Effects of Intravenous Triiodothyronine during Coronary Artery Bypass Surgery

2002 ◽  
Vol 10 (3) ◽  
pp. 219-222 ◽  
Author(s):  
Mustafa Güden ◽  
Belhhan Akpinar ◽  
Ertan Sagğbaş ◽  
İlhan Sanisoğlu ◽  
Emine Cakali ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Double Blind Study ◽  
Group A ◽  
Group B

A prospective randomized and double-blind study was performed to evaluate whether perioperative triiodothyronine administration has any effect on cardiovascular performance after coronary artery bypass surgery. Sixty patients were assigned to 2 groups of 30 each. When crossclamping ended, group A received an intravenous bolus of triiodothyronine, followed by infusion for 6 hours. Group B received a placebo. Serum triiodothyronine levels and hemo-dynamic parameters were serially measured. Mean postoperative cardiac index was slightly, but not significantly, higher in group A, whereas systemic vascular resistance was significantly lower in group A. Compared with preoperative values, serum triiodothyronine levels dropped significantly in group B at the end of cardiopulmonary bypass and remained low 12 hours postoperatively, while levels rose significantly in group A. No significant differences were detected between the groups in the incidence of arrhythmia, the need for inotropic support, intensive care unit stay, mortality, and morbidity. Perioperative administration of triiodothyronine increased cardiac output slightly and decreased systemic vascular resistance, but it had no effect on operative outcome. Routine use after coronary surgery is thus not recommended.

Conventional haemofiltration during routine coronary bypass surgery

Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Ronald M Babka ◽  
James Petress ◽  
Richard Briggs ◽  
Robert Helsel ◽  
John Mack
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Postoperative Blood Loss ◽  
Group A ◽  
The Mean ◽  
Group B

The use of conventional ultrafiltration during cardiopulmonary bypass (CPB) has been well recognized as an efficient modality of therapy to reverse the effects of deliberate haemodilution. Routine use of the haemofilter was prospectively studied on 60 patients undergoing coronary artery bypass surgery. Group A consisted of 30 patients on whom the ultrafiltrator was used and compared to group B who did not receive the ultrafiltration technique. The COBE 1200 ultrafiltration device was used. The results of the study demonstrated that, in group A, the mean total amount of ultrafiltrate collected during bypass was 2510 ± 804 ml per patient. The mean 24-h postoperative blood loss was 440 ± 192 ml in group A and 451 ± 136 ml in group B. The average bank blood transfused was 0.6 ± 1.3 units per patient in group A and 0.75 ± 1.5 units per patient in group B. Postoperative weight gain in group A averaged 3.5 ± 3.45 lb per patient, compared to 4.8 ± 3.7 lb per patient in group B. Postoperative length of stay averaged 6.4 ± 1.5 days per patient in group A and 6.4 ± 2.1 days per patient in group B. Overall patient charges averaged $33 706 ± 8348 per patient in group A and $33 041 ± 7674 per patient in group B. It was concluded that routine use of ultrafiltration during routine coronary artery bypass surgery with CPB offers no improvement in the quality of care nor does it decrease the patient’s overall charges.

Effects of cardiopulmonary bypass on systemic vascular resistance

Perfusion ◽  
1996 ◽  
Vol 11 (4) ◽  
pp. 346-350 ◽  
Author(s):  
Pca Kam ◽  
L. Hines ◽  
E. O'Connor
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Haemodynamic Changes ◽  
Neuroendocrine Responses

During cardiopulmonary bypass (CPB), complex neuroendocrine responses occur and result in haemodynamic changes. Systemic vascular resistance (SVR) before, during, and after CPB was documented in patients undergoing coronary artery bypass surgery. Whilst the overall effect was an increased SVR, transient profound decreases in SVR at the commencement of CPB, during the rewarming phase, and immediately on weaning off CPB were demonstrated.

scholarly journals Evaluation of Neurocognitive Dysfunction after Coronary Artery Bypass Surgery

2018 ◽  
Vol 10 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Tawfiq Ahmed ◽  
Md Rezaul Karim ◽  
Jahangir Haider Khan ◽  
Shahriar Moinuddin
Keyword(s):  
Coronary Artery ◽  
Postoperative Period ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Neurocognitive Dysfunction ◽  
Off Pump ◽  
Group A ◽  
Pump Cabg ◽  
Group B

