TY - JOUR. T1 - Esmolol versus diltiazem in atrial fibrillation following coronary artery bypass graft surgery. AU - Hilleman, Daniel E.. AU - Reyes, Antonio P.. AU - Mooss, Aryan N.. AU - Packard, Kathleen A.. N1 - Copyright: Copyright 2008 Elsevier B.V., All rights reserved.. PY - 2003. Y1 - 2003. N2 - Purpose: Atrial fibrillation (AF) is the most common arrhythmic complication following coronary artery bypass graft surgery (CABG). The efficacy and safety of esmolol and diltiazem were compared in patients with post-CABG AF. Methods: This study was a retrospective medical record review of consecutive patients with post-CABG AF ≥15 min in duration with a ventricular rate ≥110 b.p.m. who received either i.v. esmolol (n = 59) or i.v. diltiazem (n = 48) with or without concomitant digoxin therapy at a single university-affiliated teaching hospital. Treatment success was defined as either cardioversion to sinus rhythm or a reduction in the ventricular rate to ≤90 b.p.m. at 24h after the start ...
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Impact of perioperative myocardial infarction on angiographic and clinical outcomes following coronary artery bypass grafting (from PRoject of Ex-vivo Vein graft ENgineering via Transfection [PREVENT] IV).
TY - JOUR. T1 - Sequential changes in heart rate variability after coronary artery bypass grafting. AU - Kuo, Cheng Deng. AU - Chen, Gau Yang. AU - Lai, Shiau Ting. AU - Wang, Yia Yi. AU - Shih, Chun Che. AU - Wang, Jia Horng. PY - 1999/3/1. Y1 - 1999/3/1. N2 - Heart rate variability (HRV) decreased soon after coronary artery bypass grafting and returned to the preoperative level within 2 months; however, HRV did not exceed the preoperative level, even 6 months after coronary artery bypass grafting. Although myocardial ischemia can be improved by coronary artery bypass grafting, HRV did not benefit from coronary artery bypass grafting within 6 months.. AB - Heart rate variability (HRV) decreased soon after coronary artery bypass grafting and returned to the preoperative level within 2 months; however, HRV did not exceed the preoperative level, even 6 months after coronary artery bypass grafting. Although myocardial ischemia can be improved by coronary artery bypass grafting, HRV did not benefit ...
TY - JOUR. T1 - Network meta-analysis of antiplatelet therapy following coronary artery bypass grafting (CABG). T2 - none versus one versus two antiplatelet agents. AU - Chakos, Adam. AU - Jbara, Dean. AU - Singh, Kamal. AU - Yan, Tristan D.. AU - Tian, David H.. PY - 2018/9/1. Y1 - 2018/9/1. N2 - Background: Numerous agents have been trialed following coronary artery bypass grafting (CABG) to maintain long-term graft patency. While clear evidence exists for the use of aspirin in maintaining graft patency, the role of dual-antiplatelet therapy in CABG patients is not as well established. This network meta-analysis aimed to compare the short-term post-CABG graft patency outcomes for patients with none, one or two antiplatelet agents. Methods: Electronic databases were queried for randomized controlled trials comparing CABG graft patency rates at three months and beyond using various antiplatelet agents or placebo. Drug and graft patency data were compared using a mixed treatment comparison under ...
OBJECTIVE: Use of antifibrinolytic agents reduces the risk of bleeding and decreases the need for blood product use in patients undergoing cardiac surgery. The purpose of this study was to determine whether perioperative use of tranexamic acid decreases the rate of saphenous vein graft patency in the early postoperative period after conventional coronary artery bypass grafting surgery.. METHODS: A total of 312 patients scheduled for elective coronary artery bypass grafting surgery with cardiopulmonary bypass were randomized to receive either tranexamic acid 100 mg/kg (n = 147) or placebo (n = 165) in a double-blinded fashion before the initiation of cardiopulmonary bypass. Saphenous vein graft patency was assessed with magnetic resonance imaging 5 to 30 days after surgery.. RESULTS: Both groups were comparable with respect to baseline demographic data and surgical characteristics. A total of 237 (76%) patients underwent magnetic resonance imaging assessment. A total of 297 saphenous vein grafts ...
Background: The SHOCK Trial demonstrated that early revascularization (ERV) provided a survival advantage compared with initial medical stabilization in patients with acute myocardial infarction (MI). The ideal revascularization strategy for patients with cardiogenic shock in the setting of left main coronary artery (LMCA) disease is unknown.. Methods: We compared 30-day survival rates associated with coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in this clinical setting. A multiple Cox regression model with left truncation was used to identify risk factors for 30-day mortality and attempt to correct for the bias that would be attributable to the differential time to revascularization.. Results: The SHOCK Trial (n=144) and Registry (=33) included 177 patients with significant (,50%) LMCA disease who underwent revascularization (CABG or PCI). Although the trial protocol recommended CABG for patients with LMCA involvement, the revascularization strategy (92 ...
