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Dissertations / Theses on the topic 'Bypass graft'

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Published: 4 June 2021

Last updated: 1 February 2022

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1

Felden, Luc. "Mechanical optimization of vascular bypass grafts." Thesis, Available online, Georgia Institute of Technology, 2005, 2005. http://etd.gatech.edu/theses/available/etd-04112005-145422/unrestricted/felden%5Fluc%5F200505%5Fmast.pdf.

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Thesis (M. S.)--Mechanical Engineering, Georgia Institute of Technology, 2005.
David N. Ku, Committee Chair ; Alexander Rachev, Committee Co-Chair ; Elliot L. Chaikof, Committee Member. Includes bibliographical references.

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2

Tellmann, Gudrun. "Untersuchungen zur Pathogenese der "Bypass graft disease"." [S.l.] : [s.n.], 2001. http://ArchiMeD.uni-mainz.de/pub/2002/0040/diss.pdf.

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3

Al-Ruzzeh, Sharif Mohamed Hasan Khalaf. "Outcome of coronary artery bypass graft surgery with and without cardio-pulmonary bypass." Thesis, Imperial College London, 2003. http://hdl.handle.net/10044/1/8394.

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4

Rowe, Christopher Stuart. "Improving the local haemodynamics of bypass graft anastomoses." Thesis, University of Liverpool, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367237.

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5

Riedel, Bernard J. C. J. "Epidural analgesia for coronary artery bypass graft surgery." Master's thesis, University of Cape Town, 1999. http://hdl.handle.net/11427/25890.

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On reviewing the medical literature, there is a clear resurgence of interest in the use of TEA (thoracic epidural analgesic) in cardiac anaesthesia. This resurgence was brought about by laboratory-based evidence that TEA-induced sympatholysis may be cardioprotective through the promotion of myocardial blood flow to areas at-risk and subsequent early, small clinical studies suggesting that TEA was feasible, and possibly also beneficial in CABG surgery [Joachimsson et. al, 1989; Liem (1-3) et. al, 1992; Stenseth et. al, 1994]. Despite the positive results of these early studies and suggestions that TEA may be the preferred anaesthetic/analgesic technique in select groups of patients (promoting early extubation and fast-tracking) undergoing cardiac surgery, many anaesthetists are still reluctant, however, to use this technique because of the theoretical increased risk of the patient suffering a spinal haematoma and subsequent paraplegia. In order to outweigh this theoretical risk it is important that we show that added benefit, in addition to the provision of analgesia and expedited postoperative convalescence, can be obtained by using TEA. It is therefore our duty as anaesthetists and perioperative physicians to determine whether TEA may also affect the pathophysiology of the disease process, especially in the perioperative period - and thereby influencing the subsequent long term outcome and quality of life of the patient. An example of this latter point would be the potential role of TEA in; • reducing the incidence of perioperative myocardial infarction (P-MI), through the suggested cardioprotective effects of TEA, • reducing the incidence of early postoperative graft failure, through either; * reduction of native coronary artery and/or graft (conduit) spasm, or * reduction of postoperative hypercoagulability.

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6

Poon, Chui-yuk Mabel. "The patients lived experiences after coronary artery bypass graft surgery /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31596071.

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7

MacGinley, Robert. "Granulation tissue as a vascular graft /." [St. Lucia, Qld.], 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16819.pdf.

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8

Okrainec, Karen. "Cardiac medical therapy following coronary artery bypass graft surgery." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80344.

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Despite the benefits of coronary artery bypass graft surgery (CABG), graft closure can still occur and lead to the development of unstable angina, myocardial infarction (MI) and death. Secondary prevention is thus greatly needed in order to prevent future cardiovascular events in the post-CABG patient. Few studies have examined the benefits of cardiac medical therapy specifically among CABG patients. A review of randomized controlled trials (RCT's) was first conducted in order to understand what constitutes appropriate cardiac medical therapy in the post-CABG patient.
The use of aspirin, clopidogrel, coumadin, anti-lipid agents, anti-ischemic medications (beta-blockers, CCB's, nitrates) and ACE inhibitors was then examined among patients enrolled in the Routine versus Selective Exercise Treadmill Testing After Coronary Artery Bypass Graft Surgery (ROSETTA-CABG) Study. We examined the use of these medications among all patients as well as patients with various co-morbidities.

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9

Sarkar, S. "Development of a synthetic small calibre vascular bypass graft." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1322995/.

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Polyurethanes are an attractive class of material for bioprosthesis development due to the ability to manipulate their elasticity and strength. However, their use as long term biological implants is hampered by biodegradation. A novel polyurethane has been developed which incorporates nano-engineered polyhedral oligomeric silsesquioxane within poly(carbonate-urea) urethane to improve the biostability of the latter. Previous investigators have found this material to be cytocompatible and to have low thrombogenicity. The medium and long term clinical results of currently available prosthetic small calibre vascular bypass grafts are poor, due to neo-intimal hyperplasia associated with their non-compliant properties. The investigation reported here commences with the benchtop manufacture of compliant small calibre grafts using an original extrusion- phase inversion technique. The reproducibility of the technique as well as the effect on the pore structure of different coagulation conditions is demonstrated. Fundamental mechanical characterisation of the grafts produced is then presented, by way of tensillometry to demonstrate the viscous and elastic properties of the material. These are made more relevant to the clinical setting with functional mechanical characterisation of the grafts, showing graft compliance in a biomimetic flow circuit along with viscoelastic hysteresis, along with burst pressure testing. An examination of burst pressure testing methodology is also shown, in the light of the various non-standardised strategies reported in the graft-testing literature. Mechanical characterisation shows the short-term safety for use, but durability studies in the biological haemodynamic environment serve to assess longer term fatigability as well as confirming biostability. This has been reported using a stringent ovine carotid interposition model which remained patent over the full investigation period representing at least 45 million pulsatile cycles. Physico-chemical analysis; integrity of the structure, microstructure and ultrastructure; preservation of mechanical properties and immunohistological analysis were used to examine the grafts after implantation to show their healing properties and biostability.

