Optimization of Physiological Processes in Conditions Staged Activation of Motor Activity in Cardiac Patients

The development of coronary atherosclerosis leads to the formation of coronary heart disease, which threatens early death or disability. Such patients need a shunt operation to restore blood flow in the vessels of the heart. After this operation, patients need complex rehabilitation, which has strict stages. To expand the physical activity of patients after coronary bypass grafting, a system of motor activity consisting of 7 steps is used, modified for use in Russian clinical conditions for the rehabilitation of patients after shunting of blood vessels supplying the myocardium. This technique involves the use of seven stages of motor activation of patients, through the use of complexes of medical-physical culture with a gradual strengthening of gymnastic exercises, through the use of training using exercise bikes and dosed walking in open areas, built on the principle of "from simple to more complex." The first two stages of motor activation are applicable to patients immediately after coronary artery bypass grafting at the stationary stage; 3-5 stages of motor activation are physiologically justified for in-patient rehabilitation; the 6-7 steps of motor activation are applicable to patients on outpatient rehabilitation.

Download Full-text

The Comparison between Minimally Invasive Coronary Bypass Grafting Surgery and Conventional Bypass Grafting Surgery in Proximal LAD Lesion

The Heart Surgery Forum ◽

10.1532/hsf.1239 ◽

2015 ◽

Vol 18 (2) ◽

pp. 042 ◽

Cited By ~ 2

Author(s):

Mehmet Ezelsoy ◽

Baris Caynak ◽

Muhammed Bayram ◽

Kerem Oral ◽

Zehra Bayramoglu ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Minimally Invasive ◽

Coronary Artery Bypass ◽

Bypass Surgery ◽

Artery Bypass ◽

Coronary Bypass ◽

Bypass Grafting ◽

Robotic Group ◽

Bypass Group

Background: Minimally invasive bypass grafting surgery has entered the clincal routine in several centers around the world, with an increasing popularity in the last decade. In our study, we aimed to make a comparison between minimally invasive coronary artery bypass grafting surgery and conventional bypass grafting surgery in isolated proximal left anterior descending artery (LAD) lesions. Methods: Between January 2004 and December 2011, patients with proximal LAD lesions, who were treated with robotically assisted minimally invasive coronary artery bypass surgery and conventional bypass surgery, were included in the study. In Group 1, coronary bypass with cardiopulmonary bypass and complete sternotomy were applied to 35 patients and in Group 2, robotically assisted minimally invasive bypass surgery was applied to 35 patients. The demographic, preoperative, perioperative, and postoperative data were collected retrospectively. Results: The mean follow-up time of the conventional bypass group was 5.7 ± 1.7 years, whereas this ratio was 7.3 ±1.3 in the robotic group. There was no postoperative transient ischemic attack (TIA), wound infection, mortality, or need for intra-aortic balloon pump (IABP) in any of the patients. In the conventional bypass group, blood transfusion and ventilation time were significantly higher (P < .05) than in the robotic group. The intensive care unit (ICU) stay and hospital stay were remarkably shorter in the robotic group (P < .01). The postoperative pneumonia rate was significantly higher (20%) in the conventional bypass group (P < .01). Postoperative day 1 pain score was higher in the robotic group (P < .05), however, postoperative day 3 pain score in the conventional bypass group was higher (P < .05). Graft patency rate was 88.6% in the conventional bypass group whereas this ratio was 91.4% in the robotic bypass group, which was not clinically significant (P > .05). Conclusion: In isolated proximal LAD stenosis, robotic assisted minimally invasive coronary artery bypass grafting surgery requires less blood products, is associated with shorter ICU and hospital stay, and lesser pain in the early postoperative period in contrast to conventional surgery. The result of our studies, which showed similarities to the past studies, lead us to recognize the importance of minimally invasive interventions and the need to perform them more frequently in the future.