An aneurysm is defined as dilatation of the artery greater than 50% in diameter. Aneurysms are categorized as fusiform or saccular. The saccular aneurysms of the ascending aorta are rarely seen and are usually life-threatening. Excessive use of biologicglue, graft infection, mediastinitis, aortic dissection, atherosclerosis, hypertension, degeneration of a penetrating atherosclerotic ulcer, poorsurgical technique, trauma, fungal infections and previous aortic surgery (presumably due to the cannulation site) are the etiologic risk factors for the development of a false or true aneurysm of the ascending aorta [1]. There are a few reports for saccular aneurysm of the ascending aorta which are following coronary artery bypass grafting surgery. The wall stressis greater in saccular aneurysms rather than fusiform aneurysms. The disruption of the vesse lwall at the cannulation site oral long the aortic suture lines lead to saccular aneurysm.. Theaortic false aneurysm may surrounded and restricted by ...
Midazolam and propofol were compared in an open randomized study for postoperative sedation during 12 h of mechanical ventilation in 40 patients following coronary artery bypass grafting. After an intravenous loading dose of midazolam (50 micrograms.kg-1) or propofol (500 micrograms.kg-1), a titrated continuous infusion was administered of midazolam (mean dose 38.1 micrograms.kg-1.h-1 (SEM 2.6)) or propofol (mean dose 909 micrograms.kg-1.h-1 (SEM 100)) together with a narcotic analgesic infusion. During mechanical ventilation midazolam and propofol produced a similar quality of sedation, but recovery (midazolam 66 min (SEM 16); propofol 24 min (SEM 7)) and weaning from the ventilator (midazolam 243 min (SEM 44); propofol 154 min (SEM 33)) where faster with propofol. In the 2 groups administration of an intravenous loading dose caused a significant decrease in mean arterial pressure but hemodynamic tolerance during maintenance infusion was good ...
Rushing GD, Yuh DD. Rushing G.D., Yuh D.D. Rushing, G.D., and David D. Yuh.Primary Coronary Artery Bypass Surgery. In: Yuh DD, Vricella LA, Yang SC, Doty JR. Yuh D.D., Vricella L.A., Yang S.C., Doty J.R. Eds. David D. Yuh, et al.eds. Johns Hopkins Textbook of Cardiothoracic Surgery, Second Edition New York, NY: McGraw-Hill; 2014. http://accesssurgery.mhmedical.com/content.aspx?bookid=963§ionid=55170297. Accessed January 18, 2018 ...
According to the recent report Published by Credence Research, Inc. Coronary Artery Bypass Grafting Devices Market (Device Type: Tissue Stabilizers, Heart Positioners, Refractors, Cannulas, Cardiopulmonary Bypass Machines, Endoscopic Vessel Harvesting Systems and Others; Surgery Type: On Pump, Off Pump and Minimally Invasive Direct Coronary Artery Bypass Grafting; Technique Type: Traditional Vessel Harvesting and Endoscopic Vessel Harvesting)- Growth, Future Prospects and Competitive Analysis, 2017-2025, the global coronary artery bypass grafting devices market is estimated to grow at CAGR of 5.5%.. Browse the full report Coronary Artery Bypass Grafting Devices Market - Growth, Future Prospects and Competitive Analysis, 2017-2025 at http://www.credenceresearch.com/report/coronary-artery-bypass-grafting-devices-cabg-market. Market Insights. Coronary artery disease is one of the leading causes of death worldwide due to the blockage of coronary arteries from buildup of atherosclerotic plaques ...
According to the recent report Published by Credence Research, Inc. Coronary Artery Bypass Grafting Devices Market (Device Type: Tissue Stabilizers, Heart Positioners, Refractors, Cannulas, Cardiopulmonary Bypass Machines, Endoscopic Vessel Harvesting Systems and Others; Surgery Type: On Pump, Off Pump and Minimally Invasive Direct Coronary Artery Bypass Grafting; Technique Type: Traditional Vessel Harvesting and Endoscopic Vessel Harvesting)- Growth, Future Prospects and Competitive Analysis, 2017-2025, the global coronary artery bypass grafting devices market is estimated to grow at CAGR of 5.5%.. Browse the full report Coronary Artery Bypass Grafting Devices Market - Growth, Future Prospects and Competitive Analysis, 2017-2025 at http://www.credenceresearch.com/report/coronary-artery-bypass-grafting-devices-cabg-market. Market Insights. Coronary artery disease is one of the leading causes of death worldwide due to the blockage of coronary arteries from buildup of atherosclerotic plaques ...
