional CABG and off-pump CABG...
September 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26304568/strategies-for-the-coronary-surgeon-to-remain-competitive-and-co-operative-in-the-pci-era
#20
REVIEW
George Jose Valooran, Shiv Kumar Nair, Krishnan Chandrasekharan
BACKGROUND: The advent of percutaneous intervention has made surgical treatment of coronary artery disease less favored by patients though the evidence that supports CABG in certain patient subsets is strong. METHODS: Literature review was done using Pubmed, Scopus, Google and Google Scholar with MeSH terms-coronary artery bypass grafting, internal mammary artery, drug eluting stent, stroke, myocardial revascularization. RESULTS: The adoption of evolving techniques like anaortic off pump grafting, bilateral internal mammary artery use, hybrid and minimally invasive coronary revascularization techniques, intra-operative graft assessment, and heart team approach can lead to better outcomes following surgery as is evidenced by recent literature...
July 2015: Indian Heart Journal
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