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10

Pettersson, Nils, and Gabriella Johnsson. "Riskfaktorer för postoperativa sårinfektioner efter Coronary Artery Bypass Graft." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-225259.

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Bakgrund: Postoperativa sårinfektioner [PSI] är en allvarlig komplikation och ett hälsoproblem som orsakar lidande för patienten. Såsom vid alla operativa ingrepp förekommer en risk att få PSI i operationssåret/-såren efter Coronary Artery Bypass Graft [CABG], men det finns redan en rad kända riskfaktorer som ökar risken för PSI. Syfte och metod: Syftet med rapporten var att undersöka om kombinationen av ett antal sedan tidigare kända riskfaktorer ökade risken för PSI efter CABG på ett mellansvenskt sjukhus åren 2009-2012. En retrospektiv journalgranskningsstudie med totalt 228 patienter genomfördes. Resultat: Av 228 undersökta hade totalt 50 patienter rapporterat sårinfektion och 73 patienter hade ≥ 3 riskfaktorer. Bland de som hade ≥ 3 riskfaktorer rapporterade 32,9% PSI och bland de som hade < 3 riskfaktorer rapporterade 16,8% PSI. Risken att få PSI efter CABG-kirurgi är nästan dubbelt så stor (RR=1,960) hos patienter med ≥ 3 riskfaktorer jämfört med patienter med < 3 riskfaktorer (X2=7,516 df=1 p=0,006). Slutsats: Det finns en signifikant högre risk för PSI efter CABG vid förekomst av tre eller fler än tre patientrelaterade riskfaktorer jämfört med färre än tre riskfaktorer. Fler, större studier av detta slag efterfrågas då denna rapport kan ge en fingervisning om hur situationen föreligger på ett mellansvenskt sjukhus.
Objective: Postoperative surgery site infections [SSI] is not only a severe complication but a health problem which often cause suffering and prolonged hospitalization among afflicted patients. As with all surgical procedures, a coronary artery bypass graft [CABG] always implicates a risk for SSI and a number of risk factors have to be taken into account when dealing with it. The objective of this report is to investigate if a combination of several patient-related risk factors implicates greater risk of getting SSI after CABG. Method: A quantitative retrospective journal review of 228 patients who completed a CABG between 2009-2012 was performed on a university hospital in central Sweden. Result: Among 228 patients a total of 50 reported SSI and 73 patients had ≥ 3 patient-related risk factors. Among those who had ≥ 3 risk factors 32.9% reported SSI and among those who had < 3 risk factors 16.8% reported SSI. The risk of getting SSI after CABG is almost twice as high (RR = 1.960) in patients with ≥ 3 risk factors compared to patients with < 3 risk factors (X2 = 7.516 df = 1 p = 0.006). Conclusion: There is a significantly higher risk of getting SSI after CABG in the presence of three or more than three patient-related risk factors, compared with fewer than three risk factors. More, larger studies of this kind are in demand since this report provides an indication of how the situation may prevail on a central Swedish university hospital.

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11

Cornelissen, Jacqueline. "Saphenous vein bypass graft occlusion : signalling pathways and apoptosis." Thesis, University of the West of England, Bristol, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.431153.

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12

Strickler, Amy Ann. "Functional Capacity Outcomes following Coronary Artery Bypass Graft Surgery." Thesis, Virginia Tech, 1998. http://hdl.handle.net/10919/36680.

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The objective of this study was to determine if this is possible to predict 3 mo post-CABG treadmill VO2pk outcomes from a combination of pre-surgical physical fitness and health and clinical status variables. To determine the VO2pk, subjects performed a maximal treadmill test using a ramp protocol and gas analysis. When all pre-surgical variables where included in a multiple linear regression, the analysis yielded a model that included the prior to surgery VSAQ, orthopedic limitations, and angiotensin converting enzymes (ACE) inhibitor drugs as significant predictors (R2 = 0.50, N = 63). When an RER of 1.1 was achieved during the treadmill test, myocardial infarction (MI) and if so, the length of time lapse from the MI, chronic heart failure, lipid lowering drugs, BMI, ACE inhibitor drugs, and orthopedic limitations (R2 = 0.56, N =29) were significant predictors. The data suggest that there is some relationship between post-surgical outcomes and pre-surgical physical fitness.
Master of Science

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13

Dubyts, Deanna Christine. "The experience of waiting for coronary artery bypass graft surgery." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/27716.

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The purpose of this study W8S to explore and describe the experience of waiting for coronary artery bypass graft (CABG) surgery from the perspective of the individual who h8s a prolonged wait for this surgery. A phenomenological approach was used to guide the study. Data were collected through 17 semi-structured, audio-taped interviews with 7 men and 2 women awaiting CABG surgery. Analysis occurred concurrently with data collection. It was found that there were three interrelated core facets of the experience: the illness, the prospective surgery, and the wait. Each facet held distinct meaning: the illness represented a loss of normalcy and a threat to life; the surgery, both an opportunity to regain normalcy and a threat; and the wait, a "no control" situation which enhanced the losses and threats of the other facets, engendered further losses, and delayed the expected gain from surgery. Within each facet, representative emotional reactions, and coping strategies were identified. The findings indicate that these clients require regular contact and that nursing care must address all three facets of the experience.
Applied Science, Faculty of
Nursing, School of
Graduate

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14

Poon, Chui-yuk Mabel, and 潘翠玉. "The patients lived experiences after coronary artery bypass graft surgery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45011692.