According to the recent report Published by Credence Research, Inc. Coronary Artery Bypass Grafting Devices Market (Device Type: Tissue Stabilizers, Heart Positioners, Refractors, Cannulas, Cardiopulmonary Bypass Machines, Endoscopic Vessel Harvesting Systems and Others; Surgery Type: On Pump, Off Pump and Minimally Invasive Direct Coronary Artery Bypass Grafting; Technique Type: Traditional Vessel Harvesting and Endoscopic Vessel Harvesting)- Growth, Future Prospects and Competitive Analysis, 2017-2025, the global coronary artery bypass grafting devices market is estimated to grow at CAGR of 5.5%.. Browse the full report Coronary Artery Bypass Grafting Devices Market - Growth, Future Prospects and Competitive Analysis, 2017-2025 at http://www.credenceresearch.com/report/coronary-artery-bypass-grafting-devices-cabg-market. Market Insights. Coronary artery disease is one of the leading causes of death worldwide due to the blockage of coronary arteries from buildup of atherosclerotic plaques ...
Researchers said that in comparison to coronary artery bypass patients who have normal weight, patients with extreme obesity were thrice more vulnerable to develop an infection post-bypass surgery. Through the coronary artery bypass surgery, blood flow is redirected to the heart surrounding clogged heart arteries.. The studys senior author, Mary Forhan, Ph.D., assistant professor at the University of Alberta in Edmonton, Canada, said, Based on the results of this study it appears that addressing infection risk might be an effective strategy to decrease the length-of-stay for patients with obesity who undergo coronary artery bypass surgery.. The study used a Canadian database of heart patients, and analyzed how a racially and ethnically varied group of 7,560 patients fared following a bypass surgery in Edmonton in the years April 2003 to March 2014.. The division of the patients was done as per their body mass index into five different groups, including normal weight with BMI 18.5-24.9; ...
To investigate the application and value of continuous nursing after coronary artery bypass grafting. Coronary artery bypass surgery - creation of a graft to reroute the blood flow away from the diseased artery) Angioplasty with stent placement - also known as percutaneous coronary revascularization which involves the insertion of a catheter into the affected artery followed by inflation of balloon and insertion of a stent to keep the blood vessel open. Helpful? Little data are available to compare coronary artery bypass graft surgery (CABG) vs percutaneous coronary intervention (PCI) with drug‐eluting stents (DES) in older adults. Early and adequate discharge planning based on in‐depth knowledge of the postdischarge experience can help to ensure optimal recovery. Coronary Artery Bypass Graft (CABG) Post Op Nursing Care Learn with flashcards, games, and more - for free. Coronary angiography in the setting of coronary artery bypass grafting (CABG) is important diagnostic tool for the ...
TY - JOUR. T1 - Predictors of inotropic support during weaning from cardiopulmonary bypass in coronary artery bypass grafting surgery. AU - Hayashi, H.. AU - Prabhu, R.. AU - Kramer, D. C.. AU - Oka, Y.. PY - 1997/4/15. Y1 - 1997/4/15. N2 - Early or prophylactic inotropic drug administration is occasionally required to facilitate separation from cardiopulmonary bypass (CPB) in cardiac surgery. However, it is not without untoward effects and should be conducted on the basis of rational criteria. The purpose of our study was to clarify variables associated with the requirement for inotropic support during separation from CPB and to testify whether pre-CPB left ventricular (LV) function, as evaluated by transesophageal echocardiography (TEE), is one of the significant variables. Clinical profile data and TEE findings were retrospectively analyzed for 91 patients who had received elective primary isolated coronary artery bypass grafting (CABG) surgery. Post-CPB inotropic drug administration ...
TY - JOUR. T1 - Early intravenous thrombolytic therapy for acute myocardial infarction in patients with prior coronary artery bypass grafts. AU - Kleiman, Neal. AU - Berman, David A.. AU - Gaston, William R.. AU - Cashion, W. Richard. AU - Roberts, Robert. PY - 1989/1/1. Y1 - 1989/1/1. N2 - Treatment of acute myocardial infarction (AMI) with intravenous thrombolytic agents is gaining wide acceptance as a result of the demonstrated ability of fibrinolytic agents to restore coronary arterial patency,1 improve left ventricular function2-4 and reduce mortality.5,6 Most published trials have excluded patients with previous coronary artery bypass grafting, primarily because of difficulty in identifying the infarct-related coronary artery. However, the yearly rate of myocardial infarction is approximately 3% after coronary artery bypass surgery,7 and as the number of patients with bypass grafts increases and the population with bypass grafts in place ages, an increasing number of AMIs in this group can ...
