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Journal articles on the topic 'Coronary artery by pass surgery'

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Author: Grafiati

Published: 11 March 2023

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1

NAQVI, AJMAL HASAN, AMBER MALIK, FAIZ RASOOL, and Zafar Khan. "CORONARY ARTERY BY PASS GRAFTING." Professional Medical Journal 18, no. 03 (September 10, 2011): 396–401. http://dx.doi.org/10.29309/tpmj/2011.18.03.2354.

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Background: Several studies have suggested superiority of tight glycaemic control in reducing the incidence of surgical site infection and mortality after cardiac surgery. Objective: To compare the frequency of post operative surgical site infections after CABG in patients with tight glycamic control and those with standard glycamic control. Setting: Shaikh Zayed Hospital, Lahore. Period: June 2008 to March 2010. Methods: Total of 496 patients were included, they were randomized to tight glycaemic control group (TGC ,n =248) or standard control group(SC, n=248).In TGC group blood glucose was maintained between 90 – 130 mg/dl, while in SC group blood glucose was maintained between 131- 190mg/dl for 48 hours post surgery. Results were prospectively evaluated. Results: Demographic and surgical data was similar in both groups. Patients in TGC group showed significant reduction in post operative superficial sternal wound infection (4 vs 12 , p < 0.05) , deep sternal wound infection (1 vs 7, p <0.05) and leg wound infection ( 2vs 9, p<0.05).There was also non significant reduction in the incidence of post operative mediastinitis (1 vs 3), new myocardial infarction ( 2 vs 3),and atrial fibrillation (10 vs 12). Mortality was equal in both groups (1 in each). Conclusions: Significant reduction in SSI was observed in TGC group and no change was seen in other morbidities and short term mortality in the study.

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2

Trimboli, Stefania, Guido Oppido, Francesco Santini, and Alessandro Mazzucco. "Coronary artery spasm after off-pump coronary artery by-pass grafting." European Journal of Cardio-Thoracic Surgery 24, no. 5 (November 2003): 830–33. http://dx.doi.org/10.1016/s1010-7940(03)00412-3.

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3

Dumani, Selman, Ermal Likaj, Aferdita Veseli, Stavri Llazo, Leart Berdica, and Ali Refatllari. "Surgery Resection of a Massive Thymic Carcinoma during Urgent Coronary Artery Bypass Grafting." Open Access Macedonian Journal of Medical Sciences 6, no. 6 (June 16, 2018): 1098–100. http://dx.doi.org/10.3889/oamjms.2018.249.

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BACKGROUND: Thymic carcinoma is a very rare tumour. It is classified as thymoma type C according to World Health Organization classification. There are not many publications of simultaneous surgical treatment of thymoma during cardiac surgery interventions.CASE REPORT: We present a case of simultaneous surgical treatment of incidentally discovered thymic carcinoma during an urgent coronary artery by-pass operation. A 55-year-old man with diagnosis three coronary vessel diseases indicated urgent by-pass surgery. The patient underwent triple coronary bypass surgery. During the intervention, it was discovered incidentally a strong mass 15 x 12 cm located in the right pleural space. A tumour was excised totally, and biopsy referred thymoma type C or thymic carcinoma. The patient did very well early postoperatively. He was referred to oncologist clinicians for further treatment. The patient was clinically very good for at least 1.5 years after surgery.CONCLUSION: We think that simultaneous surgical treatment of thymoma, whenever it is encountered during cardiac surgery procedures, is the recommended solution.

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4

Piedrola, Gonzalo, Encarnación García-Domínguez, Carmen Hidalgo, Antonio Becerra, Rosa Villar, and Daniel De Luis. "By-pass surgery in coronary artery disease: Effects on insulin sensitivity." Diabetes Research and Clinical Practice 50 (September 2000): 287. http://dx.doi.org/10.1016/s0168-8227(00)80977-8.

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5

Lopes, Demetrius K., Robert A. Mericle, Guiseppe Lanzino, Ajay K. Wakhloo, Lee R. Guterman, and L. Nelson Hopkins. "Carotid Angioplasty and Stenting Before Coronary Artery By pass Grafting." Neurosurgery 43, no. 3 (September 1998): 686. http://dx.doi.org/10.1097/00006123-199809000-00240.

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6

Sagic, Dragan, Zelimir Antonic, Milan Stanisic, Nenad Ilijevski, Predrag Milojevic, Dragan Masulovic, and Djordje Radak. "Simultaneous stenting of the left main coronary stem and internal carotid artery in a hemodynamically unstable patient." Vojnosanitetski pregled 68, no. 8 (2011): 712–15. http://dx.doi.org/10.2298/vsp1108712s.

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Introduction. Combined endovascular interventions on carotid and coronary arteries are rare. Stenting of the unprotected coronary left main stem is a high risk procedure. We presented hemodynamically unstable patient with combined carotid artery and left main stem coronary artery stenting. Case report. A 78-year-old female patient was admitted to our institution for right carotid endaterectomy. The patient had 80% stenosis of the right carotid artery and occlusion of the left carotid artery. Coronary angiography revealed 70% ostial left main stenosis, occlusion of the right coronary artery and the left circumflex artery, and 80% stenosis of the left anterior descending artery. Simultaneous carotid artery endaterectomy and coronary artery by-pass grafting were considered. Due to high perioperative risk, surgery was rejected, and the patient was treated endovascularly with stenting of arteries occluded. The procedure was completed without complications and the patient was hemodynamically stabilised. Conclusion. This report illustrates simultaneous coronary and carotid stenting as a successfull lifesaving procedure.

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7

KETENCİLER, Serkan, Hüseyin GEMALMAZ, and Yıldırım GÜLTEKİN. "Can near infrared spectroscopy predict stroke in coronary artery by-pass graft?" Anatolian Current Medical Journal 4, no. 4 (October 22, 2022): 362–67. http://dx.doi.org/10.38053/acmj.1140522.

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Aim: Central nervous system may be affected after coronary artery by-pass graft (CABG) and carotid artery stenosis is an important risk factor. Near infrared spectroscopy (NIRS) is used to measure the regional cerebral oxygen concentration (rScO2). The aim of this study is to determine the relationship of rScO2 in patients with carotid artery lesion and to determine the relation of stroke with rScO2 changes. Material and Method: The patients who had cardiac bypass surgery were involved in the study. Demographic characteristics and presence of carotid artery stenosis, were collected from the files. Bilateral rSO2 measurements performed by 2 sensors. RScO2 values are detected in 5 minutes of cross-clamp (XCL5), XCL30, XCL60, XCL90, XCL120 and after the by-pass. Results: 57 patients were involved in the study (40 male and mean age 62.54±13.08). 17 (29%) patients had carotid stenosis. rScO2 levels are statistically significantly decreased in the patients with stenosis after post-clamp 30 minutes. Three patients had stroke after surgery (5.2%). Two of the patients had carotid stenosis while one patient did not have. Conclusion: RScO2 decreased in carotid artery stenosis irrespective of the degree of the stenosis after 30 minutes of cross-clamp. Cerebral perfusion follow-up is important during the CPB and NIRS is a method that can be used for this purpose.

