scholarly journals Predictors for New Native-Vessel Occlusion in Patients with Prior Coronary Bypass Surgery: A Single-Center Retrospective Research

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ze Zheng ◽  
Zi chao Cheng ◽  
Shao ping Wang ◽  
Shi ying Li ◽  
Jian Wang ◽  
...  
Keyword(s):  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Postoperative Management ◽  
Careful Consideration ◽  
Coronary Bypass Surgery ◽  
Vessel Occlusion ◽  
Total Occlusion ◽  
Reduced Ejection Fraction ◽  
Occlusion Rate

Objectives. Chronic total occlusion (CTO) is prevalent in patients with prior coronary artery bypass grafting (CABG). However, data available concerning the prevalence of new-onset CTO of native vessels in patients with prior CABG is limited. Therefore, the objective of the study is to determine predictors for new native-vessel occlusion in patients with prior coronary bypass surgery. Methods. 354 patients with prior CABG receiving follow-up angiography are selected and analyzed in the present study, with clinical and angiographic variables being analyzed by logistic regression to determine the predictors of new native-vessel occlusion. Results. The overall new occlusion rate was 35.59%, with multiple CTOs (42.06%) being the most prevalent (LAD 24.60% and RCA 18.25%, respectively). Additionally, current smoking (OR: 2.67; 95% CI: 2.60 to 2.74; p=0.01), reduced ejection fraction (OR: 1.76; 95% CI: 1.04 to 2.97; p=0.04), severe stenosis (OR: 3.65; 95% CI: 2.55 to 5.24; p=0.01), and diabetes mellitus (OR: 1.86; 95% CI: 1.34 to 2.97; p=0.04) serve as the independent predictors for new native-vessel occlusion. Conclusion. As to high incidence of postoperative CTO, appropriate revascularization strategies and postoperative management should be taken into careful consideration.

Transient liver dysfunction increases surgical site infections after coronary surgery

2018 ◽  
Vol 26 (6) ◽  
pp. 439-445 ◽  
Author(s):  
Rakan I Nazer ◽  
Khalid A Alburikan ◽  
Anhar Ullah ◽  
Ali M Albarrati ◽  
Mazen Hassanain
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Liver Dysfunction ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Surgical Site Infections ◽  
Perioperative Period ◽  
Coronary Bypass Surgery ◽  
Cardiac Procedures

Background Surgical site infections can have a significant impact on cardiac surgical outcome. The liver plays an important role in infection prevention. This study aimed to retrospectively determine whether transient postoperative liver dysfunction after coronary bypass surgery increased surgical site infections. Methods A modified version of the Schindl scoring scale for liver dysfunction was adapted to objectively quantify transient liver dysfunction in the first 7 days after on-pump coronary artery bypass grafting. A retrospective analysis of clinical outcomes at 30 months postoperatively was performed on data of 575 patients who underwent coronary artery bypass between 2014 and 2016. The patients were categorized into a liver dysfunction group (Schindl score ≥ 4) and a non-liver dysfunction group (Schindl score < 4). Results The liver dysfunction group (47.3%) had significantly more patients who were obese, current smokers, and had diabetes, renal impairment, and peripheral vascular disease. Surgical site infections occurred predominantly in the liver dysfunction group (12.1% vs. 0.3%, p < 0.001). The independent predictors of surgical site infection were liver dysfunction, body mass index > 30 kg m−2, and coronary bypass surgery combined with other cardiac procedures. Conclusions Surgical wound infections can be precipitated by multiple factors before, during, and after coronary bypass surgery. Transient liver dysfunction in the perioperative period is associated with an increased rate of surgical infections even after adjusting for known risk factors. Considering this factor as well as other known risks may help to identify and stratify patients with a potentially higher risk of surgical site infections.

