scholarly journals Sources of Variation in Hospital-Level Infection Rates After Coronary Artery Bypass Grafting: An Analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database

2015 ◽  
Vol 100 (5) ◽  
pp. 1570-1576 ◽  
Author(s):  
Donald S. Likosky ◽  
Amelia S. Wallace ◽  
Richard L. Prager ◽  
Jeffrey P. Jacobs ◽  
Min Zhang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Infection Rates ◽  
Hospital Level ◽  
Artery Bypass Grafting ◽  
Sources Of Variation

On-Pump Beating Heart Surgery Offers an Alternative for Unstable Patients Undergoing Coronary Artery Bypass Grafting

2005 ◽  
Vol 7 (2) ◽  
pp. 88 ◽  
Author(s):  
James R. Edgerton ◽  
Morley A. Herbert ◽  
Katherine K. Jones ◽  
Syma L. Prince ◽  
Tea Acuff ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Beating Heart ◽  
Bypass Grafting ◽  
Beating Heart Surgery ◽  
Artery Bypass Grafting

Precision Incision Robotic Coronary Revascularization via 3.9-cm Minithoracotomy

2012 ◽  
Vol 7 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Francis P Sutter ◽  
Tami Berry ◽  
MaryAnn C Wertan
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Heart Surgery ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Complication Rates ◽  
Bypass Grafting ◽  
Robotic Assisted ◽  
Artery Bypass Grafting

Coronary artery bypass grafting remains the treatment choice for coronary artery disease; but sternotomy, the most commonly used approach, compromises its benefits with postoperative morbidity, higher complication rates, and prolonged length of hospital stay. Despite this, minimally invasive and robotic-assisted technology has not been adopted or widely embraced because supporting literature on robotic-assisted coronary artery bypass grafting is extremely limited. Since 2005, the cardiothoracic surgical team at our institution has been developing and maturing an effective method using robotic harvesting of the left internal mammary artery (LIMA) and beating heart surgery through a minithoracotomy for coronary revascularization. This surgical technique involves precisely placing the robotic endoscopic port immediately over the left anterior descending (LAD) artery target site. The robotically harvested LIMA is secured to the epicardium at the LAD target, the robotic instruments are removed, and the endoscopic port site is enlarged slightly greater than 1 cm to become the minithoracotomy and allow for LIMA-to-LAD anastomosis. The other two robotic ports are used to complete the procedure without a need for additional incisions. This standardized method has been used in more than 750 patients, and since 2009, the last 377 consecutive non-rib-spreading minithoracotomy incisions measured a median of 3.9 cm (mean [SD], 4.16 [1.2748] cm; range, 2.3–12.0 cm). This “How I Do It” article describes our methods in detail and associated robotic nuances.

scholarly journals Pericardiectomy and Coronary Artery Bypass Grafting for Constrictive Pericarditis After Heart Surgery

1996 ◽  
Vol 60 (3) ◽  
pp. 177-180 ◽  
Author(s):  
Takaki Sugimoto ◽  
Kyoichi Ogawa ◽  
Tatsuro Asada ◽  
Nobuhiko Mukohara ◽  
Tetsuya Higami ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Constrictive Pericarditis ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

The New Era of Cardiac Surgery Hybrid Therapy for Cardiovascular Disease

2010 ◽  
Vol 5 (6) ◽  
pp. 388-393 ◽  
Author(s):  
Natalia V. Solenkova ◽  
Ramanan Umakanthan ◽  
Marzia Leacche ◽  
David X. Zhao ◽  
John G. Byrne
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Bypass Grafting ◽  
Hybrid Strategy ◽  
Artery Bypass Grafting

Surgical therapy for cardiovascular disease carries excellent long-term outcomes but it is relatively invasive. With the development of new devices and techniques, modern cardiovascular surgery is trending toward less invasive approaches, especially for patients at high risk for traditional open heart surgery. A hybrid strategy combines traditional surgical treatments performed in the operating room with treatments traditionally available only in the catheterization laboratory with the goal of offering patients the best available therapy for any set of cardiovascular diseases. Examples of hybrid procedures include hybrid coronary artery bypass grafting, hybrid valve surgery and percutaneous coronary intervention, hybrid endocardial and epicardial atrial fibrillation procedures, and hybrid coronary artery bypass grafting/carotid artery stenting. This multi-disciplinary approach requires strong collaboration between cardiac surgeons, vascular surgeons, and interventional cardiologists to obtain optimal patient outcomes.