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8

Helbo-Hansen, S., R. Fletcher, D. Lundberg, L. Nordström, O. Werner, E. Ståhl, and N. Nordén. "Clonidine and the sympatico-adrenal response to coronary artery by-pass surgery." Acta Anaesthesiologica Scandinavica 30, no. 3 (April 1986): 235–42. http://dx.doi.org/10.1111/j.1399-6576.1986.tb02404.x.

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9

Carlstedt, F., L. Lind, P. O. Joachimsson, J. Rastad, L. Wide, and S. Ljunghall. "Circulating ionized calcium and parathyroid hormone levels following coronary artery by-pass surgery." Scandinavian Journal of Clinical and Laboratory Investigation 59, no. 1 (January 1999): 47–53. http://dx.doi.org/10.1080/00365519950185995.

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10

Bajraktari, Gani, Alison Duncan, John Pepper, and Michael Henein. "P0839 PERSISTENT VENTRICULAR ASYNCHRONY AFTER CORONARY ARTERY BY-PASS SURGERY PREDICTS CARDIAC EVENTS." European Journal of Internal Medicine 20 (May 2009): S272—S273. http://dx.doi.org/10.1016/s0953-6205(09)60858-x.

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11

Swenne, C. L., C. Lindholm, J. Borowiec, and M. Carlsson. "Surgical-site infections within 60 days of coronary artery by-pass graft surgery." Journal of Hospital Infection 57, no. 1 (May 2004): 14–24. http://dx.doi.org/10.1016/j.jhin.2004.02.005.

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12

Sumer, Murat, Akcay Ovunc Ozon, Bulent Bakar, Aysenur Cila, and Sevket Ruacan. "Intravascular Lymphoma Masquerading as Multiembolic Stroke Developing After Coronary Artery By-Pass Surgery." Neurologist 15, no. 2 (March 2009): 98–101. http://dx.doi.org/10.1097/nrl.0b013e31817833ad.

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13

Ağca, Fahriye Vatansever, Kemal Karaagac, Tezcan Peker, Ozlem Arıcan Ozluk, Erhan Tenekecioğu, Muhammed Şenturk, and Mustafa Yılmaz. "The Effect of On-pump Coronary Artery By-pass Surgery on Aortic Functions." Journal of the American College of Cardiology 62, no. 18 (October 2013): C191. http://dx.doi.org/10.1016/j.jacc.2013.08.545.

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14

BAŞAR, Veysel, Emre KUBAT, Ferit CİCEKCİOGLU, Mehmed YANARTAŞ, and Hasan SUNAR. "Autologous pericardium may be an alternative carotid patch material in patient with undergoing simultaneous carotid endarterectomy and coronary artery bypass grafting." Genel Tıp Dergisi 32, no. 5 (October 29, 2022): 554–58. http://dx.doi.org/10.54005/geneltip.1147590.

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Backround: Dacron, polytetrafluoroethylene, great saphenous vein, and bovine pericardium are the commonly used as patch materials. However, there is no study about autologous pericardial as a patch material in carotid endarterectomy surgery. We aimed to assess the results of the use of autologous pericardial patch in patients undergoing concomitant carotid endarterectomy and coronary artery by-pass graft surgery. Materials and Methods:: The study involved 30 patients who underwent concomitant carotid endarterectomy with patch angioplasty and coronary artery bypass grafting surgery from January 2016 to February 2020. Patchplasty is performed with autologous pericardium for 13 patients and dacron patch for 17 patients during carotid endarterectomy. Results: No statistical difference was found between the groups in terms of reoperation, arterial occlusion, restenosis, operation time, and neurological events. In the postoperative follow-up, it was determined that the amount of drainage from the area on which the carotid surgery was applied was less in the those in whom autologous pericardium was used compared to those in whom Dacron patch was used. (p=0.001) Conclusion: We concluded that the use of autologous pericardium as a carotid artery patch is a safe, feasible, and effective method in patients undergoing combined carotid artery and coronary bypass surgery.

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15

Amendola, A., G. Paternoster, S. P. Pascale, R. Nuccorini, M. D'Amora, G. Pittella, R. D'Ascoli, F. Prestipino, G. Luzi, and M. Pizzuti. "Coronary Artery By-Pass Grafting in Patient With Paroxysmal Nocturnal Hemoglobinuria (Case Report)." General Reanimatology 17, no. 2 (April 29, 2021): 27–36. http://dx.doi.org/10.15360/1813-9779-2021-2-27-36.

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Paroxysmal nocturnal haemoglobinuria (PNH) is a clonal haematopoietic stem cell disease that presents with haemolytic anaemia, thrombosis and bone marrow failure. We report a case of a 51-year-old male with a history of PNH in treatment with Eculizumab admitted to our Hospital for acute chest pain and dyspnoea. The diagnosis was a triple vessel disease and patient was scheduled for coronary artery bypass grafting surgery. To balance the risk between thrombosis and bleeding in this particular clinical setting, we decided to use thromboelastography (TEG) as point of care solution and we used the R parameter as the target of our anticoagulant therapy. The R parameter between 11 and 14 sec can be used as a target value to balance the risk; in addition, there was no evidence of acute hemolysis during the surgery and supplemental dose of Eculizumab was administered in order to minimize any potential exacerbation of intravascular hemolysis.

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16

Zdravkovic, Marija, Miljko Ristic, Mirjana Krotin, Natasa Milic, Ivan Soldatovic, Ivana Nedeljkovic, Jovan Peruničić, and Darko Zdravkovic. "Coronary artery bypass surgery in patients with low EuroSCORE preoperative risk." Open Medicine 7, no. 3 (June 1, 2012): 388–95. http://dx.doi.org/10.2478/s11536-011-0164-4.

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AbstractPatients with EuroSCORE <2 are usually considered to have a low surgical risk and the lowest mortality. In our study preoperative factors in a group of 250 consecutive low-risk patients (EuroSCORE<2), who underwent first isolated coronary artery by-pass surgery during 1999 and 2000., were analyzed. Cumulative follow-up period was 1178.48 patient-years and the primary clinical outcome was all-cause mortality. Patients’ average age was 59.2±7.5 yr. The following preoperative risk factors of increased 5-year mortality were identified: older age (P<0.001), smoking, prior non-recent myocardial infarction and reinfarction, anteroseptal localization of myocardial infarction (P<0.001), poor ejection fraction<=35% (P<0.001), dilatative cardiomyopathy (P<0.001), wall motion systolic index 〉2 (P<0.001), left atrial dilatation (P<0.001), mitral regurgitation more than 2+ (P<0.001), presence of left main disease, triple vessel coronary artery disease (P<0.001), absence of collaterals (P<0.001) and presence of more than 3 distal anastomoses. Through the present study it has been shown that it is possible to identify a subgroup of patients with low operative mortality and excellent 5-year survival after surgical treatment for coronary artery bypass surgery using preoperative clinical, echocardiographic, coronarographic and intraoperative data, even in difficult conditions of the civil war in the region.