Comparison of two doses of aprotinin in patients receiving aspirin before coronary bypass surgery

Perfusion ◽  
2000 ◽  
Vol 15 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Sergio V Moran ◽  
Guillermo Lema ◽  
Jessica Medel ◽  
Manuel J Irarrazaval ◽  
Ricardo Zalaquett ◽  
...  
Keyword(s):  
Blood Loss ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Drug Efficacy ◽  
Coronary Bypass Surgery ◽  
Postoperative Blood Loss ◽  
Treatment Groups ◽  
Group I ◽  
Transfusion Requirements

This study was designed to evaluate efficacy and tolerability of two different doses of aprotinin in patients receiving aspirin before undergoing coronary artery bypass grafting. Forty-two patients were randomized to receive either placebo (group I), or aprotinin in doses of 4 000 000 KIU (group II) or 6 000 000 KIU (group III). Drug efficacy was determined by measuring postoperative blood loss and transfusion of blood products. Both doses were effective in reducing blood loss and transfusion requirements. Blood loss through thoracotomy drainage was 450 ± 224, 182 ± 144, 142 ± 98 ml, respectively, for control and treatment groups II and III ( p = 0.0001). The numbers of patients with blood transfusions were seven (50%), two (17%) and two (17%) for group I and treatment groups II and III, respectively ( p = 0.10). Tolerability was excellent and complications few and reversible. In conclusion, high and medium doses of aprotinin were well tolerated and reduced bleeding and transfusion requirements in patients submitted to coronary bypass surgery under the effects of aspirin.

scholarly journals Coronary bypass surgery after thrombolytic therapy for total occlusion of the left main coronary artery.

1986 ◽  
Vol 33 (2) ◽  
pp. 113-116 ◽  
Author(s):  
HIROSHI HARA ◽  
KENICHI KOSUGA ◽  
SHIGEAKI AOYAGI ◽  
HARUO AKAGAWA ◽  
IZUMI YANAGI ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Thrombolytic Therapy ◽  
Bypass Surgery ◽  
Left Main Coronary Artery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Left Main ◽  
Total Occlusion

scholarly journals Adverse Cerebral Outcomes After Coronary Bypass Surgery

2018 ◽  
pp. 81-85
Keyword(s):  
Coronary Artery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Economic Consequences ◽  
Coronary Bypass Surgery ◽  
Bypass Grafting ◽  
Neurologic Outcomes ◽  
Patients Experience ◽  
The Impact

This case focuses on the affects that coronary bypass surgery has on cerebral outcomes by asking the question: For patients undergoing elective coronary bypass surgery, what are the incidence and predictors of perioperative adverse neurologic events, and what is the impact of neurologic outcomes on resource utilization? This prospective, multicenter investigation of adverse cerebral outcomes after elective coronary artery bypass grafting found that 6.1% of patients experience adverse perioperative cerebral outcomes. The study also identified predictors of adverse cerebral outcomes and highlighted the significance and economic consequences of perioperative neurologic events.

Neuronal nitric oxide synthase-derived hydrogen peroxide effect in grafts used in human coronary bypass surgery

2017 ◽  
Vol 131 (10) ◽  
pp. 1015-1026 ◽  
Author(s):  
Patrick Wander Endlich ◽  
Rosária Dias Aires ◽  
Roberta Lins Gonçalves ◽  
Eduardo Damasceno Costa ◽  
Janaína de Paula Arantes Ângelo ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Nitric Oxide Synthase ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Neuronal Nitric Oxide Synthase ◽  
Coronary Bypass Surgery ◽  
H2o2 Production ◽  
Oxide Synthase ◽  
Nnos Inhibition

Recently, H2O2 has been identified as the endothelium-dependent hyperpolarizing factor (EDHF), which mediates flow-induced dilation in human coronary arteries. Neuronal nitric oxide synthase (nNOS) is expressed in the cardiovascular system and, besides NO, generates H2O2. The role of nNOS-derived H2O2 in human vessels is so far unknown. The present study was aimed at investigating the relevance of nNOS/H2O2 signaling in the human internal mammary artery (IMA) and saphenous vein (SV), the major conduits used in coronary artery bypass grafting. In the IMA, but not in the SV, ACh (acetylcholine)-induced vasodilatation was decreased by selective nNOS inhibition with TRIM or Inhibitor 1, and by catalase, which specifically decomposes H2O2. Superoxide dismutase (SOD), which generates H2O2 from superoxide, decreased the vasodilator effect of ACh on SV. In the IMA, SOD diminished phenylephrine-induced contraction in endothelium-containing, but not in endothelium-denuded vessels. Importantly, while exogenous H2O2 produced vasodilatation in IMA, it constricted SV. ACh increased H2O2 production in both sets of vessels. In the IMA, the increase in H2O2 was inhibited by catalase and nNOS blockade. In SV, H2O2 production was abolished by catalase and reduced by nNOS inhibition. Immunofluorescence experiments showed the presence of nNOS in the vascular endothelium and smooth muscle cells of both the IMA and SV. Together, our results clearly show that H2O2 induced endothelium-dependent vascular relaxation in the IMA, whereas, in the SV, H2O2 was a vasoconstrictor. Thus, H2O2 produced in the coronary circulation may contribute to the susceptibility to accelerated atherosclerosis and progressive failure of the SV used as autogenous graft in coronary bypass surgery.

