scholarly journals Inadvertent Entrapment of a Central Venous Catheter by a Purse-String Suture during Cardiopulmonary Bypass: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Abdorasoul Anvaripour ◽  
Forouzan Yazdanian ◽  
Mohammad-Zia Totonchi ◽  
Houshang Shahryari
Keyword(s):  
Coronary Artery ◽  
Mitral Valve ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Open Heart Surgery ◽  
Venous Catheter ◽  
Mitral Valve Stenosis ◽  
Artery Disease ◽  
Vessel Coronary Artery

A 65-year-old female patient with severe mitral valve stenosis plus coronary artery disease was scheduled for mitral valve replacement and 2-vessel coronary artery bypass graft (CABG) surgeries simultaneously. After a successful procedure, resistance was met on a CVC withdrawal. During postoperative fluoroscopy, fixation of the catheter at the heart was confirmed which necessitated reopening the chest, cutting the suture, and removing the catheter. When a catheter became hard to withdraw after open heart surgery, we should never withdraw it forcefully and blindly. Although rare, one should consider inadvertent entrapment of CVC by a suture as the possible cause.

scholarly journals Early Outcome of Off-pump Coronary Artery Bypass Graft Surgery in Patients with Multivessel Coronary Artery Disease

2014 ◽  
Vol 41 (3) ◽  
pp. 8-14
Author(s):  
NU Ahmed ◽  
K Hasan ◽  
SK Raha
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Sweat Glands ◽  
Off Pump ◽  
Artery Disease ◽  
Pump Coronary Artery Bypass ◽  
Vessel Coronary Artery

As there have been appreciable bodies of evidence supporting the theoretical and practical advantages of off-pump coronary artery bypass grafting (OPCAB) over the conventional coronary artery bypass graft (CABG) to avoid the harmful effects of cardiopulmonary bypass (CPB), many cardiac surgeons are using OPCAB as an effective alternative to conventional CABG. This study performed in National Institute of Cardiovascular Diseases (NICVD) evaluated the early surgical outcomes of OPCAB in terms of mortality and major post-operative morbidities and compared them with that of conventional CABG. Total 120 patients with multi-vessel coronary artery disease were allocated into two groups: a) 60 patients who underwent OPCAB and b) another 60 patients who underwent conventional CABG between January 2009 and December 2011. The sex and mean age. A reduced level or complete cessation of sweating can be caused by a variety of factors affecting sweat glands directly or indirectly through alterations in their nerve supply. The most common presentation is the syndrome of heal intolerance with or without features of dysautonomia. An acquired idiopathic form of generalized anhidrosis is characterized by loss of sweating in the absence of any neurological features or destruction of sweat glands. ldiopalhic acquired generalized anhidrosis is a very rare condition in which the pathogenesis is still unknown. Cholinergic urticaria has been associated with some cases of this acquired idiopathic form of generalized anhidrosis.Distributions of patients were similar among two groups. Smoking, diabetes mellitus, hypertension and dyslipidemia were major risk factors. All co-morbid conditions were homogenously distributed between the two groups. Majority of the patients had triple vessel disease. Nearly three-quarter (73.3%) of patients in OPCAB group and 80% in conventional CABG group received 3 grafts (p=0.470. The mean total operative time (258±39.5 minutes versus 306±44.8 minutes; p<0.001), intubation times (7.6±0.3 versus 16.3±0.5 hours; p<0.001), blood losses (377.8±22.3 ml vs. 602.0±18.9 ml, p<0.001); requirements for blood and blood products (689.7±21.1 vs. 1199.3±34.5 ml, p < 0.0010); intensive care unit stays (31.7±0.9 hours versus 41.6±1.5 hours; p<0.001) and hospital stays (6.2±0.2 days versus 8.3±0.3 days; p<0.0010) were all significantly shorter in the OPCAB group. OPCAB is a safe and effective procedure for patients with multi-vessel coronary artery disease and is associated with reduced morbidity and mortality. However, large randomized studies with long-term follow-up may show the real benefits of OPCAB compared with CABG on CPB. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18951 Bangladesh Medical Journal 2012 Vol.41(3): 8-14

scholarly journals Trend, Predictors and Outcomes of Combined Mitral Valve Replacement and Coronary Artery Bypass Graft in Patients with Concomitant Mitral Valve and Coronary Artery Disease; A National Inpatient Sample Database Analysis

2022 ◽  
Author(s):  
Waqas Ullah ◽  
Sajjad Gul ◽  
Sameer Saleem ◽  
Mubbasher Ameer Syed ◽  
Muhammad Zia Khan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Coronary Artery Bypass Graft ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
National Inpatient Sample ◽  
Combined Procedure ◽  
Artery Disease

Abstract   Combined mitral valve replacement (MVR) and coronary artery bypass graft (CABG) procedures have been the norm for patients with concomitant mitral valve disease (MVD) and coronary artery disease (CAD) with no large-scale data on their safety and efficacy. Methods The National Inpatient Sample (NIS) database (2002-2018) was queried to identify patients undergoing MVR and CABG. The major adverse cardiovascular events (MACE) and its components were compared using a propensity score-matched (PSM) analysis to calculate adjusted odds ratios (OR). Results A crude population of 6,145,694 (CABG-only 3,971,045, MVR-only 1,933,459, MVR+CABG 241,190), while a subset of matched cohort 724,237 (CABG-only 241,436, MVR-only 241,611 vs. MVR+CABG 241,190) was included in the PSM analysis. The combined MVR+CABG procedure had significantly higher adjusted odds of MACE (OR 1.13, 95% CI 1.11-1.14 and OR 1.96, 95% CI 1.93-1.99) and in-hospital mortality (OR 1.29, 95% CI 1.27-1.31 and OR 2.1, 95% CI 2.05-2.14) compared with CABG and MVR-alone, respectively. Similarly, the risk of post-procedure bleeding, major bleeding, acute kidney injury, cardiogenic shock, sepsis, need for intra-aortic balloon pump (IABP), mean length of stay (LOS) and total charges per hospitalization were significantly higher for patients undergoing the combined procedure. These findings remained consistent on yearly trend analysis favoring the isolated CABG and MVR groups. Conclusion Combined procedure (MVR+CABG) in patients with MVD and CAD appears to be associated with worse in-hospital outcomes, increased mortality and higher resource utilization compared with isolated CABG and MVR procedures. Randomized controlled trials are needed to determine the relative safety of these procedures in the full spectrum of baseline valvular and angiographic characteristics.