Download Full-text

Percutaneous coronary intervention for unprotected and protected left main stem disease

Oxford Textbook of Interventional Cardiology ◽

10.1093/med/9780199569083.003.019 ◽

2010 ◽

pp. 313-332

Author(s):

Christine Hughes ◽

Bruno Farah ◽

Jean Fajadet

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Left Main Coronary Artery ◽

Artery Bypass ◽

Coronary Bypass ◽

Coronary Intervention ◽

Bypass Grafting ◽

Left Main ◽

Coronary Bypass Grafting ◽

Percutaneous Coronary

Significant unprotected left main coronary artery (ULMCA) disease occurs in 5–7% of patients undergoing coronary angiography (and patients with ULMCA disease treated medically have a 3-year mortality rate of 50%. Several studies have shown a significant benefit following treatment of left main (LM) stenosis with coronary bypass grafting compared with medical treatment. Until recently coronary bypass grafting has been the gold standard therapy for LM disease. However, advances in percutaneous intervention techniques and stent technology have allowed re-evaluation of the role of percutaneous coronary intervention (PCI) for LM disease. Recent studies have focused on the safety and efficacy of stenting the left main coronary artery (LMCA) to determine if it does provide a true alternative to coronary artery bypass grafting (CABG). So should we stent the LM?

Download Full-text

The Futility of Pretransplant Coronary Bypass Grafting in Asymptomatic Patients on Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686089801800505 ◽

1998 ◽

Vol 18 (5) ◽

pp. 485-488 ◽

Cited By ~ 1

Author(s):

S. Panduranga Rao ◽

Susan Lenkei ◽

Maggie Chu ◽

Joanne M. Bargman

Keyword(s):

Peritoneal Dialysis ◽

Renal Transplantation ◽

Comparison Group ◽

Artery Bypass ◽

Coronary Bypass ◽

Study Group ◽

Bypass Grafting ◽

Comorbid Disease ◽

Dialysis Patients ◽

Asymptomatic Patients

Objective To evaluate the validity of recommending coronary artery bypass grafting (CABG) in preparation for renal transplantation in asymptomatic peritoneal dialysis (PD) patients with evidence of reversible myocardial ischemia. Design Retrospective review in a single PD unit. Participants Ten asymptomatic PD patients who underwent CABG to be placed on the transplant list comprised the study group. Ten age-, sex-, and diseasematched PD patients who did not receive CABG were used as a comparison group. Measurements Clinical outcome from 1990 to the present. Results Only 1 patient in the study group has received a transplant. Seven patients (70%) have died or have been removed from the list because of comorbid illness. Only 2 patients are still on the waiting list. Conclusion As a result of the long waiting time for cadaveric renal transplant and the high risk of interim development of comorbid disease, only a minority of patients come to transplantation. The presence of coronary disease is likely a surrogate for more generalized cardiac and vascular disease in this population. In light of these findings, the policy of prophylactic revascularization in asymptomatic dialysis patients in preparation for renal transplantation needs to be reconsidered.

Download Full-text

Combined Carotid Endarterectomy and Coronary Bypass Grafting: Risk versus Benefit - A Review

University Heart Journal ◽

10.3329/uhj.v6i1.7194 ◽

1970 ◽

Vol 6 (1) ◽

pp. 41-44

Author(s):

Rezwanul Hoque ◽

Sabrina Sharmeen Husain ◽

Zerzina Rahman ◽

Ashia Ali ◽

Mostafa Nuruzzaman ◽

...

Keyword(s):

Coronary Artery ◽

Carotid Artery ◽

Carotid Endarterectomy ◽

Carotid Artery Stenosis ◽

Artery Bypass ◽

Coronary Bypass ◽

Artery Stenosis ◽

Bypass Grafting ◽

Postoperative Stroke ◽

Bilateral Carotid

Carotid Endarterectomy (CEA) performed in combination with coronary artery bypass grafting (CABG) have also increased steadily since Bernhard and colleague’s initial report in 1972. Coexistence of symptomatic coronary artery disease and significant carotid artery stenosis ranges from 3.4% to 22%. The incidence of postoperative stroke after CABG ranges from 0.7% to 5%. Coronary revascularization in a patient with internal carotid artery stenosis more than 50% is associated with a postoperative stroke rate of 6%, which increases significantly to more than 16% when stenosis is more than 90%. To reduce the potential risk for postoperative stroke after CABG in patients with significant or symptomatic carotid artery stenosis, many surgeons have advocated combined CABG with unilateral carotid endarterectomy. However, clinical experience with the concomitant approach is conflicting. On the basis of the long-term results, it is estimated that simultaneous carotid endarterectomy and myocardial revascularization in conjunction with cardiopulmonary bypass is a method safe enough to prefer its routine use with acceptable low operative risk and satisfactory long-term morbidity. The overall 30-day mortality of combined CABG with bilateral carotid endarterectomy was 6.1% and that was unrelated to primary cardiac or cerebrovascular events. Favorable outcome also supports the justification for performing concomitant coronary artery bypass grafting with bilateral carotid endarterectomies in selected patients. Key words: Carotid endarterectomy; Coronary Bypass Grafting. DOI: 10.3329/uhj.v6i1.7194University Heart Journal Vol.6(1) 2010 pp.41-44

