Complete myocardial revascularization confers a larger clinical benefit when performed with state-of-the-art techniques in high-risk patients with multivessel coronary artery disease: A meta-analysis of randomized and observational studies

2015 ◽  
Vol 87 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Marco Zimarino ◽  
Fabrizio Ricci ◽  
Mattia Romanello ◽  
Marta Di Nicola ◽  
Alessandro Corazzini ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Observational Studies ◽  
State Of The Art ◽  
Meta Analysis ◽  
Myocardial Revascularization ◽  
Multivessel Coronary Artery Disease ◽  
Risk Patients ◽  
Artery Disease

Evaluation of renal function after mini-invasive myocardial revascularization in high-risk patients with coronary artery disease

Nephrology ◽  
2018 ◽  
Vol 3_2018 ◽  
pp. 21-24
Author(s):  
A.K. Zhalilov Zhalilov ◽  
A.S. Vishchipanov Vishchipanov ◽  
V.Yu. Merzlyakov Merzlyakov ◽  
I.V. Klyuchnikov Klyuchnikov ◽  
A.I. Skopin Skopin ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Renal Function ◽  
Coronary Artery ◽  
High Risk ◽  
Myocardial Revascularization ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease

scholarly journals Acute Kidney Injury in High-Risk Patients in Cardiac Surgery of Coronary Artery Disease

2021 ◽  
pp. 15-19
Author(s):  
Olena Gogayeva ◽  
Anatoliy V. Rudenko ◽  
Vasyl V. Lazoryshynets
Keyword(s):  
Coronary Artery Disease ◽  
Acute Kidney Injury ◽  
Coronary Artery ◽  
High Risk ◽  
Myocardial Revascularization ◽  
Kidney Injury ◽  
Ischemic Time ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease

The aim. To analyze the features of the perioperative period in high-risk patients with coronary artery disease (CAD) and postoperative acute kidney injury (AKI). Materials and methods. A post-hoc analysis of 354 high-risk patients with various forms of CAD who were operated and discharged from the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine from January 2009 till December 2019. All the patients underwent clinical and laboratory tests, ECG, echocardiography, coronary angiography, ventriculography and surgical myocardial revascularization with correction of concomitant cardiac pathology. Based on serum creatinine, the glomerular filtration rate (GFR) was calculated based on CKD-EPI equation on admission, on day 1 after surgery and at discharge. Results. On admission, 132 (37.2%) patients had chronic kidney disease (CKD) with GFR <60 ml/min/1.73 m2. Postoperative AKI occurred in 10 (2.8%) patients, with a predominance of patients with complicated forms of CAD (p = 0.0249), type 2 diabetes mellitus (p = 0.0109). There was no dependence of the occurrence of AKI on age (p = 0.6755), the initial stage of CKD (p = 0.4601) and the Charlson comorbidity index (p = 1.0000). However, AKI more often developed during on-pump operations (p = 0.0333) using cardioplegia (p = 0.0164) and was associated with longer duration (p = 0.0007) and higher blood loss (p = 0.0001). In the early postoperative period, patients with AKI more often developed acute heart failure (p = 0.0051), anemia (p = 0.0176) and were characterized by a longer length of stay in the intensive care unit (p = 0.0010) and at the Institute after surgery (p = 0.0363). Conclusions. Perioperative prevention of nephrological complications involves limitation of the use of nephrotoxic drugs, compensation of comorbid conditions and reduction of intraoperative ischemic time.

scholarly journals CHARACTERISTICS OF PHARMACEUTICAL THERAPY OF HIGH-RISK PATIENTS WITH CORONARY ARTERY DISEASE AFTER CORONARY ARTERY BYPASS GRAFTING

2021 ◽  
Vol 21 (1) ◽  
pp. 6-11
Author(s):  
O. Gogayeva
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
High Risk Patients ◽  
Pharmaceutical Therapy ◽  
Risk Patients ◽  
Artery Disease

The number of patients after surgical myocardial revascularization is growing annually. New regional centres are being created, and the cardiologists are facing the pressing issues of managing patients after cardiac surgery. The aim of this study is to analyze the characteristics of pharmaceutical therapy for high-risk patients with coronary artery disease after surgical myocardial revascularization. Material and methods: a retrospective analysis of data from 194 high-risk patients (selected by random sampling) with coronary artery disease, who were operated on and discharged from Amosov National Institute of cardiovascular surgery, National Academy of Medical Sciences of Ukraine for the period 2009–2019. The average age of the patients was 64.2+8.9 years. All patients underwent standard laboratory and clinical examinations, coronary angiography and coronary artery bypass grafting. Results: dual antiplatelet therapy has been found out as optimal for the patients with sinus rhythm. A combination of an antiplatelet agent with a vitamin K antagonist or new oral anticoaguants is effective and can be recommended for the patients with atrial fibrillation. Lipid-lowering therapy is prescribed to all patients prior to the surgery and the following parameters as the control of low-density lipoproteins, liver enzymes, and serum creatinine should be under the constant control. Gastroprotective therapy with pantoprazole is indicated to all patients after myocardial revascularization. When prescribing antihypertensive therapy in the postoperative period, it is important to consider the severity of stenosis of the carotid arteries. Conclusions: Pharmaceutical therapy of patients after coronary artery bypass surgery should be carried out in a patient-centred manner and in accordance with the principle – “non nocere” (Do not harm), taking into account the cardiac status and comorbidity.

scholarly journals Use of extracorporeal membrane oxygenation as a bridge to transcatheter aortic valve replacement in a patient with aortic stenosis and severe coronary artery disease: a case report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Majid Ahsan ◽  
Rolf Alexander Jánosi ◽  
Tienush Rassaf ◽  
Alexander Lind
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Artery Disease

Abstract Background Patients with severe aortic stenosis (AS) often present with multiple comorbidities and suffer from critical coronary artery disease (CAD). Transcatheter aortic valve replacement (TAVR) has become the therapy of choice for moderate to high-risk patients. Venoarterial extracorporeal membrane oxygenation (v-a-ECMO) offers the possibility of temporary cardiac support to manage life-threatening critical situations. Case summary Here, we describe the management of a patient with severe AS and CAD with impaired left ventricular ejection fraction (LVEF). We used v-a-ECMO as an emergency strategy in cardiogenic shock during a high-risk coronary intervention to stabilize the patient, and as a further bridge to TAVR. Discussion Very high-risk patients with severe AS are unlikely to tolerate the added risk of surgical aortic valve replacement. Using ECMO may help them to benefit from TAVR as the only treatment option available.

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