Mediastinitis after coronary artery bypass graft surgery: influence of the mammary grafting for diabetic patients

2003 ◽  
Vol 55 (1) ◽  
pp. 21-25 ◽  
Author(s):  
M Tavolacci
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Diabetic Patients ◽  
Artery Bypass Graft

Obesity in Diabetic Patients Undergoing Coronary Artery Bypass Graft Surgery Is Associated with Increased Postoperative Morbidity

2006 ◽  
Vol 104 (3) ◽  
pp. 441-447 ◽  
Author(s):  
Wei Pan ◽  
Katja Hindler ◽  
Vei-Vei Lee ◽  
William K. Vaughn ◽  
Charles D. Collard
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Postoperative Outcomes ◽  
Diabetic Patients ◽  
Artery Bypass Graft ◽  
Increased Risk

Background Despite the fact that obesity is a known risk factor for cardiovascular disease, many studies have failed to demonstrate that obesity is independently associated with an increased risk of cardiovascular morbidity and mortality in nondiabetic patients undergoing coronary artery bypass graft surgery. The authors investigated the influence of obesity on adverse postoperative outcomes in diabetic and nondiabetic patients after primary coronary artery bypass surgery. Methods A retrospective cohort study of patients undergoing primary coronary artery bypass surgery (n = 9,862) between January 1995 and December 2004 at the Texas Heart Institute was performed. Diabetic (n = 3,374) and nondiabetic patients (n = 6,488) were classified into five groups, according to their body mass index: normal weight (n = 2,148), overweight (n = 4,257), mild obesity (n = 2,298), moderate obesity (n = 785), or morbid obesity (n = 338). Multivariate, stepwise logistic regression was performed controlling for patient demographics, medical history, and preoperative medications to determine whether obesity was independently associated with an increased risk of adverse postoperative outcomes. Results Obesity in nondiabetic patients was not independently associated with an increased risk of adverse postoperative outcomes. In contrast, obesity in diabetic patients was independently associated with a significantly increased risk of postoperative respiratory failure (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.41-3.61; P < 0.001), ventricular tachycardia (OR, 2.27; 95% CI, 1.18-4.35; P < 0.02), atrial fibrillation (OR, 1.56; 95% CI, 1.03-2.38; P < 0.04), atrial flutter (OR, 2.38; 95% CI, 1.29-4.40; P < 0.01), renal insufficiency (OR, 1.66; 95% CI, 1.10-3.41; P < 0.03), and leg wound infection (OR, 5.34; 95% CI, 2.27-12.54; P < 0.001). Obesity in diabetic patients was not independently associated with an increased risk of mortality, stroke, myocardial infarction, sepsis, or sternal wound infection. Conclusion Obesity in diabetic patients is an independent predictor of worsened postoperative outcomes after primary coronary artery bypass graft surgery.

scholarly journals Multivessel Coronary Artery Disease in Diabetes Mellitus Patients

2019 ◽  
Vol 4 (2) ◽  
pp. 121-127
Author(s):  
Amanj Kamal Mohammed
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Diabetic Patients ◽  
Artery Bypass Graft ◽  
Artery Disease

Coronary artery disease is the most common cardiac disease with a worldwide distribution, and it is responsible for most of the mortalities regarding cardiovascular diseases if not detected early and treated properly. There are many lines in the treatment of coronary artery disease, starting from medical therapy, percutaneous coronary intervention, and coronary artery bypass graft surgery, preference of the choice of the type of the treatment depends on many factors. In fact when coronary artery bypass graft is indicated, although it carries a considerable risk of surgery, but the long-term survival is notably better than the other ways of treatment. This study was done to determine that the prevalence of multivessel coronary artery disease is more in diabetic patients than non-diabetic patients. And more in females than males. In this study hundred, ninety patients were retrospectively studied, all of them underwent coronary artery bypass graft surgery with or without other concomitant cardiac procedures (like valve surgery), but most of them were coronary artery bypass graft alone. We found that the number of coronary arteries affected is strongly related to the presence of diabetes mellitus. And females are more prone to have coronary artery disease than males. Thus diabetes mellitus is the most common risk factor for the development of cardiovascular disease, and the severity of the condition is confirmed by the number of the coronary arteries involved as well as the calcification or multiple stenosis in the same vessel.

Outcomes following coronary artery bypass surgery in diabetic treatment sub-groups. A propensity matched analysis of >7000 patients over 18 years

2021 ◽  
pp. 021849232199955
Author(s):  
Yama Haqzad ◽  
James Hobkirk ◽  
Priyadharshanan Ariyaratnam ◽  
Mubarak Chaudhry ◽  
Sean Carroll ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Diabetic Patients ◽  
Artery Bypass Graft ◽  
Diabetic Treatment ◽  
Sternal Wound Infections ◽  
Diabetes Patients

Background European System for Cardiac Operative Risk Evaluation II incorporates insulin-controlled diabetes whilst omitting tablet-controlled diabetes. Differences in adverse clinical outcomes following coronary artery bypass graft between these groups are poorly established. Therefore, a propensity matched comparison of short and longer term mortality and morbidity in insulin-controlled diabetes, tablet-controlled diabetes and non-diabetic patients was undertaken. Methods Isolated first-time coronary artery bypass graft surgeries between April 1999 and April 2017 were propensity score matched by pre- and intra-operative variables. Results 8241 patients; 23.5% diabetics and 76.5% non-diabetics. The groups’ demographical and clinical characteristics were comparable after matching. Insulin-controlled diabetes patients had significantly higher in-hospital mortality (3.8% vs. 1.7%, p < 0.05), multisystem failure (2.6% vs. 1.8%, p < 0.05), sternal wound infections requiring debridement (3.6% vs. 1.3%, p < 0.05), respiratory complications (25.6% vs. 21.9%, p < 0.05), new dialysis (4.7% vs. 0.9%, p < 0.05) and longer hospital stays (13.5 ± 13.3 vs. 10.6 ± 8.0, p < 0.05) compared to non-diabetic patients. Tablet-controlled diabetes patients had significantly higher strokes (2.9% vs. 1.2, p < 0.05), superficial sternal wound infections (6.7% vs. 5.4%, p < 0.05), respiratory complications (25.7% vs. 22.7%, p < 0.05), new dialysis (1.7% vs. 0.6%, p < 0.05), post-operative atrial fibrillation (37.1% vs. 33.9%, p < 0.05) and readmission with myocardial infarction (22.4% vs. 19.6%, p < 0.05) compared to non-diabetic patients. Conclusion Diabetic treatment sub-groups are an independent risk factor for sternal wound infection, new dialysis requirement, multisystem failure and readmission with myocardial infarction after isolated first coronary artery bypass graft surgery. The findings suggest the need for better risk stratification of diabetic groups prior to cardiac surgery and for improved cardiovascular risk management post-surgery in tablet-controlled diabetes patients.

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