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15

WADA, KENTARO, TOMOYUKI NODA, KENICHI HATTORI, HIDEKI MAKI, AKIRA KITO, and HIROFUMI OYAMA. "AIR VENT OF VEIN GRAFT IN EXTRACRANIAL-INTRACRANIAL BYPASS SURGERY." Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16744.

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16

Springer, Karen L. "Perceptions of learning needs of coronary artery bypass graft patients." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036191.

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With the decreasing length of hospitalization for the Coronary Artery Bypass Graft (CABG) patient population, it is becoming increasingly difficult to provide patients with necessary education. The purpose of this study was to examine patients' perceptions of the importance of patient teaching information, and how realistic they perceive it is to learn the information following CABG surgery. Patients' learning and understanding are increased when the information is perceived as important.The findings of this study indicated that CABG patients rated the areas of medication, diet and activity information as the most important to learn during the early recovery period. The patients indicated that it was less realistic to learn in the areas of anatomy and physiology, risk factors, medications, diet, activity, post surgical care, psychological factors, and other pertinent information during the early recovery period. The information gained from this study could be used to enhance educational content for patients who have undertaken CABG surgeries.
School of Nursing

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17

Shaw, P. J. "Neurological and neurophysiological complications of coronary artery bypass graft surgery." Thesis, University of Newcastle Upon Tyne, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380746.

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18

Papaharilaou, Yannis. "Studies of fluid flow in arterial bypass grafts by magnetic resonance imaging." Thesis, Imperial College London, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271254.

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19

Gambaruto, A. M. "Form and flow in anatomical conduits : bypass graft and nasal cavity." Thesis, Imperial College London, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.444079.

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20

Strid, Fredrika, and Josefine Thorsén. "Patientrelaterade riskfaktorer för postoperativ sårinfektion efter Coronary Artery Bypass Graft - CABG." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-225415.

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Introduction Postoperative wound infections leads to increased patient suffering and cost society money because it leads to longer hospital stays. Previous research shows that patient related risk factors such as smoking, diabetes, Chronic Obstructive Pulmonary Disease (COPD), advanced age (>65 years) a low preoperative hemoglobin level (<140g/L) and a high BMI (> 30) increases the risk of suffering a postoperative wound infection. Aim To investigate whether patients that underwent surgery with Coronary artery Bypass Graft (CABG) in a university hospital in central Sweden in 2013 and had any of these risk factors more often suffer from post-operative wound infection. Method The study has a descriptive design and is based on an ongoing infection registration area of operations. The study included 148 patients out of 255 (58%) undergoing CABG in 2013. Possible risk factors were collected through medical record review. Results There was no significant correlation between surgical wound infection and patient-related risk factors such as smoking (not quit smoking four weeks before surgery), diabetes, COPD, advanced age (>65 years), low preoperative hemoglobin (<140g/L) or a high BMI (>30) and suffered a postoperative wound infection. Conclusion More research and a larger sample is needed in the field to produce a reliable result could be presented.
Bakgrund Postoperativa sårinfektioner ger ett ökat lidande för patienten och kostar samhället pengar då det leder till längre vårdtider. Tidigare forskning visar att patientrelaterade riskfaktorer som rökning, diabetes, kronisk obstruktiv lungsjukdom (KOL), hög ålder (>65år) ett lågt preoperativt hemoglobinvärde (<140g/L) och ett högt BMI (>30) ökar risken för att drabbas av postoperativ sårinfektion. Syfte Att undersöka huruvida patienter som operatats med Coronary Artery Bypass Graft (CABG) på ett universitetssjukhus i Mellansverige under 2013 och hade någon av dessa riskfaktorer och om de i högre utsträckning drabbas av postoperativ sårinfektion. Metod Studien har en deskriptiv design och utgår från en fortgående infektionsregistrering på verksamhetsområdet. I studien ingick 148 patienter av 255 (58%) som genomgått CABG under 2013. Eventuella riskfaktorer samlades in genom journalgranskning. Resultat Det fanns inget samband mellan postoperativ sårinfektion och patientrelaterade riskfaktorer som rökning (ej slutat röka fyra veckor innan operation), diabetes, KOL, hög ålder (>65 år), lågt preoperativt hemoglobinvärde (<140 g/L) eller ett högt BMI (>30) och att drabbats av en postoperativ sårinfektion. Slutsats Mer forskning och större urval behövs inom området för att ett tillförlitligt resultat ska kunna presenteras.

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21

Cole, Jonathan Samuel. "Pulsatile, non-Newtonian blood flows through typical arterial bypass graft models." Thesis, Queen's University Belfast, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326405.

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22

Goudie, Beth Ann. "The transition from hospital to home following coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22742.pdf.

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23

Krijne, Ruud. "Use of the internal mammary artery as a coronary artery bypass graft." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1994. http://arno.unimaas.nl/show.cgi?fid=6957.

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24

Annapoorna, Mary. "Cardiopulmonary predicators of dysfunctional ventilator weaning response after coronary artery bypass Graft." View the abstract Download the full-text PDF version, 2007. http://etd.utmem.edu/ABSTRACTS/2007-017-annapoorna-index.html.

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Thesis (Ph.D.)--University of Tennessee Health Science Center, 2007.
Title from title page screen (viewed on July 18, 2008). Research advisor: Dr. Carol Lynn Thompson, PhD. Document formatted into pages (xiv,151 p. : ill.). Vita. Abstract. Includes bibliographical references (p. 132-144).

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25

de, Mel A. "Bio-functionalisation of a nanocomposite based coronary artery bypass graft : conferring heamocompatibility." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1335720/.