Objective: The Neurological injury is an important complication after coronary artery bypass surgery (CABG). The incidence of neurocognitive impairment after cardiac surgery varies from 20% to 80%. In this study we tried to analyze this difference of neurologic dysfunction between On-pump CABG and Off-pump CABG (OPCAB).Methods:This is a case control study done in National Institute of Cardiovascular Disease (NICVD), Dhaka during the period of July 2012 to June 2014. Sixty Patients with Ischemic heart disease were the study population. Group- A includes 30 patients underwent on pump CABG, Group-B 30 patients underwent OPCAB. All the patients of both the groups were followed up to 2 month’s postoperatively to find out any neurological and neurocognitive dysfunctionby observing motor function, sensory function,Mini Mantel state (MMS) Examination, orientation, memory, attention and calculation, recall and language test.Results: Neurocognitive dysfunction in the early postoperative period is significantly different among the groups.Neurocognitive dysfunction was more in Group A in comparison to Group B, On 3rd and 8th POD the MINI Mental Scores were found to be significantly lower in On-pump group than those in Off-pump group (22.0 ± 5.28 vs. 25.67 ± 3.34, p = 0.002 and 25.93 ± 3.11 vs. 26.63 ± 2.50, p = 0.023 respectively).This neurocognitive dysfunction gradually improved by the end of two month postoperative period. Only 6.66% patient in Group-A was found neurocognitically dysfunctional and was referred to neurophysician for further treatment. In case of OPCAB Group, no patient suffered fromneuorocognitive dysfunction.Conclusion: This study has convincingly shown cardio-pulmonary bypass (CPB) has had detrimental effect on neurocognitive function in patients who underwent CABG.Cardiovasc. j. 2018; 10(2): 186-193

Post Operative Complications Associated with Preoperative use of Clopidogrel in Patients Undergoning Coronary Artery Bypass Surgery

2021 ◽  
Vol 15 (10) ◽  
pp. 3154-3156
Author(s):  
Muhammad Shahid ◽  
Mujahid Ul Islam ◽  
Imtiaz Ahmad ◽  
Bahauddin Khan ◽  
Faizan Ahmad Ali ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Treatment Method ◽  
Significant Difference ◽  
Tube Output ◽  
Group A ◽  
Chest Tube Output ◽  
Group B

Background: Majority of the patients presenting for coronary artery bypass surgery are preoperatively on clopidogrel and aspirin i.e., Dual antiplatelets therapy (DAPT) because of high incidence of left main stem disease, acute coronary syndrome and diffuse coronary artery disease. Preceding coronary stenting and coming from far flung areas even from other countries with poor socioeconomic status contributes to continuation of DAPT till surgery. The main objective of the study was to evaluate hospital complications like chest tube output, re-explorations, blood, and blood product administration and in-hospital mortality in patients who continued DAPT till 48 hours prior to surgery versus those who continued DAPT until 48 to 120 hours before surgery. Methods: Preoperative history, perioperative and postoperative data of patients was gathered retrospectively from 1st July to 31st December 2019 in a tertiary care hospital of Peshawar. Total patients undergoing CABG Surgery were 223. From those 223 patients 192 patients were on DAPT. We than divided the 192 patients into two groups, Group A and Group B. 102 patients (Group A) received clopidogrel plus aspirin until 48 hours before surgery, and 89 patients (Group B) continued clopidogrel 48 to 120 hours prior to surgery. Chest tube output, need for exploration, in-hospital mortality, and blood or products transfusions among both groups were compared. Results: In terms of bleeding complications no significant difference between the both groups with similar chest drainage in the first 24 hours (602 ml and 609ml). In group A 33 patients received blood transfusion compared to 25 patients from group B. There was no significant difference in the amount of platelets given to group A (0.63 L) and to group B was (0.60 L). On the other hand, Group, A received 1.08 L fresh frozen plasma (FFPs) transfusion and group B 1.10 L respectively. Re-exploration was observed in Group A and B as (3 vs 2). Mortality was observed in 7 patients from group A and 2 from Group B. Conclusions: Usage of Dual antiplatelets therapy (DAPT) before surgery was an effective treatment method for postoperative complication of bleeding. It was suggested that with proper management with DAPT before surgery was planned is an effective and safe treatment method.. Keywords: Cardiopulmonary surgery, Coronary bypass grafting, hemoglobin, platelets, bleeding.

