An Uncommon Cause of Myocardial Ischemia after Coronary Artery Bypass Grafting: "The Dangerous Drainage"

2011 ◽  
Vol 14 (3) ◽  
pp. 200
Author(s):  
Andres Beiras-Fernandez ◽  
Patrick Möhnle ◽  
Carsten Kopf ◽  
Calin Vicol ◽  
Felix Kur ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Myocardial Ischemia ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Graft Occlusion ◽  
Artery Bypass Grafting ◽  
Mediastinal Drainage ◽  
Early Graft

The most common causes of myocardial ischemia and myocardial infarction early after coronary artery bypass grafting surgery are early graft occlusion/thrombosis or occlusion/ thrombosis of coronary arteries due to advanced coronary heart disease. We describe a case of postoperative myocardial ischemia due to an uncommon and quickly reversible cause: mechanical compression of a vein graft by a 19F flexible silicone mediastinal drainage tube.

Haemostatic Factors and Inhibitors and Coronary Artery Bypass Grafting: Preoperative Alterations and Relations to Graft Occlusion

1994 ◽  
Vol 72 (03) ◽  
pp. 335-342 ◽  
Author(s):  
Elisabeth Moor ◽  
Anders Hamsten ◽  
Margareta Blombäck ◽  
Istvan Herzfeld ◽  
Björn Wiman ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Factor Vii ◽  
Bypass Grafting ◽  
Graft Occlusion ◽  
Artery Bypass Grafting ◽  
The Third ◽  
Haemostatic Factors

SummaryGraft closure remains a major problem after coronary artery bypass surgery. While a number of graft characteristics influencing the risk of occlusion have been defined, the role of haemostatic factors and inhibitors has not been studied in detail. The present study examined the time course of changes in blood coagulation and fibrinolytic function after coronary artery bypass grafting in 20 consecutive patients. Pre- and postoperative determinations of haemostatic factors and inhibitors were also related to the presence of graft occlusion assessed by angiography at three months after surgery. A broad panel of haemostatic tests was used preoperatively, on the first, third and eight postoperative days, and at three months after surgery. A particular emphasis was placed on fibrinogen, factor VII activity, von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1) activity, anticoagulant proteins C and S, thrombin-antithrombin complex and D-dimer. A marked activation of the coagulation cascade was noted postoperatively along with enhanced degradation of cross-linked fibrin. The degree of activation of blood coagulation and fibrinolysis differed widely between individuals and appeared to relate only partly to the acute phase reaction produced by the surgical trauma. Preoperative values of haemostatic factors and inhibitors showed fairly weak associations with the levels of postoperative determinations. Basal tPA and factor VIII levels, fibrinogen and TAT concentrations on the third and eighth postoperative day, and factor VII amidolytic activity on the third postoperative day differed (p <0.05) between patients with and without occluded grafts at reangiography. Accordingly, combined pre- and postoperative assessment of haemostatic function may contribute to the identification of individuals at risk for early graft closure after coronary artery bypass grafting.

scholarly journals Pleiotropic Effects of Acetylsalicylic Acid after Coronary Artery Bypass Grafting—Beyond Platelet Inhibition

2021 ◽  
Vol 10 (11) ◽  
pp. 2317
Author(s):  
Dominika Siwik ◽  
Magdalena Gajewska ◽  
Katarzyna Karoń ◽  
Kinga Pluta ◽  
Mateusz Wondołkowski ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Acetylsalicylic Acid ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Platelet Inhibition ◽  
Pleiotropic Effects ◽  
Bypass Grafting ◽  
Graft Occlusion ◽  
Artery Bypass Grafting

Acetylsalicylic acid (ASA) is one of the most frequently used medications worldwide. Yet, the main indications for ASA are the atherosclerosis-based cardiovascular diseases, including coronary artery disease (CAD). Despite the increasing number of percutaneous procedures to treat CAD, coronary artery bypass grafting (CABG) remains the treatment of choice in patients with multivessel CAD and intermediate or high anatomical lesion complexity. Taking into account that CABG is a potent activator of inflammation, ASA is an important part in the postoperative therapy, not only due to ASA antiplatelet action, but also as an anti-inflammatory agent. Additional benefits of ASA after CABG include anticancerogenic, hypotensive, antiproliferative, anti-osteoporotic, and neuroprotective effects, which are especially important in patients after CABG, prone to hypertension, graft occlusion, atherosclerosis progression, and cognitive impairment. Here, we discuss the pleiotropic effects of ASA after CABG and provide insights into the mechanisms underlying the benefits of treatment with ASA, beyond platelet inhibition. Since some of ASA pleiotropic effects seem to increase the risk of bleeding, it could be considered a starting point to investigate whether the increase of the intensity of the treatment with ASA after CABG is beneficial for the CABG group of patients.

EFFECT OF ANTIPLATELET THERAPY ON EARLY GRAFT PATENCY AFTER CORONARY ARTERY BYPASS GRAFTING: VA COOPERATIVE STUDY # 207

1987 ◽  
Author(s):  
S Goldman ◽  
J Copeland ◽  
T Moritz ◽  
W Henderson ◽  
L A Harker
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Antiplatelet Therapy ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Graft Patency ◽  
Reoperation Rate ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Early Graft

To determine if specific antiplatelet therapy improved graft patency after coronary artery bypass grafting (CABG) -we compared (1) aspirin(325 mg qd), (2)aspirin(325 mg tid),(3) aspirin and dipyridamole(325 mg and 75 mg resp.tid), (4) sulfinpyrazone(267 mg tid) and (5) placebo(tid).Therapy was started 48 hours before CABGexcept for aspirin. When aspirin was a treatment,one 325 mg dose was given12 hours before surgery. Graft patency data were obtained early, one week, and then later, one year, after surgery. Preliminarydata, based on local interpretation of the angiograms at each center, in the firs 496 patients (1711 grafts), revealed thefollowing early graft patencies: aspiri qd (93%), aspirin tid (93%), aspirin and dipyridamole (93%),and sulfinpyrazone (92%). All these therapies improved(P<0.005)early graft patency compared to placebo (84%). Chest tube drainage measured within the first 35 hours after CABG revealed that the median loss with aspirintid (1114 ml) and aspirin and dipyridamole (972 ml) exceeded (P<0.001) placebo (802 ml) while aspirinqd (880 ml) and sulfinpyrazone (750 ml) did not. The reoperation rate was greater(P<0.01) in all the treatment groups thatcontained aspirin (6.1%) compared to the two non aspirin groups (1.9%). Overall operative mortality was 2.1%. In conclusion, graft patency was improved early after CABG with antiplatelet therapy. Two regimens which included preoperative aspirin has increased blood loss after CABG and preoperative aspirin increased the reoperation rate.

Myocardial ischemia in patients awaiting coronary artery bypass grafting

1989 ◽  
Vol 117 (6) ◽  
pp. 1189-1195 ◽  
Author(s):  
Andrew A. Knight ◽  
Milton Hollenberg ◽  
Martin J. London ◽  
Dennis T. Mangano
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Myocardial Ischemia ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Relation of heart rate dynamics to the occurrence of myocardial ischemia after coronary artery bypass grafting

2002 ◽  
Vol 89 (10) ◽  
pp. 1176-1181 ◽  
Author(s):  
Timo T Laitio ◽  
Timo H Mäkikallio ◽  
Heikki V Huikuri ◽  
Erkki S.H Kentala ◽  
Pekka Uotila ◽  
...  
Keyword(s):  
Heart Rate ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Myocardial Ischemia ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Heart Rate Dynamics
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