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17

Dobric, B., M. Preradovic, and A. Milovancev. "Continuous intravenous anaesthesia vs. intermittant intravenous anaesthesia in coronary artery by-pass grafting surgery." European Journal of Anaesthesiology 23, Supplement 37 (June 2006): 140. http://dx.doi.org/10.1097/00003643-200606001-00501.

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18

Rahman, Mohammad Arifur, ASM Shariful Islam, Jayanta Kumar Saha, Md Lutfar Rahman, Mezanur Rahman, and Md Abul Quashem. "Preoperative High Sensitivity C-reactive Protein Level Predicts Early Outcome After Coronary Artery By-pass Surgery." KYAMC Journal 9, no. 4 (January 31, 2019): 153–58. http://dx.doi.org/10.3329/kyamcj.v9i4.40144.

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Background: Coronary artery bypass surgery (CABG) with cardioplegia has been considered the gold standard operation for coronary revascularization. Activation of compliments system after CABG surgery involves C-reactive protein (CRP). Patients with preoperative increased CRP levels have significantly higher CRP levels on postoperative days and are at increased risk of developing postoperative complications. High sensitivity CRP ( hs-CRP ) is lower concentration of CRP measured by the hs-CRP test. It is more sensitive and more useful in predicting the potential risk level for cardiovascular disease, heart attacks and strokes. Objective: To assess the association of preoperative hs-CRP level with the incidence of postoperative arrhythmia, low output syndrome and sternal wound infection following on pump CABG surgery. Materials & Methods: The study was cross sectional analytical study. A total of 70 patients were selected. For the purpose of analysis the study subjects were divided into two group; Group A patients with preoperative hs-CRP level <3mg/l (n=35) and Group B patients with preoperative hs-CRP level >3mg/l (n=35). The incidence of early outcome- arrhythmia, low output syndrome and sternal wound infection were observed within 30 days of surgical procedure. Results: The incidence of arrhythmia, low output syndrome and sternal wound infection were significantly less in group A than those in group B. Logistic regression analysis showing significant correlation of hs-CRP with arrhythmia, p value is 0.005; with low output syndrome, p value is 0.003 and with sternal wound infection, p value is 0.004. Conclusion: Preoperative hs- CRP is an important determinant of post operative outcome after CABG surgery and might be useful as predictive marker in risk stratification for postoperative complications in patients scheduled for on pump CABG surgery. KYAMC Journal Vol. 9, No.-4, January 2019, Page 153-158

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19

Iyem, Hikmet, and Suat Buket. "Early Results of Combined and Staged Coronary Bypass and Carotid Endarterectomy in Advanced Age Patients in Single Centre." Open Cardiovascular Medicine Journal 3, no. 1 (March 20, 2009): 8–14. http://dx.doi.org/10.2174/1874192400903010008.

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Aim:In present study, we aimed to compare the staged and combined surgery in patients with severe carotid stenosis and coronary atherosclerosis and detect the factors affecting mortality and morbidity.Material and method:Between 2004 and 2008, 120 patients with predominant ischemic heart disease were enrolled to study. Patients were divided into three groups on basis surgery procedure. Group 1 (n=40) includeed patients had coronary artery disease without carotid disease underwent coronary artery by-pass graft (CABG) operation. Group 2 (n=40): included patients underwent combined surgery procedure including CABG and carotid endarterectomy (CEA). Patients underwent staged CABG and CEA were enrolled to Group 3 (n=40). All patients were in advanced aged and were had the same risk factors atributable atherosclerosisResults:Mean age of the patients in all groups were 68±6, 69±3, 71±2 respectively, and 83% were male. Eight patients died in all groups at follow-up(seven in group 2 and 3, and one in group 1) and the difference between both groups was statistically significant (p<0.001). The follow-up period in the intensive care unit, and hospitalization period were not statistically different between CABG group and combined CEA plus CABG group.Conclusion:We think that the results of staged or combined CABG plus CEA surgery are satisfactory in patients with severe carotid disease and advanced coronary artery disease. However, the mortality and morbidity in both procedures are higher than those of alone.

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20

VERMEYEN, K. M., S. G. DE HERT, F. A. ERPELS, and H. F. ADRIAENSEN. "MYOCARDIAL METABOLISM DURING ANAESTHESIA WITH PROPOFOL—LOW DOSE FENTANYL FOR CORONARY ARTERY BY PASS SURGERY." British Journal of Anaesthesia 66, no. 4 (April 1991): 504–8. http://dx.doi.org/10.1093/bja/66.4.504.

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21

Göbölös, Laszlo, Maurice Hogan, Mosaad El-Banna, Feras Bader, Emin Murat Tuzcu, and Gopal Bhatnagar. "Donor-transmitted Anterior Myocardial Ischaemia in a Teenager: How to Proceed?" New Emirates Medical Journal 2, no. 2 (July 27, 2021): 146–50. http://dx.doi.org/10.2174/0250688202666210303122918.

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Background: Heart transplantation remains the treatment of choice for end-stage heart failure patients, owing to the associated dual improvements in quality of life, and prognosis. The discrepancy between higher demand and supply of donor organs is the limiting factor, and is established universally. Increasing consideration of donor populations up to 65 years of age and marginal donor hearts has helped to facilitate the availability of potential grafts. However, grafts from older donors carry the mid-term increased risk of coronary allograft vasculopathy, including donor-transmitted coronary disease. Case report: A 15-year-old female underwent orthotopic heart transplantation for non-ischaemic cardiomyopathy, the donor was a 44-year-old male. The recipient developed anterior wall ischaemia within a year requiring coronary angioplasty and stent implantation to treat the severe obstruction in the left anterior descending coronary artery. However, two months later, the patient was readmitted with in-stent restenosis. Therefore, to optimally revascularise the left anterior descending coronary artery, and minimise risks associated with re-sternotomy, a minimally invasive direct coronary artery by pass grafting of the left internal mammary artery to the left anterior descending artery was performed. Conclusion: Surgical revascularisation in generalised coronary allograft vasculopathy is an inadequate option; repeat heart transplantation is the treatment of choice, albeit given its morbidity, should be reserved for a highly selected patient population. In localised coronary lesions, conventional coronary bypass surgery may be a feasible choice in selected patients with left anterior descending artery lesions. Minimal invasive techniques, such as minimally invasive direct coronary artery bypass grafting rather than robotic techniques, would be preferable for ease of approach and to limit the surgical re-do trauma.

