scholarly journals Cardioplegia in contemporary coronary artery bypass grafting: Effects on high-sensitivity troponins and outcomes

2014 ◽  
Vol 23 ◽  
pp. e43-e44
Author(s):  
T. Wang ◽  
A. Li ◽  
T. Wilcox ◽  
H. White ◽  
T. Ramanathan
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
High Sensitivity ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Early Prognostic Value of High-Sensitivity Troponin T after Coronary Artery Bypass Grafting

2018 ◽  
Vol 67 (06) ◽  
pp. 467-474 ◽  
Author(s):  
Mauricio Nassau Machado ◽  
Fernando Bruetto Rodrigues ◽  
Ingrid Hellen Grigolo ◽  
Amália Tieco Rocha Sabbag ◽  
Osvaldo Lourenço Silva ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Myocardial Injury ◽  
Troponin T ◽  
Artery Bypass ◽  
High Sensitivity ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
High Sensitivity Troponin T

Abstract Background Periprocedural myocardial injury after coronary artery bypass grafting (CABG) may affect the patient's prognosis and may be due to a different set of factors beyond the atherosclerotic plaque instability. Considering the challenges in the diagnosis of myocardial injury after CABG, the aim of this study was to determine the association between postoperative early elevation of high-sensitivity troponin T (hsTnT) and all-cause 30-day mortality after CABG. Methods We enrolled 600 consecutive patients who underwent CABG. The hsTnT value was measured immediately before surgery and in the morning of the first postoperative day. Results The baseline hsTnT was 13 ng/L (7–26 ng/L) and 273 patients (45.7%) had baseline hsTnT above the 99th percentile/upper reference limit (URL) (14 ng/L). The median for hsTnT at first postoperative day was 235 ng/L (152–425 ng/L). We calculated the postoperative hsTnT ratio to URL for each patient, representing the number of times exceeding the URL (hsTnT value divided by 14 ng/L). The multivariate analysis by Cox proportional hazard model revealed that age (years) (hazard ratio [HR] = 1.13, 95% confidence interval [CI]: 1.07–1.20; p < 0.001) and postoperative hsTnT ratio to URL (per 10-fold increase) (HR = 1.06, 95% CI: 1.04–1.08; p < 0.001) were independent predictors of all-cause 30-day mortality after CABG. Conclusion In our series, age and higher postoperative hsTnT levels were independent and reliable predictors of all-cause 30-day mortality after CABG.

scholarly journals The Role of Tomographic Ultrasonography in Conduit Mapping before Coronary Artery Bypass Grafting

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Syed Mohammad Asim Hussain
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
High Sensitivity ◽  
P Value ◽  
Bypass Grafting ◽  
Index Test ◽  
Artery Bypass Grafting ◽  
Vein Segment

Objective. To assess the performance of tomographic ultrasonography (TUS) in providing images that will enable optimum choice of vein segment to harvest for coronary artery bypass grafting (CABG). Methods. This was a prospective study of diagnostic accuracy. The index test was tomographic ultrasonography. The reference standard was intraoperative observation. The study was performed at the Vascular Imaging and Cardiothoracic Department at Wythenshawe Hospital, Manchester. Patients undergoing CABG who require vein mapping were included in the study. The main outcome measures were the number of tributaries identified in harvested vein segments, presence of varicosities, and usable length of vein. Results. The TUS correctly identified 89 out of 111 vein tributaries in 10 patients resulting in a sensitivity of 80.2%. This resulted in a p value of 0.000001 using an exact binomial test, with a prior probability of 0.5. TUS had a sensitivity of 66.7% and a specificity of 100% in the identification of varicosities over 14 patients. TUS had 90% agreement with intraoperative observation in assessing usable length of vein over 14 patients. Conclusions. Our results show that TUS has a high sensitivity in identifying vein tributaries. This can be used to select veins with fewer tributaries for harvesting should TUS be used for preoperative vein mapping before CABG.

Sign in / Sign up

Export Citation Format

Share Document