OBJECTIVES We sought to ascertain the utility of adenosine thallium-201 tomography for assessing graft stenoses late after coronary artery bypass graft surgery. BACKGROUND Although pharmacologic perfusion imaging has been increasingly used in the assessment of patients with coronary artery disease, the value of this stress modality for detecting coronary artery bypass graft stenosis late after surgery is unknown. METHODS We studied 109 patients who underwent both adenosine thallium-201 tomography and coronary angiography at 6.7 +/- 4.8 (mean +/- SD) years after coronary artery bypass graft surgery. Adenosine thallium-201 tomography was assessed quantitatively by computer-generated polar maps of the myocardial thallium-201 activity. RESULTS On coronary angiography, significant graft stenoses were present in 68 patients, 65 of whom had a corresponding perfusion defect as shown by thallium-201 tomography (sensitivity 96%). Significant stenoses were present in 107 (37.8%) of 283 grafts. The overall
Description of disease Coronary artery bypass graft. Treatment Coronary artery bypass graft. Symptoms and causes Coronary artery bypass graft Prophylaxis Coronary artery bypass graft
Background: Prolonged cross-clamp time during cardiac surgery increases the risk of postoperative mortality and myocardial injury. This subanalysis from the pexelizumab for reduction of infarction and mortality in coronary artery bypass grafting surgery (PRIMO-CABG) trial, a phase III double-blind, placebo-controlled study of 3,099 patients undergoing on-pump coronary artery bypass graft surgery with or without valve surgery, assessed the impact of pexelizumab, an investigational C5 complement inhibitor, on postoperative outcomes after prolonged aortic cross-clamp time. Methods: The composite endpoint of death or myocardial infarction through postoperative day 30 and death alone through days 30, 90, and 180 were examined in subpopulations of patients across different cross-clamp times. Results: After prolonged cross-clamping (≥90 minutes), death, or myocardial infarction through day 30 and death through days 30, 90, and 180 were significantly increased in the intent-to-treat population and ...
Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting. Atrial remodeling has been observed in AF and has been associated with the development of this arrhythmia. Because 3-hydroxy-3-methylglutaryl coenzyme A inhibitors (statins) have been demonstrated to modify remodeling, we hypothesized a protective role of statins against postoperative AF. We also hypothesized that extracellular matrix turnover and brain natriuretic peptide (BNP) might be related to such atrial remodeling. We studied 234 consecutive patients who underwent coronary artery bypass grafting (173 men; 65 +/- 9 years of age) in whom the occurrence of postoperative AF was monitored. In a subgroup of 66 patients, we measured plasma levels of matrix metalloproteinase-1 (MMP-1), its inhibitor, tissue inhibitor matrix metalloproteinase-1 (TIMP-1; as indexes of extracellular matrix remodeling), and N-terminus pro-BNP (related to left ventricular function) at baseline and at 24 hours after surgery. Of 234 ...
OBJECTIVE: The purpose of this study was to determine whether physical, psychological and social recovery within the first 6 weeks following coronary artery bypass surgery varied by age. METHODS: A repeated measures design was used for this study. Data were collected from a convenience sample of three age groups of patients at the following times: prior to hospital discharge and at 1, 3 and 6 weeks after discharge. The three age groups studied were less than 60 years, 60 to 70 years and more than 70 years. Data were collected by interview and mail questionnaires. The initial sample consisted of 258 patients, of whom 184 completed the study. Eleven instruments were used to measure recovery including the Sickness Impact Profile, Beck Depression Inventory, Rosenberg Self-Esteem scale and the Symptom Inventory. RESULTS: No significant differences were found among the age groups for any of the physical, psychological or social recovery measures. Within each age group physical, psychological and ...
BACKGROUND: The anti-inflammatory or anti-arrhythmic effects of n-3 long-chain polyunsaturated fatty acids (LC-PUFA) may decrease the risk of postoperative atrial fibrillation (POAF), but interventional studies have yielded conflicting results. We examined the association between n-3 LC-PUFA and n-6 LC-PUFA in plasma phospholipids (PL) and POAF in patients undergoing coronary artery bypass grafting (CABG). METHODS: A total of 125 patients undergoing CABG were enrolled in the study. The levels of fatty acids in PL were measured preoperatively and on the third postoperative day. The endpoint was defined as POAF lasting ≥5 min. The incidence of POAF was compared between quartiles of the level of each fatty acid in plasma PL by univariate and multivariable analysis. RESULTS: The incidence of POAF was 49·6%. By univariate analysis, the incidence of POAF increased significantly with each higher quartile of pre- and postoperative docosahexaenoic acid (DHA) and diminished significantly with each ...