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22

Sheela D. Kadam, Abhijeet Shelke, Priya P Roy, Megha A Doshi, and Shruti P Mohite. "Coronary Artery Dominance in Western Maharashtra Population by Angiographic Method." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 21, 2020): 1998–2002. http://dx.doi.org/10.26452/ijrps.v11ispl4.4410.

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Coronary artery disease (CAD) is going to become a significant cause of death in the world. The CAD is increasing day by day because of the changing lifestyle of people. The responsible factors for CAD are diabetes, hypertension, addiction and heredity also. So, the present work is undertaken to study the dominant pattern of coronary artery in the Maharashtra population. The present study was a hospital-based, prospective and observational study of 360 patients who have coronary artery disease undergoing coronary angiography. This study carried out from May 2018-November 2019 of both genders of 25 years of age and above [Male-215(59.72%) and female was 145(40.27 %)]. Out of that, the youngest patient below 40 years male was 30(73.17%), and the female was 11(26. 82%). While above 40 years males were 185(57.99%) and females was 134(42%). The patients with a history of by-pass surgery and angioplasty were excluded. Invasive angiography was performed by either femoral or radial artery using radio-opaque dye (OMNIPCK-50ml) that is visible by an x-ray machine (GE. INNOVA). The socio-demographic Proforma of patients, the pattern of coronary arterial dominance were recorded. Right coronary artery was dominant in 273(75.83%) patients observed in this study. While LCx was dominant in 49(13.6%) and co-dominant in 38 (10.55%) patients. Knowledge of study can be helpful to cardiologists for anatomical assessment of coronary arteries for diagnostic purposes and invasive studies.

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23

AVCI, Onur, and Oğuz GÜNDOĞDU. "Evaluation of Cerebral Oxygenation and Tissue Perfusion in Patients Ongoing Coronary Artery Surgery with Cardiopulmonary By-pass." Turkiye Klinikleri Cardiovascular Sciences 31, no. 2 (2019): 109–15. http://dx.doi.org/10.5336/cardiosci.2019-65779.

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24

GERDAN, Berna, and Ümran DAL YILMAZ. "Determination of Anxiety Levels of Patients Before and After Coronary Artery By-Pass Graft Surgery: Descriptive Study." Turkiye Klinikleri Cardiovascular Sciences 34, no. 1 (2022): 7–16. http://dx.doi.org/10.5336/cardiosci.2021-86491.

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25

Alexandri, Maria, Maria Tsellou, Nikolaos Goutas, Konstantina Galani, and Stavroula Papadodima. "Extended Stanford Type-A Aortic Dissection with Multivessel Coronary and Peripheral Artery Involvement: An Autopsy Case Report." Healthcare 11, no. 3 (January 29, 2023): 386. http://dx.doi.org/10.3390/healthcare11030386.

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We report the case of a 64-year-old male who died suddenly short after his admission to hospital because of strong chest pain and before any clinical diagnosis was established. His medical history included coronary disease with coronary by-pass surgery at the age of 40 years old, uncontrolled hypertension, diabetes mellitus, and elevated levels of cholesterol. The autopsy revealed quite a rare case of Stanford A aortic dissection with extension to the common and internal carotid arteries; the subclavian, axillary, brachial, and radial arteries; three coronary arteries; the superior mesenteric artery; and the iliac arteries. There was no histological evidence of aortitis or connective tissue disease. The death did not result from the rupture of the aortic dissection, but from myocardial ischemia due to coronary occlusion in combination with hemodynamic disturbance from stress caused by the extended aortic dissection.

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26

Halvorsen, P. S., A. Espinoza, R. Lundblad, M. Cvancarova, P. K. Hol, E. Fosse, and T. I. Tønnessen. "Agreement between PiCCO pulse-contour analysis, pulmonal artery thermodilution and transthoracic thermodilution during off-pump coronary artery by-pass surgery." Acta Anaesthesiologica Scandinavica 50, no. 9 (October 2006): 1050–57. http://dx.doi.org/10.1111/j.1399-6576.2006.01118.x.

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27

Yay, K., S. Surer, and O. T. Darcin. "OP-097: CORONARY BY-PASS SURGERY VERSUS MEDICAL TREATMENT AT SEPTAGENARIAN WHO HAS A SURGICAL INDICATION FOR CORONARY ARTERY DISEASE." International Journal of Cardiology 147 (March 2011): S62. http://dx.doi.org/10.1016/s0167-5273(11)70183-8.

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28

Held, Claes, Jean Pierre Bassand, Richard C. Becker, Christopher P. Cannon, Marc J. Claeys, Robert A. Harrington, Jay Horrow, Steen Husted, Stefan K. James, and Kenneth W. Mahaffey. "TICAGRELOR VERSUS CLOPIDOGREL IN PATIENTS WITH ACUTE CORONARY SYNDROMES UNDERGOING CORONARY ARTERY BY-PASS SURGERY: RESULTS FROM THE PLATO TRIAL." Journal of the American College of Cardiology 55, no. 10 (March 9, 2010): A124.E1163. http://dx.doi.org/10.1016/s0735-1097(10)61164-3.

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29

Efros, L. A., and I. V. Samorodskaya. "Evaluation of patients survival with coronary heart disease after coronary bypass surgery depending on the passage of recovery phase." CardioSomatics 4, no. 2 (June 15, 2013): 37–42. http://dx.doi.org/10.26442/cs45011.

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In a retrospective study based on the register of patients with coronary heart disease after coronary artery bypass grafting clinical and functional characteristics and long-term survival in 2398 men, age 54,8±6,3 were analized, depending on the passage of the recovery phase from 2000 to 2009. The results showed that people of pre-retirement age were sent to the sanatorium therapy stage (72,5%) with a mild coronary and myocardial insufficiency. Mortality in the long-term period of 1 year to 10 years in the group after sanatorium therapy stage was 7,9%, whereas among patients who have not undergone sanatorium rehabilitation mortality rate was higher – 8,4%. Analysis of survival by Kaplan-Meier method of patients after sanatorium rehabilitation revealed that 3, 5 and 10-year survival rate was significantly higher than in those that did not pass the sanatorium stage of treatment. Two tests – Gehan's Wilcoxon Test (p=0,01835), Cox-Mantel Test (p=0,02820) – confirmed the accuracy of the comparison groups.

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Peric, Vladan, Snežana Jovanovic-Markovic, Dejan Peric, Dragisa Rasic, Tatjana Novakovic, Bogdan Dejanovic, and Milorad Borzanovic. "Quality of Life in Patients of Different Age Groups before and after Coronary Artery By-Pass Surgery." Annals of Thoracic and Cardiovascular Surgery 21, no. 5 (2015): 474–80. http://dx.doi.org/10.5761/atcs.oa.15-00041.

