Predictors of intra-aortic balloon pump insertion in different spectrum of patients undergoing elective coronary artery bypass grafting

2017 ◽  
Vol 33 (4) ◽  
pp. 296-302
Author(s):  
Manoj Kumar Sahu ◽  
Anupam Das ◽  
Milind Padmakar Hote ◽  
Palleti Rajashekar ◽  
Vishnubhatla Sreenivas ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Elective Coronary Artery Bypass ◽  
Intra Aortic Balloon Pump ◽  
Spectrum Of Patients

Nicorandil Infusion during Off-Pump Coronary Artery Bypass Grafting Reduces Incidence of Intra-aortic Balloon Pump Insertion

2016 ◽  
Vol 11 (2) ◽  
pp. 123-127 ◽  
Author(s):  
Kamales Kumar Saha ◽  
Ajay Kumar ◽  
Mandar Manohar Deval ◽  
Kakalee K. Saha ◽  
Rinu V. Jacob ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Intra Aortic Balloon Pump ◽  
Pump Coronary Artery Bypass

Objective Off-pump coronary artery bypass grafting in patients with left ventricular dysfunction has proven to be advantageous. However, it carries risk of emergency conversion to cardiopulmonary bypass. We have successfully used an intra-aortic balloon pump to prevent such conversion. The objective of the present study was to evaluate if intravenous nicorandil infusion reduces the incidence of intraoperative intra-aortic balloon pump insertion. Methods Consecutive cases of isolated off-pump coronary artery bypass surgery performed by a single surgeon were studied. Patients were divided into two groups. The first group did not receive nicorandil, and the second group received intraoperative nicorandil infusion (started in the operating room after central line insertion). Results A total of 375 patients were included in the study. Four patients in the non-nicorandil group and the patients in nicorandil group were on preoperative intra-aortic balloon pump and hence excluded from the study. After routine use of nicorandil infusion, incidence of intra-aortic balloon pump insertion during off-pump coronary artery bypass surgery decreased from 12.4% (21/169) to 2.9% (6/206). Conclusions Nicorandil infusion significantly (P = 0.007) reduced the incidence of intra-aortic balloon pump insertion in our series. In patients with left ventricular dysfunction (ejection fraction ≤ 30%), this difference (P = 0.008) assumes a special significance as off-pump bypass surgery is considered high risk in this subset. Nicorandil is an inexpensive drug, and the reduction in cost of surgery by avoiding intra-aortic balloon pump insertion is an added advantage. The use of nicorandil infusion during off-pump coronary artery bypass may result in favorable patient outcomes by reducing invasive intra-aortic balloon pump insertion during off-pump coronary artery bypass grafting.

scholarly journals An incidental finding of thymic carcinoma during elective coronary artery bypass grafting

2016 ◽  
Vol 69 (5-6) ◽  
pp. 167-169
Author(s):  
Zivojin Jonjev ◽  
Milorad Pavlovic ◽  
Bojan Ilic ◽  
Golub Samardzija
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Squamous Cell ◽  
Thymic Carcinoma ◽  
Incidental Finding ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Elective Coronary Artery Bypass

Introduction. Thymoma is a rare malignant tumor of the anterior mediastinum. Thymic squamous cell carcinoma has been recognized as an aggressive form of thymoma with different behavior. It is associated with paraneoplastic syndromes, variety of clinical presentations, different way of treatment and complex prognosis. Improved imaging techniques show that an early diagnosis of thymoma is possible, which makes thymoma a potentially dangerous but preventable disease. Case Report. In this report, we describe the clinical and histological findings of a patient with incidental finding of squamous cell thymic carcinoma presented during elective coronary artery bypass grafting surgery.

Preoperative intra-aortic balloon pump inserted in acute myocardial infarction patients without cardiogenic shock undergoing surgical coronary revascularization

Perfusion ◽  
2019 ◽  
Vol 35 (2) ◽  
pp. 145-153
Author(s):  
Feng Yang ◽  
Liangshan Wang ◽  
Dengbang Hou ◽  
Jinhong Wang ◽  
Xiaomeng Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Intra Aortic Balloon Pump ◽  
Pump Coronary Artery Bypass

Objectives: The benefit of preoperative intra-aortic balloon pump implantation in high-risk cardiac surgery patients is still debated. The role of preoperative intra-aortic balloon pump insertion in acute myocardial infarction patients without cardiogenic shock undergoing off-pump coronary artery bypass grafting remains unknown. This study aimed to determine the efficacy and safety of the preoperative intra-aortic balloon pump insertion in those patients undergoing off-pump coronary artery bypass grafting. Methods: A total of 421 consecutive acute myocardial infarction patients without cardiogenic shock who underwent isolated off-pump coronary artery bypass grafting were enrolled in this retrospective observational propensity score–matched analysis study. Patients who received intra-aortic balloon pump before off-pump coronary artery bypass grafting (the intra-aortic balloon pump group, n = 157) were compared with those who had not (control group, n = 264). The 30-day postoperative survival, postoperative complications, and postoperative hospital length of stay were compared between the two groups. Results: A total of 99 pairs of patients were matched. The preoperative intra-aortic balloon pump did not show a 30-day postoperative survival benefit compared with the control group (hazard ratio, 0.9; 95% confidence interval, 0.2-4.2; p = 0.92). Patients with preoperative intra-aortic balloon pump were more likely to have shorter postoperative lengths of stay (8 (6-11) days vs. 10 (6-15) days, p = 0.02) and decreased total days in the hospital (median days: 18.2 vs. 21.8, p = 0.02) compared to patients without balloon pumps. Conclusion: Preoperative intra-aortic balloon pump insertion in acute myocardial infarction patients without cardiogenic shock undergoing off-pump coronary artery bypass grafting improved convalescence as shown by significantly shorter postoperative lengths of hospital stay.

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