scholarly journals Minimal invasive coronary bypass surgery the robotic total endoscopic approach

2019 ◽  
Vol 147 (3-4) ◽  
pp. 243-247
Author(s):  
Dusko Terzic ◽  
László Göbölös ◽  
Jehad Ramahi ◽  
Johannes Bonatti
Keyword(s):  
Cardiopulmonary Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Cleveland Clinic ◽  
Myocardial Revascularization ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Postoperative Treatment ◽  
Routine Practice ◽  
Eligibility Criteria

The aim of this paper is to present the latest recommendations for practitioners for preoperative preparation, surgical procedures and postoperative treatment in patients with myocardial revascularization using robotic total endoscopic coronary artery bypass grafting (CARG), which is applied as daily clinical routine practice at the Heart and Vascular Institute, Cleveland Clinic Abu Dhabi. Many patients indicated for coronary bypass surgery may be candidates for robotic total endoscopic CARG. The paper illustrates eligibility criteria of this procedure, preoperative assessment and preparation principles, peripheral access for cardiopulmonary bypass and port insertion, then graft harvesting procedure, initiation of cardiopulmonary bypass and application of endoaortic clamping, identification and exposure of the target vessels, anastomosis procedure and postoperative care in this group of patients.

scholarly journals Causes affecting the working capacity of patients undergoing coronary bypass surgery (systematic review)

2021 ◽  
Vol 65 (6) ◽  
pp. 581-586
Author(s):  
Maria A. Kuzmichkina ◽  
Viktoria N. Serebryakova
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

A review of the available domestic and foreign literary sources is presented concerning factors affecting the working capacity of persons after coronary artery bypass grafting. It was found that in Russia, after surgical treatment of coronary heart disease, there is an increase in the number of disabled people compared to foreign data. In recent years, there has been an increase in patients undergoing coronary bypass surgery. However, this did not reduce the increasing number of disabled people after coronary artery bypass grafting, which does not correspond to the initial expectations about the cost-effectiveness of this type of surgery. According to Russian researchers, the proportion of persons with disabilities referred for surgical myocardial revascularization was 39.0-42.5%. Subsequently, this indicator increased to 64.0%. In other countries, the dynamics are different. Among patients under 60 years of age who underwent surgical treatment of coronary artery disease, more than half returned to work. In general, labour activity was restored by 67.5%, and the number of disabled persons decreased from 56.0 to 42.0%. Social and medical factors were assessed to establish the causes of disability after coronary artery bypass grafting. World experience testifies to the critical role of state social support in preserving the labour status of patients, which ultimately justifies the economic costs of surgical treatment. To assess the degree of disability after coronary artery bypass grafting, social status before surgical treatment of coronary heart disease, and the severity of comorbid pathology. To increase the economic efficiency of coronary bypass surgery, it is necessary to organize an affordable and effective rehabilitation program, uniform criteria for referring patients to medical and social expertise.

A Case Report on Concomitant Coronary Artery Bypass Operation and Renal Transplantation

2014 ◽  
Vol 17 (3) ◽  
pp. 180
Author(s):  
Yucel Ozen ◽  
Sabit Sarikaya ◽  
O. Atlas ◽  
D. Cekmecelioglu ◽  
Kann Kirali ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Renal Transplantation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Asymptomatic Patients ◽  
Artery Disease

Renal transplantation is successfully implemented in patients undergoing coronary bypass surgery. We performed concomitant coronary bypass surgery and renal transplantation in a patient found to have a left main coronary artery lesion after coronary angiography, which was performed in our clinic during preoperative evaluation of renal transplantation. We suggest the application of coronary-artery bypass grafting (CABG) or stent implantation 2 months after renal transplantation in asymptomatic patients with coronary artery disease. But, if severe coronary artery disease is detected in symptomatic patients, we suggest the concurrent application CABG and renal transplantation.

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