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31

Mihajlovic, Bogoljub, Svetozar Nicin, Nada Cemerlic-Adjic, Katica Pavlovic, Slobodan Dodic, Lazar Velicki, and Miklos Fabri. "Trends of risk factors in coronary surgery." Srpski arhiv za celokupno lekarstvo 138, no. 9-10 (2010): 570–76. http://dx.doi.org/10.2298/sarh1010570m.

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Introduction. In current era of widespread use of percutaneous coronary interventions (PCI), it is debatable whether coronary artery by-pass graft (CABG) patients are at higher risk. Objective. The aim of the study was to evaluate trends in risk profile of isolated CABG patients. Methods. By analysing the EuroSCORE and its risk factors, we reviewed a consecutive group of 4675 isolated CABG patients, operated on during the last 8 years (2001-2008) at our Clinic. The number of PCI patients was compared to the number of CABG patients. For statistical analyses, Pearson?s chi-square and ANOVA tests were used. Results. The number of PCI increased from 159 to 1595 (p<0.001), and the number of CABG from 557 to 656 (p<0.001). The mean EuroSCORE increased from 2.74 to 2.92 (p=0.06). The frequency of the following risk factors did not change over years: female gender, previous cardiac surgery, serum creatinine >200?mol/l, left ventricular dysfunction and postinfarct ventricular septal rupture. Chronic pulmonary disease, neurological dysfunction, and unstable pectoral angina declined significantly (p<0.001). Critical preoperative care declined from 3.1% in 2001 to 0.5 % in 2005, than increased and during the last 3 years did not change (2.3%). The mean age increased from 56.8 to 60.7 (p<0.001) and extracardiac arteriopathy increased from 9.2% to 22.9% (p<0.001). Recent preoperative myocardial infarction increased from 11% to 15.1% (p=0.021), while emergency operations increased from 0.9% to 4.0% (p=0.001). Conclusion. The number of CABG increases despite the enlargement of PCI. The risk for isolated CABG given by EuroSCORE increases over years. The risk factors, significantly contributing to higher EuroSCORE are: older age, extracardiac arteriopathy, recent myocardial infarction and emergency operation.

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Peric, V. "The relationship between EuroSCORE preoperative risk prediction and quality of life changes after coronary artery by-pass surgery." Interactive CardioVascular and Thoracic Surgery 4, no. 6 (September 6, 2005): 622–26. http://dx.doi.org/10.1510/icvts.2005.109546.

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BOER, F., J. G. BOVILL, A. G. L. BURM, and A. HAK. "Effect of ventilation on first-pass pulmonary retention of alfentanil and sufentanil in patients undergoing coronary artery surgery." British Journal of Anaesthesia 73, no. 4 (October 1994): 458–63. http://dx.doi.org/10.1093/bja/73.4.458.

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Broglio, Fabio, Fabio Guarracino, Andrea Benso, Cristina Gottero, Flavia Prodam, Riccarda Granata, Enrico Avogadri, Giampiero Muccioli, Romano Deghenghi, and Ezio Ghigo. "Effects of acute hexarelin administration on cardiac performance in patients with coronary artery disease during by-pass surgery." European Journal of Pharmacology 448, no. 2-3 (July 2002): 193–200. http://dx.doi.org/10.1016/s0014-2999(02)01934-9.

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FOX, D., S. PETKAR, N. DAVIDSON, and A. FITZPATRICK. "Biventricular pacing in a patient with ventilatory and inotropic dependant heart failure following coronary artery by-pass surgery." Europace 7, no. 5 (September 2005): 490–91. http://dx.doi.org/10.1016/j.eupc.2005.05.002.

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Rahim, AM Asif, MAH Pervez, MG Kibria, MSH Talukder, A. Zaman, and QM Hoque. "Intraoperative Validation of Left Internal Mammary Artery Graft by Flourescence Imaging Technique." Cardiovascular Journal 10, no. 2 (April 6, 2018): 145–49. http://dx.doi.org/10.3329/cardio.v10i2.36282.

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Background: In coronary artery bypass surgery (CABG) left internal mammary artery (LIMA) is considered gold standard conduit of choice for myocardial revascularization. Graft failure following CABG reduces cardiac mortality and morbidity both in short and long term. Although conventional angiography is gold standard for assessing graft patency but rarely available in same operating room. So intraoperative florescence imaging could be an efficient and reliable method of assessing the patency of graft.Methods: This study was conducted between July 2013 to June 2014 in the Department of Cardiac Surgery of National Institute of Cardiovascular Diseases (NICVD). Thirty six LIMA grafts were assessed by using IFI system .ICG administered through CVP line and imaging acquired during pass of the ICG through field of view graft flow. Quality of anastomosis was intra operatively to validate graft.Results: Mean age of study population was 54±8.38 years. Per operative assessment of LIMA to left anterior descending artery revealed 32 (88.8%) patent anastomosis, narrowing of anastomosis was found in 2 (5.55% ) patients.Conclusion: Intraoperative fluorescence imaging is an effective and inexpensive way to validate patency of LIMA graft.Cardiovasc. j. 2018; 10(2): 145-149

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Hakala, T., O. Pitkänen, and M. Hippeläinen. "Feasibility of Predicting the Risk of Atrial Fibrillation after Coronary Artery Bypass Surgery with Logistic Regression Model." Scandinavian Journal of Surgery 91, no. 4 (December 2002): 339–44. http://dx.doi.org/10.1177/145749690209100406.

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Background and Aims: The aim of this study was to determine the risk factors of postoperative atrial fibrillation (AF) after coronary artery bypass grafting and to create predictive model and to evaluate the effects of AF on patients outcome. Material and Methods: Data of 3,676 consecutive patients were analysed to identify the predictors of AF. Multivariate logistic regression model was validated prospectively in 1,107 patients. Results: Increasing age (p < 0.001), preoperative use of digoxin (p = 003), need of intra-aortic balloon pump or inotropic medication in the weaning off cardiopulmonary by pass or during the first 24 hours postoperatively (p = 0.013), increasing body surface area (p = 0.006) and lower ejection fraction (p = 0.048) were independent risk factors for postoperative AF. The predictive model gave area under the receiver-operating characteristic (ROC) curve 0.682, 95 % confidence interval 0.663–0.701, and p < 0.001. The patients with AF incidence had more postoperative stroke (p = 0.008), confusion (p < 0.001) severe gastrointestinal complications (p = 0.005), readmission to ICU (p < 0.001), longer ICU (p < 0.001) and hospital stay (p < 0.001) when compared with the patients who remained in sinus rhythm. Conclusion: Logistic regression model with the parameters used was not accurate enough for clinical purposes. Postoperative AF is associated with postoperative stroke, severe gastrointestinal complications, readmission to ICU, and longer ICU and hospital stay.

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Šemetienė, Giedrė, Eglė Gatelienė, and Giedrius Uždavinys. "Stafilokokinio anatoksino vartojimas pooperacinėms žaizdoms gydyti: klinikinio atvejo aprašymas." Lietuvos chirurgija 8, no. 3 (January 1, 2010): 0. http://dx.doi.org/10.15388/lietchirur.2010.3.2114.