TY - JOUR. T1 - Coronary artery bypass in patients with type 2 diabetes. T2 - Experience from the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial. AU - Sako, Edward Y.. AU - Brooks, Maria Mori. AU - Hardison, Regina M.. AU - Schaff, Hartzel. AU - Frye, Robert L.. N1 - Funding Information: The details of the design of BARI 2D have been previously presented. 1 The trial was sponsored by the National Institutes of Health, with additional support from industry. The industry sponsors did not have access to the outcomes data and did not participate in the data analysis or preparation of our report. The institutional review board at each participating site approved the protocol ( ClinicalTrials.gov NCT00006305). All patients provided written informed consent. An independent data and safety monitoring board approved the study protocol and monitored the conduct of the study and safety of the patients. PY - 2014/10/1. Y1 - 2014/10/1. N2 - Objective: Bypass Angioplasty Revascularization ...
New research shows that a minimally invasive approach used during coronary artery bypass grafting surgery is safe and effective, despite previous studies that linked endoscopic vein harvesting to a higher mortality rate. The research, published in the August 1, 2012 edition of The Journal of the American Medical Association, was an observational study of more than 235,000 patients included in The Society of Thoracic Surgeons National Database who underwent CABG surgery at 934 participating surgical centers. Investigators compared the three-year outcomes of patients undergoing EVH to the outcomes of patients undergoing the more invasive open vein harvesting (OVH) procedure and found no difference in mortality rates. This study should alleviate concerns of patients and surgeons raised by past studies, and confirms the superiority of the EVH technique in terms of infection and wound complication rates that makes the minimally invasive approach the preferred method, said senior author Peter K. ...
The quality of myocardial protection during Coronary Artery Bypass Grafting (CABG) has a direct effect on post-operative cardiac function, recovery and complications. The optimal route for delivery of cardioplegia is still in debate in patients with ischemic heart disease. This prospective randomized clinical study was designed to assess and compare the use of combined antegrade-retrograde cardioplegia versus antegrade cardioplegia in providing adequate myocardial preservation during coronary artery bypass graft surgery
OBJECTIVES The mechanisms of postoperative cognitive dysfunction in patients with diabetes after coronary artery bypass grafting are not fully understood. We sought to determine which type 2 diabetes-related factors contributed to postoperative cognitive dysfunction at 7 days and 6 months after coronary artery bypass grafting. METHODS One hundred eighty patients with type 2 diabetes who were scheduled for elective coronary artery bypass grafting were studied. As a control group, 100 patients without diabetes mellitus matched for age, sex, and educational level were examined. Hemodynamic parameters (arterial and jugular venous blood gas values) were measured during cardiopulmonary bypass. All patients underwent a battery of neurologic and neuropsychologic tests the day before surgery, 7 days after surgery, and 6 months after surgery. RESULTS Age (odds ratio 1.5, 95% confidence interval 1.3-1.8, P = .03), presence of hypertension (odds ratio 1.8, 95% confidence interval 1.3-2.0, P = .01), jugular
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TY - JOUR. T1 - RR interval dynamics before atrial fibrillation in patients after coronary artery bypass graft surgery. AU - Hogue, Charles W.. AU - Domitrovich, Peter P.. AU - Stein, Phyllis K.. AU - Despotis, George D.. AU - Re, Lisa. AU - Schuessler, Richard B.. AU - Kleiger, Robert E.. AU - Rottman, Jeffery N.. PY - 1998/8/4. Y1 - 1998/8/4. N2 - Background-Atrial fibrillation/flutter (AF) is a frequent complication of coronary artery bypass graft surgery (CABG) that leads to increased costs and morbidity. We hypothesized that heart rate variability (HRV), an indicator of cardiac sympathovagal balance, is altered before the onset of postoperative AF. Because nonlinear methods of HRV analysis provide information about heart rate dynamics not evident from usual HRV measures, we also hypothesized that approximate entropy (ApEn), a nonlinear measure of HRV, might have predictive value. Methods and Results-Analysis of HRV was performed in 3 sequential 20-minute intervals preceding the onset of ...