scholarly journals Trends of Coronary Artery Bypass Grafting Performance in a Cohort of Hospitals in China Between 2013 and 2018

2021 ◽  
Author(s):  
Xi Li ◽  
Dachuan Gu ◽  
Xianqiang Wang ◽  
Xiaolin Diao ◽  
Sipeng Chen ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Arterial Graft ◽  
Bypass Grafting ◽  
Hospital Level ◽  
Artery Bypass Grafting

Background: China has witnessed a rapid increase in the volume of coronary artery bypass grafting (CABG) but substantial gaps in the performance for CABG across the nation. The present study aimed to investigate the change in CABG performance after years of quality improvement measures in a national registry in China. Methods: The study included 66 971 patients who underwent isolated CABG in a cohort of 74 tertiary hospitals in China between January 2013 and December 2018. Data were collected from the Chinese Cardiac Surgery Registry. Outcomes were in-hospital mortality and postoperative length of stay. Five process measures for surgical technique and secondary prevention were also analyzed. We described the changes in the overall performance and interhospital heterogeneity across the years. Results: The in-hospital mortality declined from 0.9% in 2013 to 0.6 in 2018, with a risk-adjusted odds ratio of 0.66 (95% CI, 0.46–0.93; P <0.001). The standard mean difference for risk-standardized mortality rate between hospitals in the lowest and highest quartile narrowed from 1.63 in 2013 to 1.35 in 2018. The median (interquartile range) hospital-level rate of using arterial graft increased from 93.9% (86.0%–97.8%) to 94.6% (83.3%–99.2%), but the difference was not statistically significant. Meanwhile, the rate of free from blood transfusion increased from 17.0% (2.6%–32.0%) to 34.1% (8.8%–52.9%). The hospital-level rate of prescribing β-blockers at discharge significantly increased from 82.8% (66.7%–90.3%) to 91.1% (82.1%–97.1%), statin from 75.8% (55.7%–88.9%) to 88.9% (75.0%–96.0%), and aspirin from 90.3% (83.9%–95.2%) to 95.3% (88.9%–98.1%). Conclusions: In the Chinese Cardiac Surgery Registry, there were notable improvements in the treatment process related to CABG and decline of in-hospital mortality with reduced interhospital heterogeneity.

Off-pump cardiac surgery abolishes complement activation

Perfusion ◽  
2007 ◽  
Vol 22 (4) ◽  
pp. 251-256 ◽  
Author(s):  
Tom N. Hoel ◽  
Vibeke Videm ◽  
Tom E. Mollnes ◽  
Kjell Saatvedt ◽  
Frank Brosstad ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Complement Activation ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Randomized Study ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump

Background. This prospective randomized study compared the inflammatory response in patients undergoing elective on-pump and off-pump coronary artery bypass grafting. Patients and methods. Forty-four patients undergoing elective coronary artery bypass grafting were recruited with 22 patients randomized to on-pump heart surgery and 22 patients to off-pump coronary bypass surgery. Plasma levels of C3bc, the terminal SC5b-9 complement complex, myeloperoxidase, β -thromboglobulin and prothrombin fragment F1 + 2 were measured before the operation, intraoperatively, at termination of the operation, and two hours post-operatively. Results. Complement was markedly activated in the on-pump group as indicated by a significant increase in C3bc and SC5b-9 (p < 0.001 for both), whereas no complement activation was seen in the off-pump group (p = 0.001 between the groups). In contrast, both groups showed significant activation of neutrophils, platelets and coagulation, as indicated by an early increase in myeloperoxidase and a post-operative increase in β-thromboglobulin and F1 + 2, respectively. Notably, there were no inter-group differences with regard to neutrophil and platelet activation, whereas coagulation activation was more pronounced in the off-pump group (p < 0.01). Conclusions. Off-pump surgery completely eliminated the heart-lung machine-induced complement activation. Neutrophils and platelets were equally activated in both groups, whereas coagulation was enhanced post-operatively in the off-pump group. Perfusion (2007) 22, 251—256.

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