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Giedrė Šemetienė, Eglė Gatelienė, Giedrius UždavinysVilniaus universiteto ligoninės Širdies ir kraujagyslių ligų klinikos Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusVilniaus universiteto Širdies chirurgijos centrasEl paštas: egleu@yahoo.com Pooperacinis mediastinitas po aortokoronarinių jungčių operacijų – reta, bet labai grėsminga komplikacija, lemianti didelį mirštamumą, sudėtingą gydymą, daugybę papildomų chirurginių procedūrų, ilgą gydymo stacionare laiką, keliolika kartų išaugusias gydymo išlaidas. Šiuolaikiniai gydymo metodai ne visada duoda norimą poveikį, todėl kartais pravartu prisiminti ir seniai pamirštus, bet kartais labai veiksmingus gydymo metodus. Šiame straipsnyje nagrinėjame ligonio, sergančio išemine širdies liga, kuriai būdingas išplitęs visų vainikinių arterijų pažeidimas, klinikinį atvejį. Po operacijos, kurios metu suformuotos 5 apeinamosios aortokoronarinės jungtys, pacientui išsivystė pūlinis mediastinitas, kurį net 8 mėnesius teko gydyti stacionare. Žaizdai sugijus antriniu būdu, krūtinėje, pjūvio vietoje, išliko fistulė, kuri neužgijo dar vienerius metus. Tik pritaikius gydymą stafilokokiniu anatoksinu, fistulę pavyko sugydyti per 2 mėnesius. Šiuolaikinėje širdies chirurgijos praktikoje beveik nebenaudojamas gydymo metodas – imunizacija stafilokokiniu anatoksinu – galėtų būti puiki alternatyva, kai tradiciniai gydymo metodai negelbsti. Reikšminiai žodžiai: mediastinitas, stafilokokinis anatoksinas, imunizacija. Staphylococcal anatoxin in treatment of surgical wounds: case report Giedrė Šemetienė, Eglė Gatelienė, Giedrius UždavinysVilnius University, Clinic of Cardiovascular Diseases, Centre of Cardiac Surgery,Santariškių str. 2, LT-08661 Vilnius, LithuaniaVilniaus universiteto Širdies chirurgijos centrasE-mail: egleu@yahoo.com Postoperative mediastinitis after coronary artery by-pass grafting operations is a rare but threatening complication, causing a high mortality, complicated treatment with a number of additional surgical procedures, long in-hospital stay, several times higher treatment costs. The modern methods of treatment not always enable to achieve desirable results, that is why sometimes it is reasonable to think of old and even forgotten methods of treatment, which might be highly effective in some cases. We present a case of a patient ill with coronary artery disease and three-vessel pathology, who underwent a coronary artery by-pass grafting operation (5 grafts) in our clinic and developed a postoperative complication – mediastinitis, which needed 8 months of in-hospital stay. The patient was discharged from the hospital with a sternal fistula, which persisted for 12 months more despite the complex treatment. Only treatment with staphylococcal anatoxin enabled a closure of the fistula within 2 months. Immunization with staphylococcal anatoxin – the method that is no longer used in modern cardiac surgery – might be a perfect alternative when standard treatment fails. Key words: mediastinitis, staphylococcal anatoxin, imunization.

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Refatllari, Ali, Ermal Likaj, Selman Dumani, Endri Hasimi, and Artan Goda. "Surgical Treatment of Anomalous Origin of Right Coronary Artery in a Patient with Mitral Stenosis." Open Access Macedonian Journal of Medical Sciences 4, no. 1 (December 23, 2015): 131–34. http://dx.doi.org/10.3889/oamjms.2016.002.

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BACKGROUND: An anomalous origin of the right coronary artery is rarely observed, with a reported incidence between 0.026% and 0.25%. This condition is often completely asymptomatic and is found incidentally during angiographic evaluation for other cardiac diseases. However some patients present with exertion angina or sudden death. Surgical treatment in patients with anomalous RCA is still controversial. Treatment can be conservative, angioplasty or surgery.CASE PRESENTATION: A 59-year-old man was admitted with severe mitral stenosis. He complained exertion and rest dyspnea, NYHA III class. He had sequels of embolic stroke, results of left atrial thrombus. Echocardiography showed calcified severe mitral stenosis with mitral orifice area of 1.1 square centimeters with PSPAP 60 mmHg and normal LV function. Routine coronary angiography before surgery showed aberrant origin of RCA from the left sinus of Valsalva with 90% stenosis at his origin. Multi-slice computed tomography proved the diagnosis of anomalous RCA arising from the left sinus of Valsalva and taking an inter-arterial course between the aorta and pulmonary artery. The patient underwent mitral valve replacement with mechanical St. Jude prosthesis No 29 and saphenous vein graft to RCA. We chose by-pass grafting techniques because after aortotomy, RCA was too close to LMCA, intramural course was too short and stenosis of RCA was outside of aortic wall. The patient's perioperative course was without complications and patient was discharged on the seventh postoperative day.CONCLUSION: Correction of anomalous of the origin of right coronary artery is mandatory in cases where patient has to be operated for other cardiac causes.

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Sharma, Asma, Vaishali Kishan, A. G. Jayakrishnan, Niraj Kumar, and V. Prem. "EFFECT OF MUSIC MEDICINE ON ANXIETY AND DEPRESSION IN CORONARY ARTERY BY PASS GRAFT SURGERY PATIENTS: A RANDOMISED CONTROLLED TRIAL." International Journal of Advanced Research 8, no. 1 (January 31, 2020): 553–64. http://dx.doi.org/10.21474/ijar01/10329.

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Maksimovich, Ye N., T. P. Pronko, V. A. Yanushko, Yu A. Kashcheyeu, and V. A. Snezhitski. "THE ROLE OF HEMOLYSIS IN THE EMERGENCE OF HEART RHYTHM DISORDERS AFTER CORONARY BYPASSING." Jounal of arrhythmology 26, no. 2(96) (October 10, 2019): 29–36. http://dx.doi.org/10.35336/va-2019-2-29-36.