Download Full-text

Combined Aortic Valve Replacement and Coronary Bypass Grafting in Patient With Lipton’s R-III Type of Single Coronary Artery Anomaly

10.20944/preprints202102.0167.v1 ◽

2021 ◽

Author(s):

Milica Karadzic Kocica ◽

Hristina Ugrinovic ◽

Dejan Lazovic ◽

Nemanja Karamarkovic ◽

Milos Grujic ◽

...

Keyword(s):

Coronary Artery ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Artery Bypass ◽

Coronary Bypass ◽

Rare Condition ◽

Single Coronary Artery ◽

Bypass Grafting ◽

Congenital Coronary Artery Anomalies

A single coronary artery is a very rare condition, commonly associated with other congenital anomalies. It could be generally classified as neither benign nor malignant form of congenital coronary artery anomalies since its pathophysiological and clinical implications grossly depend on different anatomical patterns defined by the site of origin and distribution of the branches. By presenting the patient with an isolated single coronary artery, who underwent successful combined aortic valve replacement and coronary artery bypass grafting surgery, we intend to distinguish casual from causal in this extremely rare clinical and surgical scenario. This is the first-ever case published, combining such underlying pathology, clinical presentation, and surgical treatment.

Download Full-text

Does Age Affect the Short- and Long-Term Outcomes of Coronary Bypass Grafting?

International Journal of Angiology ◽

10.1055/s-0041-1735221 ◽

2021 ◽

Author(s):

Pavan Ashwini Anand ◽

Suresh Keshavamurthy ◽

Ellis M. Shelley ◽

Sibu Saha

Keyword(s):

Coronary Artery ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Artery Bypass ◽

Coronary Bypass ◽

Diabetic Patients ◽

Bypass Grafting ◽

Arterial Grafts ◽

Age Related ◽

Increased Risk

AbstractThe etiology of coronary artery disease (CAD) is multifactorial, stemming from both modifiable and nonmodifiable risk factors such as age. Several studies have reported the effects of age on various outcomes of coronary artery bypass grafting (CABG). This article reviews age-related outcomes of CABG and offers direction for further studies in the field to create comprehensive, evidence-based guidelines for the treatment of CAD. Ninety-two primary sources were analyzed for relevance to the subject matter, of which 17 were selected for further analysis: 14 retrospective cohort studies, 2 randomized clinical trials, and 1 meta-analysis. Our review revealed four broad age ranges into which patients can be grouped: those with CAD (1) below the age of 40 years, (2) between the ages of 40 and 60 years, (3) between the ages of 60 and 80 years, and (4) at or above 80 years. Patients below the age of 40 years fare best overall with total arterial revascularization (TAR). Patients between the ages of 40 and 60 years also fare well with the use of multiarterial grafts (MAGs) whereas either MAGs or single-arterial grafts may be of significant benefit to patients at or above the age of 60 years, with younger and diabetic patients benefitting the most. Arterial grafting is superior to vein grafting until the age of 80 years, at which point there is promising evidence supporting the continued use of the saphenous vein as the favored graft substrate. Age is a factor affecting the outcomes of CABG but should not serve as a barrier to offering patients CABG at any age from either a cost or a health perspective. Operative intervention starts to show significant mortality consequences at the age of 80 years, but the increased risk is countered by maintenance or improvement to patients' quality of life.

