Pediatric Coronary Artery Bypass Surgery for Congenital Heart Disease

Abstract Background Despite increasing survival, cardiovascular disease remains the primary cause of death worldwide with an estimated 7.4 million annual deaths. The main symptom of ischaemic heart disease is chest pain (angina pectoris) most often caused by blockage of a coronary artery. The aim of coronary artery bypass surgery is revascularisation achieved by surgically grafting harvested arteries or veins distal to the coronary lesion restoring blood flow to the heart muscle. Older evidence suggested a clear survival benefit of coronary artery bypass graft surgery, but more recent trials yield less clear evidence. We want to assess the benefits and harms of coronary artery bypass surgery combined with different medical therapies versus medical therapy alone in patients with ischaemic heart disease. Methods This protocol for a systematic review follows the recommendations of Cochrane and the eight-step assessment procedure suggested by Jakobsen and colleagues. We plan to include all randomised clinical trials assessing coronary artery bypass surgery combined with different medical therapies versus medical therapy alone in patients with ischaemic heart disease. We plan to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded on Web of Science, and BIOSIS to identify relevant trials. Any eligible trial will be assessed as high risk or low risk of bias, and our conclusions will primarily be based on trials at low risk of bias. The analyses of the extracted data will be performed using Review Manager 5, STATA 16 and trial sequential analysis. For both our primary and secondary outcomes, we will create a ‘Summary of Findings’ table and use GRADE to assess the certainty of the evidence. Discussion Coronary artery bypass surgery is invasive and can cause death, which is why its use must be thoroughly studied to determine if it yields a large enough long-term benefit for the thousands of patients receiving it every year. Systematic review registration PROSPERO ID 131924

Download Full-text

Prevalence and structure of periodontal disease in patients with coronary heart disease preparing for coronary artery bypass surgery

Kazan medical journal ◽

10.17750/kmj2015-170 ◽

2015 ◽

Vol 96 (2) ◽

pp. 170-174 ◽

Cited By ~ 2

Author(s):

S L Blashkova ◽

A S Galyavich ◽

E M Vasilevskaya

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Periodontal Disease ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

World Health

Aim. To study the prevalence and structure of periodontal disease in in-patients with coronary heart disease preparing for coronary artery bypass surgery.Methods. The study included 144 male in-patients with coronary heart disease who were prepared for coronary artery bypass surgery in the department of cardiac surgery. The diagnosis of periodontal disease was set according to the World Health Organization recommendations based on the comprehensive dental examination. Exclusion criteria were: diabetes mellitus, survived blood transfusions and all teeth missing. A prognostic model based on binary logistic regression method was created for estimation of risk factors on periodontal disease risk.Results.The prevalence of chronic generalized periodontitis in patients with coronary heart disease preparing for coronary artery bypass surgery reaches 73.6%. Mild (51.9%) and moderately severe (48.1%) chronic generalized periodontitis were the most common. Among the risk factors for periodontal disease patients, we have identified older age, smoking, hypertension and survived acute ischemic episodes. For the created model, χ2 value was assessed as 42.7, meaning statistical significance of pConclusion. In in-patients with coronary heart disease, prophylaxis for periodontal disease should be performed to decrease the risk for exacerbations. Using the created prognostic tool in clinical practice may be used for outlining patients with higher risk for periodontal disease.

Download Full-text