scholarly journals Influence of Hypertension on Early outcome after Coronary Artery Bypass Surgery

2012 ◽  
Vol 7 (1) ◽  
pp. 13-15
Author(s):  
Md Aslam Hossain ◽  
Rezwanul Hoque ◽  
Md Saifullah Khan ◽  
Asit Baran Adhikary ◽  
Mostafizur Rahman ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Postoperative Complications ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Hypertensive Patients ◽  
Early Outcome ◽  
Hypertensive Group ◽  
Group A ◽  
Group B

Influence of hypertension on early outcome after coronary bypass surgery was studied during the period from January 2004 to December 2004, in the Department of cardiovascular surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. Sixty patients undergoing conventional coronary artery bypass grafting in cardioplegic arrested heart were divided equally into two groups, 30 patients with hypertension(Group A) and 30 patients without hypertension(Group B). Study showed that in hypertensive group, 60.00% developed postoperative complications, whereas it is 13.30% of non-hypertensive group. Twenty percent of group A and none of the Group-B patients developed sternal wound infection. Leg infections were 39% and 13.3% in Group A and Group B respectively. Two patients from the Group A developed stroke during postoperative period, but none of the Group B patient had the same problem. Duration of average postoperative ventilation was 2.35 times greater in hypertensive patients than non-hypertensive patients. Mean postoperative hospital stay for Group A and Group B patients being 13.20 and 10.90 days respectively. The study showed that hypertensive patients were at higher risk of developing postoperative complications compared to patients without hypertension. DOI: http://dx.doi.org/10.3329/uhj.v7i1.10203 UHJ 2011; 7(1): 13-15

Early Outcome of Minimally Invasive Direct Coronary Artery Bypass Surgery- A hospital based study

2021 ◽  
Vol 13 (2) ◽  
pp. 135-143
Author(s):  
SM Quamrul Akhter ◽  
AM Asif Rahim ◽  
Quazi A Azad ◽  
MF Maruf ◽  
NA Kamrul Ahsan
Keyword(s):  
Quality Of Life ◽  
Cardiac Surgery ◽  
Coronary Artery ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Post Operative Period ◽  
Group A ◽  
Group B

Background: coronary artery bypass surgery (CABG) is expensive, uses disposable appliances and patients require more perioperative intensive care, long stay in hospital and often have a lengthy recovery time. These complications, together with the growing trend towards less invasive techniques in other areas of surgery, have encouraged cardiac surgeons to see if minimally invasive cardiac surgery can become a reality with improved outcomes and costs. Methods: This is a prospective nonrandomized comparative clinical study done at the Department of Cardiac Surgery in National Institute of Cardiovascular Diseases (NICVD) Sher-E- Bangla Nagar, Dhaka from July 2006 to June 2008 among routine CABG patients. Purposive sampling was done with 26 patients in group A selected for MIDCAB and 24 patients in Group B selected for conventional CABG surgery. Patients were followed up for three months. Postoperative outcomes were assessed to evaluate the safety and efficacy of MIDCAB in relation to conventional CABG. Results: Mean age were 54.19 vs 53.87 in group A and Group B. 92.3% vs 87.5% were male respectively. Mean duration of operation, per operative blood loss transfusion and arrythmia were lower in MIDCAB group (p<0.05) number of grafts were also statistically significant (p< 0.001). Regarding post-operative outcome ventilation time in hours ICU stay post-operative hospital stay in days, postoperative MI and stroke rate were lower in favor of group A MIDCAB patients (p<0.001). Three months postoperatively six-meter walking distance is also statistically significant in favor of Group A MIDCAB (p<0.01) patients. However, pain score in early post-operative period was higher in group A significantly but it decreased significantly in late post-operative period which is also highly statistically different (p<0.001). However, mortality and quality of life at three months were similar in both groups. Conclusion: No difference in mortality rates detected between MIDCAB and CCABG group. But there was evidence that MIDCAB is associated with less perioperative and early postoperative morbidity and improved quality of life. The MIDCAB surgery is an effective procedure of complete revascularization in ischemic heart diseases like CCABG. The procedure is associated with shorter operating time, shorter ICU stay time, shorter hospital stays and better quality of life than for CCABG. Cardiovasc. j. 2021; 13(2): 135-143

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