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The operation of coronary shunting in patients with coronary heart disease leads to the development of various complications in the postoperative period, the most frequent are heart rhythm disturbances.Purpose. To establish the connection of intraoperative hemolysis (IOH) with the development of cardiac rhythm disturbances in patients with coronary artery disease after coronary shunting in con-ditions of cardiopulmonary bypass (CB).Material and research methods. The assessment of the degree of IOH was made by the level of free hemoglobin [Hb] In the blood plasma at the beginning of the operation, immediately after the patient was connected to the CB device and 15 minutes before removal from the CB, using the HemoCue Plasma / Low Hb analyzer. According to the degree of IOH, patients (n = 123) are divided into 3 groups (gr.) in accordance with free [Hb]: gr.1 - ≤0,1 g/l; gr.2 - > 0.1 g/l and <0,5 g/l; gr.3 - ≥0,5g/l. Were used the following instrumental methods of investigation: electrocardiography, 24-hour ECG mon itoring. Was analyzed the frequency of heart rhythm disturbances in patients after coronary shunting with various levels of IOH in the perioperative (during the operation and during the first days after it) and in the early (up to 1 month) periods.Results. Arrhythmias were observed in 2.3% of patients of the 1st group, in 11.9% - the 2nd group, in 52.6% - the 3rd group. Associations were noted between [Hb]. In plasma at the end of cardio-pulmonary bypass and the frequency of arrhythmias (rs=0,70, p<0.001). The share of life-threatening and hemodynamically significant arrhythmias in the study period in the group with a high degree of IOH accounted for about half of all arrhythmias that occur, which is significantly more than in the group without IOH and with low IOH, p <0.001.Conclusion. The operation of coronary artery bypass surgery in conditions of artificial blood circu-lation leads to the development of arrhythmias in the postoperative period in 22% of patients with ischemic heart disease. A significant proportion of these are arrhythmias that pose a threat to the pa-tient’s life and arrhythmias, causing hemodynamic disturbances and hypoperfusion of vital organs. The largest number of patients with cardiac rhythm disturbances after coronary artery bypass graft-ing was observed in the group with the level of free hemoglobin in the blood plasma of 0.5 g/l or more (p <0.001), which indicates the relationship between the occurrence of arrhythmias and the degree of intraoperative hemolysis. The high risk of arrhythmias in patients with coronary heart dis-ease after coronary artery bypass surgery is determined when the content of free hemoglobin is more than 0.85 g/l. One of the ways to assess the risk of heart rhythm disturbances should be to determine the level of free hemoglobin in the blood plasma of patients in the intraoperative period of coronary artery by-pass grafting, which is necessary for the timely prevention and correction of possible hemodynamic disorders.

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Ramunni, A., L. F. Morrone, G. Baldassarre, E. Montagna, A. Saracino, and P. Coratelli. "Effectiveness of Long-term Heparin-induced Extracorporeal LDL Precipitation (HELP) in Improving Coronary Calcifications." International Journal of Artificial Organs 26, no. 3 (March 2003): 252–55. http://dx.doi.org/10.1177/039139880302600312.

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There is clear clinical evidence that a drastic lowering of plasma LDL- Cholesterol (LDL) concentrations significantly reduces the rate of total and coronary mortality as well as the incidence of cardiovascular events in high risk hypercholesterolemic patients. We describe the case of a 51-year-old woman with coronary heart disease (CHD) who presented with increasing angina on exertion in 1995, at the age of 45. She suffered from a heterozygous familial hypercholesterolemia and in 1985 her total cholesterol (TCHO) was 328±62 mg/dl (mean value of ten analysis). After ten years of statins her mean values (20 analysis, 2 per year) were: TCHO 259±71, LDL 209±47, HDL 35±7 mg/dl. Coronary angiography (CA) performed in 1995 disclosed three vessel coronary heart disease with significant stenoses of the distal right coronary artery, multiple calcifications of the interventricularis artery and multiple plaques with significant stenoses in the ramus circumflexus. The woman underwent coronary by-pass surgery. Thereafter the patient was treated for six years with HELP in biweekly intervals, in combination with statins. TCHO, LDL, HDL and fibrinogen (fb) levels were measured before and after each treatment. Their mean values for an amount of 120 sessions were: TCHO pre 216±23, post 111±18 LDL pre 152±16 post 67±18, HDL pre 42±5 post 35±4 fb pre 306±48 post 125±31. In 2001 a new CA was performed. Calcifications disappeared and stenoses were identical to the previous CA or reduced. There were no further clinical manifestations of CHD. We trust that the clinical benefit of the HELP procedure will be substantial for those patients who have problems in clearing LDL from their plasma pool and who are at the same time sensitive to elevated LDL levels by the development of premature coronary sclerosis.

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Chryssagis, Konstantinos, Stefan Klügl, Aris Liangos, Klaus J. Gutleben, Johannes Brachmann, and Anno Diegeler. "Surgical Feasibility of the Injection of Fibrin Sealant in Cardiac Fat Pads to Reduce the Incidence of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting or Valve Surgery: A Pilot Study." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 3, no. 3 (May 2008): 151–54. http://dx.doi.org/10.1097/imi.0b013e31817f82e6.

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Objective Atrial fibrillation (AF) is the most common complication following coronary artery bypass grafting or valve surgery. The autonomic nervous system is an important determinant in the development of AF. We have assessed the role of injection of fibrin sealant (FS) as a method to modify conduction in the fad pads, to mimic temporary denervation and to reduce the incidence of postoperative AF in patients undergoing coronary artery bypass grafting or valve surgery. Patients and Methods Twenty eligible patients who underwent coronary bypass grafting or aortic valve surgery in our Institution were included in this pilot – study. Detection of AF after surgical intervention was based on patient symptomatology and on daily electrocardiograms obtained on all patients. Telemetry was used in all patients for the entire hospitalization period. Results 20% of the studied population (n = 4) developed postoperative AF. At the time of discharge one patient (5%) had persistent AF. Postoperative mortality was 5% (n = 1) and not cardiac related. None of the patients required permanent pacemaker implantation. Conclusions This first human study of FS injected into the anterior fad pads following low to moderate risk open heart surgery shows, that this procedure is safe and feasible. Moreover, CM −1 injection appears to reduce the need for postoperative intervention and/or treatment of AF by diminishing its incidence.

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Sarwar, Usman, Nikky Bardia, Ali Hussain, Muhammad Nadeem, and Hassan Tahir. "Left Main Disease PCI vs CABG: A Brief Review of Important Literature." International Journal of Medical Science and Clinical Invention 8, no. 09 (September 23, 2021): 5652–55. http://dx.doi.org/10.18535/ijmsci/v8i09.012.

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Left main coronary artery (LMCA) disease is defined as > 50% narrowing of vessel diameter; it is the disease of significant morbidity and mortality because it supplies 75% of the left ventricle, so any insult to the left main can lead to severe LV dysfunction, sudden cardiac arrest and arrhythmia. The incidence of left main disease in patients undergoing coronary angiography is 4-6%. The untreated left main disease has mortality around 20% at 1 year [1,2].Initially, the procedure of choice for the significant left main disease was coronary artery by-pass surgery (CABG), as medical therapy carries a high mortality rate as compared to CABG (36.5% vs 16.0%). Nevertheless, with the advancement in percutaneous intervention (PCI), there is a growing interest and passion in the percutaneous intervention of LMCA [3]. European [4] and American [5] guidelines recommend CABG (class I) as the treatment method of choice for LMCA in patients with all anatomical complexities. Current European treatment guidelines give PCI class I along with CABG if SYNTAX score < 22, class IIa if between 23-32, and class III (Harm) if SYNTAX > 33. Current US guidelines currently gives class IIa recommendation for PCI if syntax score is low, class IIb for a score between 23-32 and similar to European guideline's class III (Harm) for SYNTAX score > 33. We reviewed the major landmark trials that compare PCI vs CBAG as a treatment option for left main disease along with important meta-analysis

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Bar-Tal, Yoram, Hannah Gardosh, and Sivia Barnoy. "The Differential Effect of Perceived Control and Negative Affectivity as a Function of Gender after Coronary Artery By-pass Graft Surgery." Sex Roles 55, no. 11-12 (December 1, 2006): 853–59. http://dx.doi.org/10.1007/s11199-006-9137-5.

