scholarly journals Determination of the threshold of cardiac troponin I associated with an adverse postoperative outcome after cardiac surgery: a comparative study between coronary artery bypass graft, valve surgery, and combined cardiac surgery

Critical Care ◽  
2007 ◽  
Vol 11 (5) ◽  
pp. R106 ◽  
Author(s):  
Jean-Luc Fellahi ◽  
François Hedoire ◽  
Yannick Le Manach ◽  
Emmanuel Monier ◽  
Louis Guillou ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Postoperative Outcome ◽  
Valve Surgery ◽  
Artery Bypass Graft

Effect of Xenon Anesthesia Compared to Sevoflurane and Total Intravenous Anesthesia for Coronary Artery Bypass Graft Surgery on Postoperative Cardiac Troponin Release

2017 ◽  
Vol 127 (6) ◽  
pp. 918-933 ◽  
Author(s):  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cardiac Troponin I ◽  
Artery Bypass Graft ◽  
Intravenous Anesthesia

Abstract Background Ischemic myocardial damage accompanying coronary artery bypass graft surgery remains a clinical challenge. We investigated whether xenon anesthesia could limit myocardial damage in coronary artery bypass graft surgery patients, as has been reported for animal ischemia models. Methods In 17 university hospitals in France, Germany, Italy, and The Netherlands, low-risk elective, on-pump coronary artery bypass graft surgery patients were randomized to receive xenon, sevoflurane, or propofol-based total intravenous anesthesia for anesthesia maintenance. The primary outcome was the cardiac troponin I concentration in the blood 24 h postsurgery. The noninferiority margin for the mean difference in cardiac troponin I release between the xenon and sevoflurane groups was less than 0.15 ng/ml. Secondary outcomes were the safety and feasibility of xenon anesthesia. Results The first patient included at each center received xenon anesthesia for practical reasons. For all other patients, anesthesia maintenance was randomized (intention-to-treat: n = 492; per-protocol/without major protocol deviation: n = 446). Median 24-h postoperative cardiac troponin I concentrations (ng/ml [interquartile range]) were 1.14 [0.76 to 2.10] with xenon, 1.30 [0.78 to 2.67] with sevoflurane, and 1.48 [0.94 to 2.78] with total intravenous anesthesia [per-protocol]). The mean difference in cardiac troponin I release between xenon and sevoflurane was −0.09 ng/ml (95% CI, −0.30 to 0.11; per-protocol: P = 0.02). Postoperative cardiac troponin I release was significantly less with xenon than with total intravenous anesthesia (intention-to-treat: P = 0.05; per-protocol: P = 0.02). Perioperative variables and postoperative outcomes were comparable across all groups, with no safety concerns. Conclusions In postoperative cardiac troponin I release, xenon was noninferior to sevoflurane in low-risk, on-pump coronary artery bypass graft surgery patients. Only with xenon was cardiac troponin I release less than with total intravenous anesthesia. Xenon anesthesia appeared safe and feasible.

scholarly journals Pleural effusion in patients undergoing coronary artery bypass graft and valve replacement: a population study

2018 ◽  
Vol 4 (3) ◽  
pp. 167
Author(s):  
Maria Rossolatou ◽  
Dimitris Papageorgiou ◽  
Georgia Toylia ◽  
Georgios Vasilopoulos
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Pleural Effusion ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Valve Surgery ◽  
Artery Bypass Graft