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Coronary artery bypass surgery is a life saving surgical solution for patients presented with greater than 70% occluded or stenosed arteries. For these patients, autologous vein is the graft of choice. Alarmingly, 5-30% of patients have no suitable veins available due to previous use or diseased vein wall, thus the critical clinical need for nonthrombogenic vascular grafts is underscored. Our group has synthesised and patented a nanocomposite polymer based on polyhedral oligomeric silsesquioxane modified polycarbonate urea-urethane (POSS-PCU) nanocomposite polymer. The polymer was extruded using coagulation technique to match mechanical properties of a native artery. Optimising the interactions with blood on the graft surface is of keen interest. Endothelialisation is a favourable solution for enhancing antithrombogenic properties. The protective effect of the endothelium is recognised to be governed by nitric oxide (NO). A graft designed for in-situ endothelialisation will have an interval, where it will be prone to platelet adhesion before complete endothelialisation. Therefore it is desirable to induce antithrombogenic properties during this initial period and the induction of NO is desirable. In this study, current research on biofunctionalisation of biomaterials to enhance antithrombogenic properties by inducing in-situ endothelialisation and NO release were reviewed. The possibility of biofunctionalisation of POSS-PCU polymer whilst retaining its original polymer chemistry was investigated by using amine functionalised nanoparticles including POSS and fumed silica to anchor bioactive peptides (RGD) and amino acids (larginine). The antithrombogenic properties of the biofunctionalised polymer were demonstrated to be due to NO release and endothelialisation. The biofunctionalised polymer was exposed to whole blood, endothelial progenitor cells and platelets. Overall this study presents a novel method of biofunctionalising vascular bypass grafts to induce endothelialisation as tested in a bioreactor and also a means of exploiting the possibility of adhesion of platelets to induce NO synthesis. Overall I aimed to look into methods of functionalising graft surface to induce nitric oxide synthesis when the graft is implanted and is in contact with blood.

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26

Rashid, Sheikh Tawqeer. "Development of a hybrid vascular bypass graft using a tissue engineering approach." Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/1446274/.

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Introduction: A third of patients needing arterial bypass grafts lack sufficient autologous vessels. Prosthetic alternatives - principally PTFE and Dacron - have poor patency rates because of compliance mismatch with elastic arteries and inherent surface thrombogenicity. The aim of this research was to develop - for the first time - a hybrid tissue-engineered bypass graft consisting of an elastic scaffold of compliant poly(carbonate-urea)urethane (CPU), incorporated with human smooth muscle cells (SMC) and endothelial cells(EC).;Methods: 1) Methods of human vascular SMC and EC extraction were assessed for both saphenous vein and umbilical cord vessels. 2) Extracted cells were assessed by immunostaining and for SMC the ability to contract collagen gels. 3) Coating CPU with various biomolecules (to make the surface bioactive), cell seeding density and attachment period were assessed for their impact on SMC attachment. 4) Cell growth on CPU was investigated by retroviral transduction of the GFP (Green Fluorescent Protein) gene and assays of cell viability and nucleic acid content. 5) A bioreactor and pulsatile flow circuit was developed for long-term culture of cells on CPU. 6) The impact of shear stress pre-conditioning on cell retention on the hybrid bypass graft was investigated under arterial flow conditions.;Results: 1) SMCs were reliably extracted from umbilical cord and saphenous vein. ECs were only reliably extracted from umbilical cord. 2) Cord SMCs grew faster than saphenous vein SMCs (doubling time of 3.4+0.6 days against 5.6+1.9 days p = 0.0227): all SMCs stained for alpha-actin and contracted collagen gels 3) SMC attachment to CPU was significantly enhanced by Fibronectin-like Engineered Polymer Protein Plus FEPP+ (from 20.7+4.6% to 31.5 5.9%: pO.Ol), higher cell density but not longer attachment period. 4) Transducing SMCs with GFP successfully allowed live cell imaging on CPU and assays of both viable cells and nucleic acid confirmed cell growth on CPU. 5) The flow circuit successfully allowed long-term sterile culture of cells on CPU. 6) Retention of SMCs and ECs on CPU was improved by a period of shear stress pre-conditioning: from 56.7+7.0% to 76.2+6.5% SMC retention and from 45.6+2.3% to 67.4+4.0% EC retention (p < 0.03). Conclusion: Pre-lining CPU with FEPP+ enhances SMC attachment. GFP-transduction allows study of SMC growth on CPU. Pre-conditioning enhances retention of SMCs and ECs onto CPU, probably because the mechanical stimuli orientate the cells and increase the release of matrix proteins and attachment factors. The stage is now set for developing a hybrid graft for in vivo studies.

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Banner, Davina Jayne. "Women's experiences of coronary artery bypass graft surgery : a grounded theory approach." Thesis, University of the West of England, Bristol, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.438783.

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Coronary heart disease (CHD) is the leading cause of morbidity and mortality for both sexes in the United Kingdom Traditionally, CHD has been viewed as a disease primarily affecting /Ten with women being largely overlooked in the media, health educatbn campaigns and clinical research. Healthcare services came to reflect the generalisations formulated from studies of white middle class ruales. Consequently, inequalities exist in the recognition, diagnosis end treatment of CHD in women. Despite a growing body of literature e

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28

Eriksson, Frida, and Jessica Kalmér. "Ett lagat hjärta : Ett spektrum av patientupplevelser tiden efter en Coronary artery bypass graft." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-32976.