Aim. During ischemia, the glycolytic pathway is up-regulated to anaerobically produce adenosine triphosphate (ATP). However, this is short-lived, due to negative feedback on phosphofructokinase from accumulating lactate. Since fructose-1,6-diphosphate (FDP) enters glycolysis distal to this inhibitory site, exogenously administered FDP may yield ATP-independent lactate accumulation and thus ameliorate ischemic injury. The aim of this prospective randomized study was to investigate whether the improved myocardial preservation by FDP could be attributed to improved intermediary metabolism in patients who underwent coronary artery bypass grafting surgery (CABG ...
Potential risk factors for early large pleural effusion after coronary artery bypass grafting surgery, Mehmet Cengiz Colak, Cemil Colak, Nevzat Erdil, Suleyman Sandal
TY - JOUR. T1 - Closed-chest coronary artery bypass grafting on the beating heart with the use of a computer-enhanced surgical robotic system. AU - Boyd, Walter D. AU - Rayman, Reiza. AU - Desai, Nimesh D.. AU - Menkis, Alan H.. AU - Dobkowski, Wojciech. AU - Ganapathy, Sugantha. AU - Kiaii, Bob. AU - Jablonsky, George. AU - McKenzie, F. Neil. AU - Novick, Richard J.. PY - 2000. Y1 - 2000. UR - http://www.scopus.com/inward/record.url?scp=0033779652&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0033779652&partnerID=8YFLogxK. M3 - Article. C2 - 11003767. AN - SCOPUS:0033779652. VL - 120. SP - 807. EP - 809. JO - Journal of Thoracic and Cardiovascular Surgery. JF - Journal of Thoracic and Cardiovascular Surgery. SN - 0022-5223. IS - 4. ER - ...
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Between 2001 and 2008, the annual rate of coronary artery bypass graft surgeries performed in the United States decreased by more than 30 percent, but rates of percutaneous coronary interventions (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries) did not change significantly, according to a study in the May 4 issue of JAMA.. Coronary revascularization, comprising coronary artery bypass graft (CABG) surgery and PCI, is among the most common major medical procedures provided by the U.S. health care system, with more than 1 million procedures performed annually, according to background information in the article. Several innovations in coronary revascularization, such as drug-eluting stents (DES) and minimally invasive CABG surgery have been adopted widely in the past decade, with the promise of improved clinical outcomes compared with older revascularization technologies and techniques. During this period of technological innovation, new ...
Main Research Question(s):. What is the effect of continuing aspirin until the time of coronary artery bypass graft surgery and of adding clopidogrel to aspirin after coronary artery bypass graft surgery for preventing blockage of coronary grafts, heart attack, stroke, and death? To reliably answer this question requires a large randomised trial. Before applying for a major grant from the Canadian Institute for Health Research to do the large study we would like to perform a small pilot study of 150 patients to demonstrate that it is feasible to recruit patients and to use a new test called CT angiography to determine whether the bypass grafts are still working or have become blocked.. (ii) Why is this research important? Coronary artery bypass surgery has made a very important contribution to improving the health and survival of patients with advanced coronary artery disease but still has many problems. One in 10 patients experiences a heart attack at the time of surgery, 1 in 20 experiences ...
Define coronary artery bypass. coronary artery bypass synonyms, coronary artery bypass pronunciation, coronary artery bypass translation, English dictionary definition of coronary artery bypass. Surgery to create an alternative route of blood flow to the heart
The generalizability of a prediction model from North America for incident nosocomial pneumonia following coronary artery bypass graft surgery was assessed for 23247 patients on the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) registry. The performance of the North American model was evaluated using measures of calibration and discrimination. The model had reasonable discrimination (area under the receiver-operating characteristic curve, AUC=0·69), but unsatisfactory calibration (Hosmer-Lemeshow test, P,0·001) in the ANZSCTS patients. An update of the model coefficients yielded a model with AUC=0·71 and good calibration (P=0·46). © 2013 Cambridge University Press.. ...
TY - JOUR. T1 - Effect of storage time of transfused plasma on early and late mortality after coronary artery bypass grafting. AU - Straten, van, A.H.M.. AU - Soliman Hamad, M.A.. AU - Martens, E.J.. AU - Tan, M.E.S.H.. AU - Wolf, de, A.M.. AU - Scharnhorst, V.. AU - Zundert, A.A.J.. PY - 2014. Y1 - 2014. N2 - OBJECTIVES: Because some concern has been raised about the storage time of red blood cells and outcomes after cardiac surgery, we investigated whether longer storage time of transfused plasma increases the risk for early or late mortality among patients who have undergone coronary artery bypass grafting. METHODS: We retrospectively analyzed the data of all 10,626 patients who underwent isolated coronary artery bypass grafting in Catharina Hospital, Eindhoven, The Netherlands, between January 1998 and December 2007. All patients who received at least 1 unit of plasma intraoperatively or during the first 5 postoperative days were studied. They were divided into 3 groups (only younger plasma, ...