Introduction: The postoperative pleural effusion (PE) is common in patients who undergo cardiac surgery. Most of these effusions develop as a consequence of the surgical procedure itself and follow a generally benign course. The characteristics of PE and the factors predisposing factors should be documented further.Aim: The aim of this study was to determine the prevalence of PE after cardiac surgery. And also to determine whether this prevale is related to the type of cardiac surgery.Material and Methods: This retrospective study was conducted at a large private hospital in Athens. The sample of the study was all adult patients who undergo coronary artery bypass graft (CABG), valve replacement or a combination of these surgeries. A special form was made to record patients’ demographic and clinical data. Descriptive statistics and correlation studies were performed with the SPSS 22.0, at significant level a=0.05.Results: Among the 118 patients, who included in this study, 42.4% underwent CABG surgery, 29.7% valve surgery, and 28% a combination of two types of surgery. Postoperative pleural effusion was developed in 40% of those who underwent CABG, 42.9% of those who underwent cardiac valve surgery, and 42.4% of those who underwent in both types of surgeries. The mean time development of PE was 6.65 days for the CABG group, 4.8 days for the valve group and 8.7 days for the CABG +valve group. There was no statistically significant difference in the demographic and clinical data of patients with pleural effusion according the type of cardiac surgery.Conclusions: Postoperative PE is a common complication at cardiac surgery and is more common in patients undergoing surgical recuperation of valve.

Perioperative cardiac troponin T and risk of postoperative atrial fibrillation in coronary artery bypass graft surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ali Vasheghani Farahani ◽  
Abbas Salehi Omran ◽  
Kyomars Abbasi ◽  
Ali Gholamrezaei ◽  
Pejman Mansouri ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cardiac Troponin T ◽  
Artery Bypass Graft

Cardiac Surgery Nurse Practitioner Home Visits Prevent Coronary Artery Bypass Graft Readmissions

2014 ◽  
Vol 97 (5) ◽  
pp. 1488-1495 ◽  
Author(s):  
Michael H. Hall ◽  
Rick A. Esposito ◽  
Renee Pekmezaris ◽  
Martin Lesser ◽  
Donna Moravick ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Nurse Practitioner ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Home Visits ◽  
Artery Bypass Graft

scholarly journals The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Leerang Lim ◽  
Karam Nam ◽  
Seohee Lee ◽  
Youn Joung Cho ◽  
Chan-Woo Yeom ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Postoperative Delirium ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cerebral Oximetry ◽  
Artery Bypass Graft ◽  
Off Pump ◽  
Pump Coronary Artery Bypass ◽  
The Relationship

Abstract Background Cerebral oximetry has been widely used to measure regional oxygen saturation in brain tissue, especially during cardiac surgery. Despite its popularity, there have been inconsistent results on the use of cerebral oximetry during cardiac surgery, and few studies have evaluated cerebral oximetry during off pump coronary artery bypass graft surgery (OPCAB). Methods To evaluate the relationship between intraoperative cerebral oximetry and postoperative delirium in patients who underwent OPCAB, we included 1439 patients who underwent OPCAB between October 2004 and December 2016 and among them, 815 patients with sufficient data on regional cerebral oxygen saturation (rSO2) were enrolled in this study. We retrospectively analyzed perioperative variables and the reduction in rSO2 below cut-off values of 75, 70, 65, 60, 55, 50, 45, 40, and 35%. Furthermore, we evaluated the relationship between the reduction in rSO2 and postoperative delirium. Results Delirium occurred in 105 of 815 patients. In both univariable and multivariable analyses, the duration of rSO2 reduction was significantly longer in patients with delirium at cut-offs of < 50 and 45% (for every 5 min, adjusted odds ratio (OR) 1.007 [95% Confidence interval (CI) 1.001 to 1.014] and adjusted OR 1.012 [1.003 to 1.021]; p = 0.024 and 0.011, respectively). The proportion of patients with a rSO2 reduction < 45% was significantly higher among those with delirium (adjusted OR 1.737[1.064 to 2.836], p = 0.027). Conclusions In patients undergoing OPCAB, intraoperative rSO2 reduction was associated with postoperative delirium. Duration of rSO2 less than 50% was 40% longer in the patients with postoperative delirium. The cut-off value of intraoperative rSO2 that associated with postoperative delirium was 50% for the total patient population and 55% for the patients younger than 68 years.

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