scholarly journals Preoperative Serum Alkaline Phosphatase and Clinical Outcome of Off-Pump Coronary Artery Bypass Surgery

2017 ◽  
Vol 81 (6) ◽  
pp. 799-805 ◽  
Author(s):  
Tae Kyong Kim ◽  
Deok Man Hong ◽  
Yoon Hyeong Choi ◽  
Chang-Hoon Koo ◽  
Youn Joung Cho ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Coronary Artery ◽  
Clinical Outcome ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Serum Alkaline Phosphatase ◽  
Artery Bypass ◽  
Off Pump ◽  
Preoperative Serum ◽  
Pump Coronary Artery Bypass

Effect of Exogenous Albumin on the Incidence of Postoperative Acute Kidney Injury in Patients Undergoing Off-pump Coronary Artery Bypass Surgery with a Preoperative Albumin Level of Less Than 4.0 g/dl

2016 ◽  
Vol 124 (5) ◽  
pp. 1001-1011 ◽  
Author(s):  
Eun-Ho Lee ◽  
Wook-Jong Kim ◽  
Ji-Yeon Kim ◽  
Ji-Hyun Chin ◽  
Dae-Kee Choi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Albumin Level ◽  
Control Group ◽  
Off Pump ◽  
Preoperative Serum ◽  
Pump Coronary Artery Bypass

Abstract Background Hypoalbuminemia may increase the risk of acute kidney injury (AKI). The authors investigated whether the immediate preoperative administration of 20% albumin solution affects the incidence of AKI after off-pump coronary artery bypass surgery. Methods In this prospective, single-center, randomized, parallel-arm double-blind trial, 220 patients with preoperative serum albumin levels less than 4.0 g/dl were administered 100, 200, or 300 ml of 20% human albumin according to the preoperative serum albumin level (3.5 to 3.9, 3.0 to 3.4, or less than 3.0 g/dl, respectively) or with an equal volume of saline before surgery. The primary outcome measure was AKI incidence after surgery. Postoperative AKI was defined by maximal AKI Network criteria based on creatinine changes. Results Patient characteristics and perioperative data except urine output during surgery were similar between the two groups studied, the albumin group and the control group. Urine output (median [interquartile range]) during surgery was higher in the albumin group (550 ml [315 to 980]) than in the control group (370 ml [230 to 670]; P = 0.006). The incidence of postoperative AKI in the albumin group was lower than that in the control group (14 [13.7%] vs. 26 [25.7%]; P = 0.048). There were no significant between-group differences in severe AKI, including renal replacement therapy, 30-day mortality, and other clinical outcomes. There were no significant adverse events. Conclusion Administration of 20% exogenous albumin immediately before surgery increases urine output during surgery and reduces the risk of AKI after off-pump coronary artery bypass surgery in patients with a preoperative serum albumin level of less than 4.0 g/dl.

Initial Report of Off-Pump Coronary Artery Bypass Surgery as Sole Therapy for Moderate Ischemic Mitral Regurgitation: Operative and Intermediate-Term Outcome

2005 ◽  
Vol 8 (2) ◽  
pp. 89 ◽  
Author(s):  
Kevin M. Harris ◽  
Avinash Reddy ◽  
Dorothee Aepplii ◽  
Betsy Wilson ◽  
Robert W. Emery
Keyword(s):  
Coronary Artery ◽  
Mortality Rate ◽  
Mitral Regurgitation ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Mortality Rates ◽  
Off Pump ◽  
Moderate Ischemic Mitral Regurgitation ◽  
Pump Coronary Artery Bypass

Background: Patients undergoing on-pump coronary artery bypass surgery (CAB) with coexistent moderate ischemic mitral regurgitation (IMR) have a significant mortality rate compared to patients without MR. The mortality rate is elevated both perioperatively (0%-12% mortality), as well as over a 1- and 2-year postoperative period (15%-25%). It is thought that some patients are best served by off-pump CAB (OPCAB); however, outcomes have not been reported for such patients with coexistent moderate IMR. Methods: We reviewed the independent database of patients undergoing OPCAB between 1995 and 2002 to find 989 patients, 17 (1.7%) of whom had moderate or moderately severe MR. Patients were contacted and clinical and echocardiographic data were obtained. Results: The patient group consisted of 11 men and 6 women (age, 65 15 years). The study group had a PA pressure of 52 14, creatinine of 1.6 0.7, and left ventricular ejection fraction of 43 18. Nine patients (53%) had advanced New York Heart Association (class III-IV) heart failure. Mortality rates perioperatively and at 1, 2, and 3 years were 0%, 6.25% (1/16), 12.5% (2/16), and 38% (4/8), respectively. At the time of this report, no patient had returned for a reparative procedure. Conclusion: In patients felt to be best served by OPCAB with ischemic MR, operative and intermediate mortality rates are remarkably similar to those previously reported for on-pump series. These data underscore the continued need to understand which patients undergoing CAB require mitral valve problems to be addressed at the time of surgery.

Impact of postoperative hypothermia on outcomes after off-pump coronary artery bypass grafting

2021 ◽  
pp. 021849232110195
Author(s):  
Vasileios Ntinopoulos ◽  
Nestoras Papadopoulos ◽  
Achim Haeussler ◽  
Dragan Odavic ◽  
Patricia Fodor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Propensity Score ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Background Even though the physiological derangements caused by hypothermia are well described, there is no consensus about its impact on postoperative outcomes. The aim of this study is to assess the effect of postoperative hypothermia on outcomes after off-pump coronary artery bypass surgery. Methods A total of 1979 patients undergoing isolated off-pump coronary artery bypass surgery in a single center in the period 2007–2018 were classified according to their axillary temperature measurement at intensive care unit admission postoperatively to either hypothermic (<36°C) or normothermic (≥36°C). Between-group differences on baseline characteristics and postoperative outcomes were assessed before and after propensity score matching. Results Data analysis showed that 582 patients (29.4%) were hypothermic (median temperature 35.5°C) and 1397 patients (70.6%) were normothermic (median temperature 36.4°C). Using propensity score matching, 567 patient pairs were created. Patients with hypothermia exhibited a higher rate of postoperative transfusion of at least three red cell concentrate units (14.3% vs 9%, p = 0.005), a longer intubation duration (median duration, 6 vs 5 h, p < 0.0001), and a longer intensive care unit stay (median stay, 1.6 vs 1.3 days, p = 0.008). There was no difference in reoperation for bleeding, renal replacement therapy, infections, and mortality between the two groups. Conclusions Even though associated with a higher blood transfusion requirement and a slightly longer intensive care unit stay, mild postoperative hypothermia was not associated with a higher morbidity and mortality.

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