TY - JOUR. T1 - Clinical and operative characteristics of patients randomized to coronary artery bypass surgery in the Bypass Angioplasty Revascularization Investigation (BARI). AU - Schaff, Hartzell V.. AU - Rosen, Allan D.. AU - Shemin, Richard J.. AU - Leclerc, Yves. AU - Wareing, Thomas H.. AU - Aguirre, Frank V.. AU - Sopko, George. AU - VanderSalm, Thomas J.. AU - Loop, Floyd D.. AU - BARI Investigators, Investigators. PY - 1995/1/1. Y1 - 1995/1/1. N2 - The surgical cohort of the Bypass Angioplasty Revascularization Investigation (BARI) is the largest group of patients with multivessel coronary artery disease randomly assigned to surgical treatment. This report presents baseline and operative characteristics of the cohort and describes some aspects of the variability in surgical practice among the 14 primary clinical centers and 4 co-investigational sites participating in BARI. Preoperative clinical and angiographic data and intraoperative variables were reviewed in 892 patients who were ...
Objective: The aim of this study was to investigate whether acute kidney injury (AKI) after coronary artery bypass grafting can be attributed to intraoperative hypotension during cardiopulmonary bypass (IOH-CPB). Design: Retrospective analysis. Setting: Tertiary-care hospital. Participants: Patients undergoing on-pump coronary artery bypass grafting from June 2011 to January 2014. Interventions: ... read more None. Measurements and Main Results: IOH-CPB was defined as blood pressure below several absolute and relative mean arterial pressure (MAP) thresholds and as the area under the curve for absolute MAP thresholds. AKI was defined as an absolute increase in serum creatinine of≥26 μmol/L within 48 hours or an increase to 150% or more within 7 days of surgery. Poisson regression with robust standard errors both before and after adjustment for confounders was used. Of the 1,891 patients included, 386 (20%) developed AKI. In univariable analysis, all IOH-CPB thresholds defined as a MAP of 50 ...
To evaluate the relative long-term improvement in coronary artery hemodynamics after revascularization by coronary artery bypass graft surgery (CABG) or percutaneous transluminal coronary angioplasty (PTCA), regional coronary flow reserve (CFR) was measured, by digital computer analysis of 35 mm cine film, in 50 men undergoing cardiac catheterization. CFR (mean +/- SEM) in 12 atherosclerotic arteries before revascularization was 1.02 +/- 0.05. Mean CFR in 29 normal arteries of men with normal coronary arteriograms was significantly higher (2.59 +/- 0.11) than that in 16 atherosclerotic arteries of patients revascularized by CABG (2.02 +/- 0.17, p less than .01) or in 14 atherosclerotic arteries of those revascularized by PTCA (1.97 +/- 0.12, p less than .01). No difference in CFR between the CABG and PTCA groups was found and variables known to influence CFR were similar between groups. Equivalent and significant long-term improvement in coronary artery hemodynamics is provided by CABG or PTCA. ...
TY - JOUR. T1 - Effects of foot massage and patient education in patients undergoing coronary artery bypass graft surgery. T2 - A randomized controlled trial. AU - Chandrababu, Ramesh. AU - Nayak, Baby S.. AU - Pai, Vasudev Baburaya. AU - N, Ravishankar. AU - George, Linu Sara. AU - Devi, Elsa Sanatombi. AU - George, Anice. PY - 2020/8. Y1 - 2020/8. N2 - Background: Anxiety, pain, and fatigue are common postoperative problems that disturb the recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. These postoperative problems are associated with prolonged recovery and decreased quality of life. This study was aimed at evaluating the combined effects of foot massage and patient education on anxiety, fatigue, pain, self-efficacy, and quality of life in patients undergoing CABG surgery. Material and methods: In this randomized controlled trial (RCT), 130 participants were randomly allocated to experimental (n = 65) and control (n = 65) groups. The ...
We read with great interest the study by Hongo et al. (1)entitled The Effect of Clopidogrel in Combination With Aspirin When Given Before Coronary Artery Bypass Grafting. This very interesting study highlights an emerging problem for patients having routine coronary artery bypass graft surgery (CABG) after percutaneous intervention, as described in their report, but also for patients with an acute coronary syndrome who require urgent in-house surgery because these patients are invariably on both clopidogrel and aspirin therapy.. In their study, the investigators showed that continued clopidogrel therapy within seven days of elective CABG results in increased blood loss, increased use of blood products, and increased re-exploration rates. Unfortunately, although the study was prospective there was no blinding of the nurses or clinicians to clopidogrel and aspirin exposure.. This lack of blinding is crucial to determine whether the main outcomes of the study are credible. The investigators ...