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Coronary artery bypass graft (CABG) är en väl etablerad behandling för patienter med kranskärlssjukdom. Operationen är utmanande och påfrestande för patienten och upplevelserna efter genomgången operation är varierade. Att som sjuksköterska ha kännedom om patienters upplevelser tiden efter operationen är av betydelse för att möjliggöra god omvårdnad och återhämtning för patienten. Syftet var att belysa patienters upplevelser tiden efter en CABG. Studien grundades på 11 vetenskapliga artiklar och genomfördes som en litteraturstudie. Fyra teman framkom i resultatet; den relationella upplevelsen, den kroppsliga upplevelsen, den mentala skörheten och en ny syn på livet. Det framkom att patienterna upplevde stödet från omgivningen som det viktigaste för god återhämtning. Information från vårdpersonalen ansågs till viss del bristfällig av patienterna. Flera upplevde smärta efter operationen och hade delvis symtom kvar, men dessa avtog med tiden. Centralt efter operationen var även oro, men med tiden kom förbättrad livskvalitet och motivation. Det framkom att en CABG var en stor påfrestning för patienten och upplevelserna var både positiva och negativa. Kunskapsluckor avseende patientupplevelser efter operationen finns och ytterligare forskning bör fokusera på området för att ge sjuksköterskestudenter och sjuksköterskor ökad kunskap i mötet med denna patientgrupp.
Coronary artery bypass graft (CABG) is a well-established treatment for patients with coronary artery disease. The surgery is challenging and stressful for the patient and experiences varied after surgery. It’s important for the nurse to be aware of patients’ experiences after surgery to enable good care and recovery for the patient. The aim was to illuminate patients’ experiences during the time after a CABG. The study was based on 11 scientific articles and was conducted as a literature review. Four themes emerged; the relational experience, the bodily experience, the mental fragility and a new view on life. The result showed that patients' experienced the support from the surroundings as the most important for good recovery. Information given by caregivers were in some cases considered inadequate by the patients. Patients experienced pain after surgery and had partial symptoms left, which subsided with time. Concern was a central experience after surgery, but over time came improved quality of life and motivation. A CABG is a major strain for the patients and the experiences were both positive and negative. There are gaps in knowledge regarding patient experiences after the surgery and further research should focus on that area to give nursing students and nurses knowledge in the meeting with these patients.

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Brugård, Maria, and Peter Lindbergh. "Personalens följsamhet till riktlinjer avseende glukoskontroll postoperativt efter Coronary Artery Bypass Graft (CABG)." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-103896.

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The aim of the study was auditing medical records examine postoperative blood glucose levels after undergoing CABG surgery. Furthermore the aim was to determine if the ward staff abides the local guidelines frame of reference concerning each ward, regarding blood glucose measurements and blood glucose levels. The study included 70 patients undergoing CABG surgery at the cardiothoracic surgery, Uppsala University Hospital. The study was conducted by retrospective medical record auditing. Studied factors were postoperative blood glucose levels, number of registered blood glucose measurements, a current diagnosis of DM and preoperative HbA_1c. Mean level of blood glucose levels stayed continuously above the local guidelines frame of reference for both TIVA/TIMA and the care ward throughout the continuity of patient care. The number of registered blood glucose measurements per postoperative day at TIVA/TIMA where within the local guidelines. The result showed that the local guidelines frame of reference concerning the ward were not reached. A difference could be seen between patients with DM and patients without DM regarding the previously mentioned factors. Preoperative elevated levels of HbA_1c could have influenced the number of postoperative blood glucose measurements. Recommendations will therefore be too audit the current local guideline that concerns the treatment, therapy goals and the number of blood glucose measurements. Establishing criterions regarding termination of blood glucose measurements and the transfer day between TIVA/TIMA and the care ward are recommended.

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Valentine, Sarah, and n/a. "Neuropsychological functioning of patients before and after undergoing coronary artery bypass graft surgery." University of Otago. Dunedin School of Medicine, 2007. http://adt.otago.ac.nz./public/adt-NZDU20070803.140127.

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Cardiovascular disease (CVD) affects millions of people worldwide. Many of these people require treatment for their condition, and for roughly a million individuals each year, this treatment includes coronary artery bypass graft (CABG) surgery - a procedure that aims to restore proper blood flow to the arteries of the heart. Although the physical impact of CVD and CABG surgery are well-known, their cognitive impact has not been clearly established. Recent studies suggest that both CVD and CABG surgery may have a detrimental effect on neuropsychological functioning. The first goal of the present study was to cognitively assess patients with severe, chronic CVD to determine the association of heart disease with neuroopsychological functioning. The second goal was to then continue monitoring these patients once they had undergone CABG surgery to establish what cogntive effect this treatment has. CABG surgery has traditionally been performed with the aid of a cardiopulmonary bypass (CPB) machine, but in the past decade, another technique, in which the heart remains beating, has been developed. Some have argued that this beating heart surgery (BHS) may be a superior alternative to the CPB procedure. Consequently, the third goal of the present study was to compare outcomes in patients undergoing these two surgical procedures. The present study had a prospective, double blind design. Patients were randomly assigned to either CPB surgery (CPBS) or BHS. Sixty-three patients were recruited and underwent a comprehensive neuropsychological assessment preoperatively and 6 days, 6 weeks and 30 weeks postoperatively. Despite including a higher risk group than previous comparative studies, there were virtually no differences between the CPBS and BHS groups. When the groups were combined and the sample was examined as a whole, the patients were cognitively impaired even before their surgery. Given that their premorbid abilities were estimated to be in the average range, their pre-surgery deficits were likely to be the result of a long-standing history of CVD. Immediately after surgery (Day 6), the neuropsychological performance of the sample decreased further, but they had significantly improved by Week 6 and this improvement increased further by the Week 30 time-point (with many scores in the average range). This postoperative recovery suggests that the decline these patients exhibit preoperatively may be reversible and that rather than causing cognitive deficits, CABG surgery may ultimately improve both cardiac and cognitive health. Psychologically, patients in the present sample reported the highest level of anxious and depressive symptoms, and the lowest quality of life, pre-surgically, but their psychological health gradually improved over the course of the postoperative period. Compared to other samples, however, the present sample were generally psychologically healthy.

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Adderley, Natasha Lorraine. "Intrathecal morphine for analgesia following coronary artery bypass graft surgery, a pilot study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0024/MQ36388.pdf.