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Canturk, Mehmet. "The Canturk combination: Erector spinae plane block and femoral nerve block for postoperative analgesia after coronary artery by-pass grafting surgery." Journal of Clinical Anesthesia 62 (June 2020): 109700. http://dx.doi.org/10.1016/j.jclinane.2020.109700.

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Istomin, T. A., I. S. Kurapeev, Y. B. Mihaleva, E. V. Suborov, I. A. Domanskaya, and G. N. Vasilieva. "LOW-VOLUME CARDIOPLEGIA BY «CUSTODIOL» SOLUTIONIN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS." HERALD of North-Western State Medical University named after I.I. Mechnikov 9, no. 1 (March 15, 2017): 59–67. http://dx.doi.org/10.17816/mechnikov20179159-67.

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The study presents the results of quality assessment of antiischemic myocardial protection by low- volume method of cardioplegia by «Custodiol» solution during operations with cardiopulmonary by- pass. The study involved 57 patients who underwent different cardiosurgery operations with cardio- pulmonary bypass. The patients were divided into two groups on the basis of the volume of cardioplegic solution. Research group (Group № 1) consists of 33 patients who were administered «Custodiol» in low volume limited by 1000 ml. The control group (Group № 2) consists of 24 patients who were ad- ministered standart volume of the solution corresponding to the manufacturer's instructions: 1 ml per 1 g of myocardial mass during 6-8 minutes. The results has indicated that the use of low volume of car- dioplegic «Custodiol» in a single administration manner provides a complete antiischemic protection of the myocardium during the correction of valvular heart disease, including combination with coronary artery bypass grafting. usage of low volume «Custodiol» solution method does not increase the need of inotropic and vasopressor usage and pacing time. The use of low volumes of «Custodiol» helps to reduce transfusion requirements of blood and its components.

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Konstanty-Kalandyk, Janusz, Anna Kędziora, Piotr Mazur, Radosław Litwinowicz, Bogusław Kapelak, and Jacek Piątek. "Bilateral internal thoracic artery use in two-vessel disease does not increase the perioperative risk—A propensity score matched analysis." PLOS ONE 16, no. 12 (December 22, 2021): e0261176. http://dx.doi.org/10.1371/journal.pone.0261176.

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Background Bilateral internal thoracic arteries (BITA) are uncommonly used in the every-day practice due to safety concerns and technical challenges with Y-grafts. We hypothesized that in-situ BITA use during coronary artery by-pass grafting (CABG) for two vessel disease is equally safe to standard strategy with left internal thoracic artery-left anterior descending artery revascularization and venous graft to other target vessels. Methods A propensity score matched analysis was used to compare elective on-pump CABG patients who received in-situ BITA (BITA-group), versus left internal thoracic artery graft to the left anterior descending artery plus vein (SITA-group). Primary end points were 30-days all-cause-mortality, major adverse cardiac events and incidents and deep sternal wound infections. Results A total of 50 matched pairs (c-statistics 0.769) were selected from patients operated on between January 2015 and April 2020 using BITA (n = 50) and SITA (n = 2170). There were no inter-group differences in demographics and basic clinical characteristics. The total operation time was longer in the BITA-group (4.0 vs 3.6 hours; p = 0.004). The rate of complete revascularization was similar, as was median aortic cross-clamp time, median extracorporeal circulation time, rate of re-explorations for bleeding, deep sternal wound infections or length of stay. One patient died in BITA group, 3 days after surgery, from a non-cardiac cause. After 36 months, the survival rate was 98% for BITA-group and 96% for controls (log-rank, p = 0.577). Conclusions In-situ use of BITA during coronary revascularization for two-vessel disease is as safe and effective, as use of single ITA and vein graft. In-situ strategy abolishes allows to avoid the technically demanding composite graft configuration.

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Kang, Dong-Hun, Byung Moon Kim, Ji Hoe Heo, Hyo Suk Nam, Young Dae Kim, Yang Ha Hwang, Yong-Won Kim, et al. "Effects of first pass recanalization on outcomes of contact aspiration thrombectomy." Journal of NeuroInterventional Surgery 12, no. 5 (September 28, 2019): 466–70. http://dx.doi.org/10.1136/neurintsurg-2019-015221.

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BackgroundFirst pass recanalization (FPR, defined as achieving a modified Thrombolysis in Cerebral Ischemia (mTICI) grade 2c/3 with a single pass of a thrombectomy device) effect has not yet been evaluated in contact aspiration thrombectomy (CAT). We evaluated FPR effect on clinical outcomes and FPR predictors in CAT.MethodsAll consecutive patients who underwent frontline CAT for anterior circulation large vessel occlusion with recanalization (mTICI 2b–3) were identified from registries at six stroke centers. The patients were dichotomized into FPR and non-FPR groups. Clinical features and outcomes were compared between the groups. Multivariate analyses were performed to determine whether FPR was independently associated with clinical outcomes and to identify predictors of FPR.ResultsOf the 429 patients who underwent frontline CAT, recanalization was successful in 344 patients (80.2%; mean age 68.7±11.0 years; M:F ratio 179:165). The FPR group had a higher rate of good outcome (modified Rankin Scale score 0–2) than the non-FPR group. Furthermore, the good outcome rate was higher in the FPR group than in patients who achieved mTICI 2c/3 with multiple passes or rescue treatment. FPR (OR 2.587; 95% CI 1.237 to 5.413) remained independently associated with good outcomes, in addition to age, baseline National Institute Health Stroke Scale, and coronary artery disease. The use of a balloon guide catheter (OR 3.071; 95% CI 1.699 to 5.550) was the only predictor of FPR.ConclusionsPatients in the FPR group had better clinical outcomes than the non-FPR group in CAT. FPR was independently associated with a good outcome. The use of a balloon guide catheter was the only predictor of FPR.

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Lindén, T. "Serum lipids, lipoprotein(a) and apo(a) isoforms in patients with established coronary artery disease and their relation to disease and prognosis after coronary by-pass surgery." Atherosclerosis 137, no. 1 (March 3, 1998): 175–86. http://dx.doi.org/10.1016/s0021-9150(97)00247-5.

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