BACKGROUND: Uncertainty remains regarding the benefits and risks of the technique of operating on a beating heart (off pump) for coronary artery bypass grafting (CABG) surgery versus on-pump CABG. Prior trials had few events and relatively short follow-up. There is a need for a large randomized, controlled trial with long-term follow-up to inform both the short- and long-term impact of the 2 approaches to CABG. METHODS: We plan to randomize 4,700 patients in whom CABG is planned to undergo the procedure on pump or off pump. The coprimary outcomes are a composite of total mortality, myocardial infarction (MI), stroke, and renal failure at 30 days and a composite of total mortality, MI, stroke, renal failure, and repeat revascularization at 5 years. We will also undertake a cost-effectiveness analysis at 30 days and 5 years after CABG surgery. Other outcomes include neurocognitive dysfunction, recurrence of angina, cardiovascular mortality, blood transfusions, and quality of life. RESULTS: As of May 3,
There are limitations to the conclusions that can be drawn from this study. Firstly, the comparisons we have made here are not an attempt to estimate either the effectiveness of coronary artery bypass surgery, or the relative balance of benefits and risks associated with early intervention for particular patients. There is clear evidence from randomised controlled trials that an initial strategy of coronary artery bypass surgery is associated, in the long term, with reduced mortality rates in patients with significant left main-stem stenosis, three vessel disease and proximal left anterior descending artery disease.2 However, it should be remembered that, on average, coronary artery bypass surgery prolongs life by only 4.26 months.2 Secondly, the six month postoperative period analysed here accentuates mortality risk associated with the procedure itself; for people who would benefit prognostically from surgery, the total risk faced is the sum of the risk while waiting plus the postoperative ...
BACKGROUND: External stents inhibit saphenous vein graft (SVG) intimal hyperplasia in animal studies. We investigated whether external stenting inhibits SVG diffuse intimal hyperplasia 1 year after coronary artery bypass graft surgery. METHODS: Thirty patients with multivessel disease undergoing coronary artery bypass graft surgery were enrolled. In addition to an internal mammary artery graft, each patient received one external stent to a single SVG randomly allocated to either the right or left coronary territories; and one or more nonstented SVG served as the control. Graft patency was confirmed at the end of surgery in all patients. The primary endpoint was SVG intimal hyperplasia (mean area) assessed by intravascular ultrasonography at 1 year. Secondary endpoints were SVG failure, ectasia (|50% initial diameter), and overall uniformity as judged by Fitzgibbon classification. RESULTS: One-year follow-up angiography was completed in 29 patients (96.6%). All internal mammary artery grafts were patent.
BACKGROUND: External stents inhibit saphenous vein graft (SVG) intimal hyperplasia in animal studies. We investigated whether external stenting inhibits SVG diffuse intimal hyperplasia 1 year after coronary artery bypass graft surgery. METHODS: Thirty patients with multivessel disease undergoing coronary artery bypass graft surgery were enrolled. In addition to an internal mammary artery graft, each patient received one external stent to a single SVG randomly allocated to either the right or left coronary territories; and one or more nonstented SVG served as the control. Graft patency was confirmed at the end of surgery in all patients. The primary endpoint was SVG intimal hyperplasia (mean area) assessed by intravascular ultrasonography at 1 year. Secondary endpoints were SVG failure, ectasia (|50% initial diameter), and overall uniformity as judged by Fitzgibbon classification. RESULTS: One-year follow-up angiography was completed in 29 patients (96.6%). All internal mammary artery grafts were patent.
The latest report on coronary artery bypass graft surgery in Califormia details quality ratings for the 125 state-licensed hospitals and 271 surgeons that performed coronary artery bypass graft (CABG) surgery during 2013-2014. Released by Californias Office of Statewide Health Planning and Development, the report - Coronary Artery Bypass Graft (CABG) Surgery in California - publishes performance ratings based on three key risk-adjusted outcomes: operative mortality for isolated CABG, operative mortality for CABG + Valve, and post-operative stroke.. Read more:. ...
PubMed journal article: Long-term clinical outcomes after percutaneous coronary intervention versus coronary artery bypass grafting for ostial/midshaft lesions in unprotected left main coronary artery from the DELTA registry: a multicenter registry evaluating percutaneous coronary intervention versus coronary artery bypass grafting for left main treatment. Download Prime PubMed App to iPhone, iPad, or Android
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