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32

Lester, Arnette Sandland 1952. "Orthostatic blood pressure and heart rate responses after coronary artery bypass graft surgery." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277795.

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A quasi-experimental study was conducted to compare preoperative and postoperative postural responses to position change. A convenience sample of 30 men and women admitted for elective coronary artery bypass graft (CABG) surgery performed supine to sitting and supine to standing position changes prior to surgery and on postoperative day two or three. An ANOVA with repeated measures compared the responses of systolic blood pressure, diastolic blood pressure and heart rate. Systolic blood pressure exhibited a significant change from preoperative to postoperative measurements. Diastolic blood pressure remained the same; heart rate changed over time, but no significant preoperative to postoperative changes occurred. Comparison of normotensive and hypertensive subjects revealed reduced postoperative responsiveness in the hypertensive subjects for systolic blood pressure and heart rate. Nurses caring for postoperative CABG patients should anticipate a reduction in blood pressure and an increase in heart rate upon standing.

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33

Wiggins, Matthew Corbin. "Bayesian based risk stratification of atrial fibrillation in coronary artery bypass graft patients." Diss., Atlanta, Ga. : Georgia Institute of Technology, 2007. http://hdl.handle.net/1853/24775.

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Thesis (Ph.D.)--Bioengineering, Georgia Institute of Technology, 2007.
Committee Co-Chair: Litt, Brian; Committee Co-Chair: Vachtsevanos, George; Committee Member: Butera, Robert; Committee Member: Frazier, Bruno; Committee Member: Gerstenfeld, Edward; Committee Member: Hunt, William.

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34

Lindsay, Grace M. "The health and well-being of individuals before and after coronary artery bypass surgery." Thesis, University of Glasgow, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298692.

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35

Yogaratnam, Jeysen Zivan. "The effects of preconditioning coronary artery disease patients with hyperbaric oxygen prior to coronary artery bypass graft surgery & cardiopulmonary bypass." Thesis, University of Hull, 2011. http://hydra.hull.ac.uk/resources/hull:4803.

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IntroductionCoronary artery bypass graft (CABG) is associated with periods of ischaemia and reperfusion, which may lead to myocardial dysfunction. In clinical studies, hyperbaric oxygen (HBO2) treatment following an acute myocardial infarction (AMI), has been shown to limit myocardial injury and improve myocardial function. The primary efficacy objective of this study was to determine if systemically preconditioning coronary artery disease (CAD) patients with HBO2, prior to first time elective on cardiopulmonary bypass (CPB) CABG surgery, leads to a remote preconditioning like effect that is capable of improving myocardial function following CABG. The main secondary objectives of this study were to assess the safety of HBO2 preconditioning and, its effects on myocardial injury and post operative intensive care unit (ICU) length of stay. The exploratory secondary objectives were to assess the effects of HBO2 preconditioning on surrogate serum biomarkers of endothelial and neutrophilic adhesiveness and, myocardial biomarkers of cardioprotection. Methods In this single centre, randomised control study, 81 patients, who were having first time elective on CPB CABG surgery, were recruited. 40 were randomised to the Control Group and 41 to the HBO2 Group. Treatment with HBO2 preconditioning was completed approximately 2 hours prior to CPB and consisted of two 30 minute sessions of 100% oxygen at 2.4 atmospheres (ATA) separated 5 minutes apart. Efficacy was measured by determining peri-operative haemodynamic measurements using a pulmonary artery (PA) catheter. Safety was measured by collecting peri-operative data on myocardial injury and adverse events (AEs) and, post operative days spent in ICU. Using collected peri-operative venous blood, myocardial injury was determined by measuring the concentration of serum Troponin-T. In these same venous blood samples, endothelial and neutrophilic adhesiveness was indirectly assessed by measuring the concentrations of sE-selectin, sP-Selectin and sICAM-1 and, sPSGL-1, respectively. Using intra-operative right atrial biopsies, the degree of cardioprotection provided by HBO2 preconditioning was determined by measuring the quantity of myocardial eNOS and Hsp72. Analysis of the serum and myocardial biomarkers were done by ELISA.Results Compared to the Control Group, the HBO2 Group demonstrated a significant improvement in left venticular stroke work (LVSW) 24 hours post CPB (p=0.005). While there were no significant safety findings, there were fewer cardiovascular, pulmonary, renal and neurological AEs in the HBO2 Group. This group also had a significantly shorter post operative ICU length of stay. 1 hour post HBO2 preconditioning, the concentration of sPSGL-1 increased significantly in the HBO2 Group. At all time points, the peri-oprative concentration of sPSGL-1 was higher in the HBO2 Group but none of the changes were significant. The latter was also the case for the peri-operative concentration of sP-Selectin, apart from following the period of ischaemic and reperfusion, when it was lower in the HBO2 Group. Intra-operatively, the concentration of sE-Selectin increased significantly in the HBO2 Group and was higher in this group throughout the peri-operative period. During this intra-operative period also, the concentration of sICAM-1 was higher in the HBO2 Group and the increase was particularly significant following the period of ischaemia and reperfusion. 24 hours post CPB, the concentrations of all the serum soluble adhesion molecules were higher in the HBO2 Group. No significant differences were observed between the groups with respect to the concentrations of serum Troponin-T and, the quantity of myocardial eNOS and Hsp72. However, in the HBO2 Group, the peri-operative concentrations of serum Tropinin-T, eNOS and Hsp72 were lower. Furthermore, while there was a pre-CPB reduction of both eNOS and Hsp72, following ischaemia and reperfusion, the quantity of both these myocardial biomarkers were increased. Conclusion From this study, it can be concluded that HBO2 preconditioning of patients with CAD prior to on CPB CABG, is capable of improving myocardial function 24 hours post CABG. Additionally, the data suggest that this may also be a safe modality of treatment as it did not lead to significant post operative AEs, limited peri-operative myocardial injury and reduced post operative ICU length of stay. It also led to increased post operative concentrations of the measured surrogate biomarkers of endothelial and neutrophilic adhesiveness, with a number of significant peri-operative changes. Finally, while HBO2 treatment did not lead to significant changes in the myocardial biomarkers of cardioprotection, the quantities of these increased in the HBO2 Group following ischaemia and reperfusion, suggesting that it may be capable of inducing endogenous cardioprotection following ischaemia and reperfusion.

