Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery

2015 ◽  
Vol 18 (4) ◽  
pp. 171 ◽  
Author(s):  
Tolga Demir ◽  
Mehmet Umit Ergenoglu ◽  
Hale Bolgi Demir ◽  
Nursen Tanrikulu ◽  
Mazlum Sahin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Myocardial Protection ◽  
Troponin T ◽  
Artery Bypass ◽  
Control Group ◽  
Study Group ◽  
Cabg Surgery ◽  
Anti Inflammatory ◽  
Pump Coronary Artery Bypass

<strong>Background</strong>: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB).<br /><strong>Methods</strong>: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time. <br /><strong>Results</strong>: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P &lt; .001; T3: <br />P &lt; .001; T4: P &lt; .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group <br />(P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001).<br /><strong>Conclusions</strong>: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.<br /><br />

scholarly journals Outcome of off-pump coronary artery bypass graft (OPCAB) surgery: Analysis of 129 cases

2016 ◽  
Vol 31 (1) ◽  
pp. 23-25
Author(s):  
AKM Manzurul Alam ◽  
Istiaq Ahmed ◽  
Manzil Ahmed ◽  
Al Mamun Hossain
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Cabg Surgery ◽  
Off Pump ◽  
Opcab Surgery ◽  
Pump Coronary Artery Bypass

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, including Bangladesh. Besides medical and interventional treatment, coronary artery bypass graft (CABG) surgery in an effective modality for the management of a subset of CAD patients. Off-pump coronary artery bypass graft (OPCAB) surgery is a recent modification of conventional CABG surgery, which, like other parts of the world, is being increasingly practiced in Bangladesh. But the outcome of this relatively recent surgical approach in our setting is largely unknown. In this study, the outcomes of 129 cases off-pump CABG surgery done in a tertiary cardiovascular centre and a private institute in Dhaka were analyzed. Majority (67, 54.2%) had triple vessel disease (TVD), while 4 (3.2%) patients had left main disease. One, two and three grafts were used in 17 (13.2%),74 (57.4%) and 38 (29.4%) cases respectively. There was no mortality. Post-operative complications occurred in 17 (13.18%) patients; secondary wound infection in 10 (7.75%) and immediate respiratory distress in 7 (5.43%) cases. Ten (7.75%) patients needed secondary stitches.Bangladesh Heart Journal 2016; 31(1) : 23-25

scholarly journals Effect of an Educational Support Programme on Caregiver Burden Among the Family Members of Patients Undergoing Coronary Artery Bypass Graft Surgery

2021 ◽  
Vol 21 (2) ◽  
pp. e266-274
Author(s):  
Helen Dalirirad ◽  
Naima Seyedfatemi ◽  
Tahereh Najafi
Keyword(s):  
Coronary Artery ◽  
Family Caregivers ◽  
Coronary Artery Bypass ◽  
Caregiver Burden ◽  
Artery Bypass ◽  
Control Group ◽  
Educational Support ◽  
Cabg Surgery ◽  
Support Programme ◽  
The Family

Objectives: The family caregivers of patients undergoing coronary artery bypass graft (CABG) surgery experience considerable physical and emotional distress. This study aimed to investigate the effect of an educational support programme on caregiver burden among the family caregivers of patients undergoing CABG surgery in Iran. Methods: This non-randomised controlled clinical trial was conducted from January to April 2017 at a cardiovascular centre in Tehran, Iran. A total of 80 family caregivers of patients undergoing CABG surgery were sequentially selected and non-randomly assigned to intervention and control groups. The control group received routine care, whereas the intervention group received additional education sessions at baseline, prior to surgery, the day after surgery and before discharge. Caregiver burden was compared at baseline and six weeks post-discharge using the Persian-language versions of the Caregiver Burden Inventory (CBI) and Katz Index of Independence in Activities of Daily Living (IADL). Results: A significant difference was observed between family caregivers in the control and intervention groups with regards to pre-post differences in mean CBI scores (+1.67 ± 19.23 versus +17.45 ± 9.83; P <0.001), with an effect size of −1.14. In addition, there was a significant increase in mean post-discharge IADL scores among CABG patients in the intervention group compared to the control group (4.42 ± 1.05 versus 3.07 ± 1.09; P <0.001). Conclusion: An educational support programme significantly reduced caregiver burden among the family members of patients undergoing CABG surgery in Iran. As such, in addition to routine care, healthcare providers should provide educational support to this population to help mitigate caregiver burden. Keywords: Caregiver Burden; Coronary Artery Bypass Surgery; Patient Education as Topic; Caregivers; Education; Quality of Life; Controlled Clinical Trial; Iran.

Cardiac Troponin T Levels in On- and Off-Pump Coronary Artery Bypass Surgery

2007 ◽  
Vol 10 (1) ◽  
pp. E42-E46 ◽  
Author(s):  
Jeremiah Brown ◽  
Felix Hernandez ◽  
John Klemperer ◽  
Robert Clough ◽  
Francis DiPierro ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Cardiac Troponin ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Troponin T ◽  
Artery Bypass ◽  
Cardiac Troponin T ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

scholarly journals Effect of Pre-operative Angiotensinconverting Enzyme Inhibitors on Haemodynamic Parameters and Vasoconstrictor Requirements in Patients Undergoing Off-pump Coronary Artery Bypass Surgery

2005 ◽  
Vol 33 (6) ◽  
pp. 693-702 ◽  
Author(s):  
YK Lee ◽  
SW Na ◽  
YL Kwak ◽  
SB Nam
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Control Group ◽  
Off Pump ◽  
Left Circumflex Artery ◽  
Haemodynamic Parameters ◽  
Pump Coronary Artery Bypass

The effects of pre-operative angiotensin-converting enzyme inhibitor (ACEI) treatment on haemodynamic status and vasoconstrictor requirements during off-pump coronary artery bypass surgery (OPCAB) were studied. Eighty patients selected for OPCAB were divided into those who had been treated with ACEIs for 4 weeks or more pre-operatively (ACEI group) (n = 43) and those who had not been treated with ACEIs (control group) (n = 37). Noradrenaline was infused during the operation when the mean systemic arterial pressure (SAP) fell below 60 mmHg. No significant differences in the haemodynamic parameters measured were detected between the two groups, except for cardiac output, which was found to be significantly greater in the control group. During anastomosis of the obtuse marginal branch of the left circumflex artery (OM), a significantly larger amount of noradrenaline was required by the ACEI group compared with the control group. In conclusion, pre-operative treatment with ACEIs significantly increased the amount of vasoconstrictor necessary to maintain the target SAP during OM anastomosis during OPCAB.

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