scholarly journals Coronary Artery Bypass Graft Surgery in Tanzania: 5 Years of Experience at Jakaya Kikwete Cardiac Institute

2020 ◽  
Author(s):  
Mohamed Yakubu Janabi ◽  
Evarist Nyawawa ◽  
Bashir Nyangasa ◽  
William Ramadhani Ramadhan ◽  
Ramadhani Hassan Hamis ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Open Heart Surgery ◽  
World Health

Abstract Cardiac surgery is not widely available in most developing countries, and most patients have no choice but to live in morbid conditions and managed conservatively or the few who are referred abroad for surgical procedures costs the respective countries millions of hard earned foreign currency. The World Health Organization projects that over the next ten years the continent of Africa will experience the largest increase in death rates from cardiovascular disease. The Jakaya Kikwete Cardiac Institute (JKCI) is a government owned National Specialized and Teaching Hospital that serves patients from all the regions of the United Republic of Tanzania with a population of nearly 60,000,000 people and also serves beyond the borders (Rwanda, Burundi, DR Congo, South Sudan, Comoro, Malawi and Zambia) for advanced cardiovascular medical, intervention, vascular and open heart surgery, the Institute was established in 2015. Methods: Here we report all patients who underwent coronary artery bypass surgery grafting only performed at the Centre since its inauguration in 2015- till 2019. Data were collected for basic demography, diagnosis, investigations, clinical and surgical outcome parameters. Results: A total of 85 patients with heart diseases and underwent coronary artery bypass surgery grafting (CABG) are analysed in this study. There were 64 (75%) male and 21 (25%) female patients. Their age ranged from 41–85 years old with almost half 42 (49%) of the cohort being between the age between 61–70 years old. Most of the patients had two or more grafts and an internal mammary artery graft was used over 80% of the procedures. The overall 30-day mortality was 7.1%, incidence of stroke 0.2%, duration of mechanical ventilation was an average of 9.98 hours and intensive care unit (ICU) stay post CABG was an average of 6.48 days and final discharge from the centre ranged from 10–16 days.Conclusion: This study has demonstrated that coronary artery bypass surgery grafting in low/middle income country is safe and feasible. A sustainable program demands highest level of governmental support as seen in this case, and a dedicated multidisciplinary team with profound know how in cardiac pathologies. Furthermore, a need for good local data to know the prevalence of coronary disease is mandatory to determine the magnitude of coronary artery disease in each country.

scholarly journals COMPARISON OF THE EFFECT OF ANTEGRADE AND ANTEGRADE/RETROGRADE CARDIOPLEGIA ON THE OUTCOME OF CORONARY ARTERY BYPASS GRAFT SURGERY FOR SEVERE CORONARY ARTERY DISEASE

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S792-98
Author(s):  
Ali Gohar Zamir ◽  
Asif Mahmood Janjua ◽  
Musfireh Siddiqeh ◽  
Farrah Pervaiz ◽  
Noor Shah ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Protection ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Vessel Coronary Artery Disease ◽  
Group 2 ◽  
Artery Disease ◽  
Vessel Coronary Artery ◽  
Group 1

Objective: To compare the early outcome of Coronary Artery Bypass Graft surgery using a combination of antegrade and retrograde cardipoplegia with that utilizing antegrade cardioplegia alone in triple vessel coronary artery disease. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Adult Cardiac Surgery of Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, from Sep 2013 to Apr 2019. Methodology: A total of 160 patients with triple vessel coronary artery disease who underwent CABG surgery for 90% or greater stenos is in at least one major vessel in each of the three territories, namely the left anterior descending, the circumflex and the right coronary artery were investigated retrospectively. These were divided into 2 equal groups on the basis of the technique of administration of cardioplegia: in group-1 only ante grade blood cardioplegia was administered for myocardial protection and group-2 was given ante grade and retrograde cardiolplegia. Clinical outcomes like peri-operative mortality and morbidity were recorded, and serum creatine kinase MB, lactate, and mixed venous oxygen saturation levels were monitored. Two dimensional echocardiogram was performed on the 6th post-operative day and follow-up visits were planned 1 week and 4 weeksafter discharge from hospital. Results: There were 2 (2.5%) early deaths in group-1 and no peri-operative mortality in group-2. Five patients in group-1 (6.25%) and 2 (2.5%) in group-2 had non-fatal peri-operative myocardial infarction. However, significant differences included increased incidence of intra-operative ventricular dysrythmias, higher CK-MB levels at 24 hours after surgery, and increased requirement of intra-aortic balloon pump and inotropic support in Group-1. Conclusion: We conclude from this study that the combined delivery of ante grade and retrograde cardioplegia during CABG surgery for triple vessel coronary artery disease provides better myocardial protection and hence better outcome than antegrade cardioplegia alone.Keywords: , , ,

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