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Namazi, Esfahani Neda. "Lived experience of patient with diabetes after Cronary Artery Bypass Graft- A case study." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-22746.

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37

Ghahramani, Melody. "Simultaneous modelling of long- and short-term survival after coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0018/MQ37536.pdf.

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38

Alhashemi, Jamal A. "Effect of subarachnoid morphine administration on extubation time following coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ39800.pdf.

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39

Schmid, Markus. "Vascular adaption of the internal mammary artery graft early and late after bypass surgery /." [S.l.] : [s.n.], 2008. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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40

Pursch, Lindsay Jane. "The short-term effects of off-pump cardiopulmonary bypass graft surgery on cognitive performance." Master's thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/10772.

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Includes bibliographical references (leaves 56-67).
Postoperative neurocognitive impairment has been associated with coronary artery bypass graft surgery (CABG). This study investigates the short-term effects of off-pump cardiopulmonary bypass graft surgery (OPCAB) on cognitive performance, as a possible safer alternative in the treatment of coronary artery disease. This research forms part of a larger study in which, in addition to the OPCAB procedure, the cognitive effects of CABG surgery and percutaneous transluminal coronary angioplasty with intra-coronary stenting are assessed. 36 participants undergoing OPCAB surgery were included in the study, with a further 36 participants included as an age- and education- matched non-surgical control group. A standardized battery of neuropsychological tests, designed to assess seven cognitive domains, was administered on two occasions, preoperatively at 1-2 days prior to surgery, and postoperatively at 1 month after surgery, with control participant assessments at the same intervals. Emotional state scales assessing depression and anxiety levels were administered at each assessment. Data analysis included a two-way mixed analysis of variance conducted on each measure of cognitive function, and on the indicators of emotional state. In addition, standard multiple regression was conducted to assess whether change in emotional state is able to predict change in any of the cognitive domains. Results indicated no evidence of short-term cognitive decline, and highlighted an improvement in cognitive performance in both surgical and control groups in the domain of language, psychomotor speed, executive function and visual memory, with the control group demonstrating a consistently superior performance. This counter-intuitive finding could not be attributed to practice effects.

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Chiang, Yin-Jung Helen. "The short-term effects of coronary artery bypass graft (CABG) surgery on cognitive performance." Master's thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/10246.

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Includes bibliographical references (leaves 63-74).
Considerable research evidence suggests that post-operative cognitive impairment is a common complication of coronary artery bypass graft (CABG) surgery. This study evaluated the short-term effects of CABG surgery on cognitive performance one to two days prior to surgery (baseline) and one-month post-surgery (follow up). 40 CABG surgical patients and 40 healthy, nonsurgical control participants were assessed with a standard neurocognitive battery that evaluated seven areas of cognitive functioning. Visioconstruction, visual memory, verbal memory, attention, psychomotor speed, executive functioning and language were measured. Additionally, the Beck Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI) were included to assess mood and anxiety states pre- and post-operatively. Demographic data pertaining to participants' general medical conditions were also collected. The repeated measures ANOV A with mixed designs procedure showed cognitive improvement on the domains of visioconstruction (p = 0.017), visual memory (p = 0.001), psychomotor speed (p = 0.001), executive functioning (p = 0.012) and language (p = 0.001). Significant cognitive decline on the domain of verbal memory (p = 0.026) was also found in both control and surgical groups. Furthermore, changes in mood and anxiety states did not influence post-operative changes in neurocognitive performance. The results yielded in the present study are mixed and confirm the multifactorial problem of studying cognitive functioning post-CABG surgery.

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Musil, Ian, Vanessa Jensen, Jolyon Schilling, Boyd Ashdown, and Tyler Kent. "Enterobacter cloacae infection of an expanded polytetrafluoroethylene femoral-popliteal bypass graft: a case report." BioMed Central, 2010. http://hdl.handle.net/10150/610188.

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INTRODUCTION:Enterobacter cloacae infections are common among burn victims, immunocompromised patients, and patients with malignancy. Most commonly these infections are manifested as nosocomial urinary tract or pulmonary infections. Nosocomial outbreaks have also been associated with colonization of certain surgical equipment and operative cleaning solutions. Infections of an aortobifemoral prosthesis, an aortic graft, and arteriovenous fistulae are noted in the literature. To our knowledge, this is the first isolated account of an E. cloacae infection of a femoral-popliteal expanded polytetrafluoroethylene bypass graft.CASE PRESENTATION:A 68-year-old Caucasian man presented with fever and rest pain in the right lower extremity five months after the placement of a vascular expanded polytetrafluoroethylene graft for femoral-popliteal bypass. Computed tomography angiography demonstrated peri-graft fluid that was aspirated percutaneously with image guidance and cultured to reveal E. cloacae. The graft was revised and then removed. The patient completed a six-week course of ceftazidime and is currently without signs of infection. There were no other reports of E. cloacae graft infections in any patients receiving treatment in the same surgical suite within a month of this report.CONCLUSION:Isolated cases of E. cloacae infection of surgical bypass grafts are rare (unique in this setting). Clinicians should have a high index of suspicion for device contamination in such cases and should consider testing for possible microbial reservoirs. Graft removal is required due to the formation of biofilm and the recent emergence of Enterobacteriaceae producing extended-spectrum beta-lactamase in community acquired infections.

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Parry, Monica J. E. "Physiologic and psychological responses of men and women waiting for coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ55925.pdf.

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44

Brown, C. Ann. "Autonomic modulation of heart rate in men and women following coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape2/PQDD_0034/NQ59518.pdf.

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45

Swenne, Christine Leo. "Wound Infection Following Coronary Artery Bypass Graft Surgery : Risk Factors and the Experiences of Patients." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7168.

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46

Mussa, Mohamedshafi Yakub. "The radial artery as a coronary artery bypass graft : studies to reduce peri-operative vasospasm." Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611084.

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47

Engel, Amy M. "The Impact of Body Mass Index on Hospital Outcomes following Coronary Artery Bypass Graft Surgery." University of Cincinnati / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1240590704.

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48

Nishiyama, Kei. "Temporal Pattern of Strokes after On-Pump and Off-Pump Coronary Artery Bypass Graft Surgery." Kyoto University, 2010. http://hdl.handle.net/2433/120611.

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49

Jackson, Mark John Clinical School St Vincent's Hospital Faculty of Medicine UNSW. "A study of vein graft haemodynamics using computational fluid dynamics techniques." Awarded by:University of New South Wales, 2007. http://handle.unsw.edu.au/1959.4/38575.

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Atherosclerosis, the leading cause of mortality in Western societies, affects large elastic arteries, causing focal deposition of proliferative inflammatory and lipid-laden cells within the artery. Several risk factors have been causally implicated in the ???reaction to injury??? hypothesis first described by Ross in 1969. The ???injury??? sustained by endothelial cells may be either mechanical or chemical. Environmental factors have a role in the production of chemical agents that are injurious to the endothelium. Mechanical stresses such as wall tensile stress are proportional to systemic blood pressure and pulse pressure. Essentially, these systemic pressures are fairly evenly distributed throughout the circulation. However, atherosclerotic lesions characteristically occur at focal sites within the human vasculature; at or near bifurcations, within the ostia of branch arteries and at regions of marked or complex curvature, where local haemodynamic abnormalities occur. The most discussed haemodynamic factor seems to be low or highly oscillating wall shear stress which exists on the outer wall of bifurcations and on the inner aspect of curving vessels. The magnitude of these haemodynamic forces may not be great but the subtleties of their variable spatial distribution may help to explain the multifocal distribution of atherosclerotic plaques. With the altered haemodynamics there is endothelial injury and phenotypic changes in the endothelium result, which in turn lead to endothelial cell dysfunction. These haemodynamic variables are difficult to measure directly in vivo. In this work a novel model is developed utilising human autologous vein bypass grafts as a surrogate vessel for the observation of pathological structural changes in response to altered haemodynamics. The influence of haemodynamic factors (such as wall shear stress) in the remodeling of the vein graft wall and the pathogenesis of Myointimal Hyperplasia (MIH) and resultant wall thickening in femoral bypass grafts is analysed. The haemodynamic determinants of MIH (which have been established in many animal models) are similar to those implicated in atherosclerosis. The accelerated responses of the vein (Intimal hyperplasia develops much more rapidly than atherosclerotic lesions in native vessels) make it an ideal model to expediently examine the hypothesised relationships prospectively in an in vivo setting. Furthermore, the utilisation of in vivo data acquired from non-invasive diagnostic methods (such as Magnetic Resonance Angiography (MRA) and Duplex ultrasound) combined with the application of state-of-the-art Computational Fluid Dynamic (CFD) techniques makes the model essentially non-invasive. The following hypotheses are examined: 1) regions of Low shear and High tensile stress should develop disproportionately greater wall thickening, 2) regions of greater oscillatory blood flow should develop greater wall thickening, and 3) regions of lower wall shear should undergo inward (or negative) remodelling and result in a reduction in vessel calibre. The conclusions reached are that abnormal haemodynamic forces, namely low Time-averaged Wall Shear Stress, are associated with subsequent wall thickening. These positive findings have great relevance to the understanding of vein graft MIH and atherosclerosis. It was also evident that with non-invasive data and CFD techniques, some of the important haemodynamic factors are realistically quantifiable (albeit indirectly). The detection of parameters known to be causal in the development of graft intimal hyperplasia or other vascular pathology may improve ability to predict clinical problems. From a surgical perspective this might be employed to facilitate selection of at-risk grafts for more focused postoperative surveillance and reintervention. On a broader stage the utilisation of such analyses may be useful in predicting individuals at greater risk of developing atherosclerotic deposits, disease progression, and the likelihood of clinical events such as heart attack, stroke and threat of limb loss.

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Filion, Kristian B. 1980. "Use and effectiveness of perioperative cardiac medical therapy among patients undergoing coronary artery bypass graft surgery." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97952.

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The perioperative use of cardiac medical therapy (aspirin, angiotensin-converting-enzyme (ACE) inhibitors, lipid lowering agents (including statins), and beta-blockers) holds the potential to improve clinical outcomes among patients undergoing coronary artery bypass graft surgery (CABG). These medications have been shown to be efficacious in reducing adverse events in a small number of trials involving non-cardiac surgery patients. However, their use has not been closely examined among CABG patients. We performed a systematic review of the literature in which we identified all studies that examined the perioperative use of cardiac medical therapy among CABG patients. We also examined the use and effectiveness of these medications using a cohort of 2,389 consecutive CABG patients. We found that in-hospital medication use was low for all 4 medication classes. We also found a trend indicating an association between perioperative beta-blocker and statin use and a decrease in in-hospital mortality or non-fatal cardiac complications. Increasing perioperative cardiac medical therapy use may therefore lead to improved clinical outcomes among patients undergoing CABG.

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