Download Full-text

Optimization of Vessel Orientation for Robotic Coronary Artery Bypass Grafting

The Heart Surgery Forum ◽

10.1532/hsf98.20041039 ◽

2005 ◽

Vol 8 (1) ◽

pp. 9

Author(s):

Maurice-Andre Recanati ◽

Arvind K. Agnihotri ◽

Jennifer K. White ◽

James Titus ◽

David F. Torchiana

Keyword(s):

Coronary Artery ◽

Artery Bypass ◽

Coronary Bypass ◽

Bypass Grafting ◽

High Quality ◽

Critical Position ◽

Vessel Orientation ◽

The Impact ◽

Speed And Accuracy ◽

Distal Vessel

The availability of telemanipulation robots has not yet resulted in the emergence of a reliable endoscopic coronary bypass procedure. A major challenge in performing a closed-chest coronary operation is creating a high-quality anastomosis in a reasonable period of time. In this experimental study, the impact of distal vessel orientation on the speed and accuracy of anastomosis was quantifed. We found that vessel orientation and the relative angle of the surgical plane influence anastomosis speed, the trauma to the vessel, the accuracy of stitch placement, and the eventual achievement of hemostasis. Our results suggest that the speed and accuracy of a robotically performed anastomosis of a vessel graft to a coronary artery can be improved by making small changes in vessel orientation. Vessels should be positioned between the horizontal and diagonal orientation and inclined between the horizontal and +45. Because the 6-o'clock stitch is particularly challenging, surgeons may benefit from an orientation that moves the heel or the toe of the anastomosis away from this critical position.

Download Full-text

Coronary Bypass Surgery in Patient with Malaria

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230201000216 ◽

2002 ◽

Vol 10 (2) ◽

pp. 160-161 ◽

Cited By ~ 4

Author(s):

Mehmet Balkanay ◽

Denyan Mansuroğlu ◽

Kaan Kirali ◽

Suat Nail Ömeroğlu ◽

Cevat Yakut

Keyword(s):

Bypass Surgery ◽

Internal Mammary Artery ◽

Left Internal Mammary Artery ◽

Artery Bypass ◽

Coronary Bypass ◽

Early Postoperative Period ◽

Beating Heart ◽

Bypass Grafting ◽

Antimalarial Therapy ◽

Internal Mammary

A 65-year-old man with unstable angina pectoris developed malaria prior to coronary artery bypass grafting. After 3 weeks on antimalarial therapy, left internal mammary artery-toleft anterior descending artery anastomosis was performed on the beating heart to avoid the effects of cardiopulmonary bypass. There was no complication in the early postoperative period.

Download Full-text

Coronary Artery Bypass Surgery with On-Pump Beating-Heart Technique

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230701500507 ◽

2007 ◽

Vol 15 (5) ◽

pp. 392-395 ◽

Cited By ~ 2

Author(s):

Mohammed Fouda

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Coronary Bypass ◽

Median Number ◽

Beating Heart ◽

Bypass Grafting ◽

Logistic Euroscore ◽

The Mean ◽

Parsonnet Score

To evaluate the results of on-pump beating-heart coronary bypass grafting, a retrospective study was carried out on 106 patients who had this procedure between 2003 and 2006. There were 87 (82%) men and 19 (18%) women, with a mean age of 60.53 ± 11.97 years. Five (5%) patients had unstable angina, 10 (9%) had a recent myocardial infarction, and 16 (15%) had congestive heart failure. The mean ejection fraction was 40.38% ± 11.46%. The mean cardiopulmonary bypass time was 66.81 ± 31.14 min. The median number of grafts per patient was 3. The median intensive care unit stay was 47 hours, and hospital stay was 7 days. There were 4 (3.8%) deaths. The mean Parsonnet score was 12.75 ± 11.27 and the logistic EuroSCORE was 7.06 ± 8.62. This study shows that the on-pump beating-heart technique is a safe and convenient method for coronary artery bypass grafting.

Download Full-text

Coronary Bypass Surgery in a 105-Year-Old Patient with Cardiopulmonary Bypass

Case Reports in Medicine ◽

10.1155/2010/725173 ◽

2010 ◽

Vol 2010 ◽

pp. 1-3

Author(s):

Temucin Noyan Ogus ◽

Filiz Erdim ◽

Ozer Selimoglu ◽

Fatih Tekiner ◽

Murat Ugurlucan

Keyword(s):

Cardiac Surgery ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Management Strategy ◽

Bypass Surgery ◽

Artery Bypass ◽

Coronary Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting

Coronary artery bypass grafting is one of the routine daily surgical procedures in the current era. Parallel to the increasing life expectancy, cardiac surgery is commonly performed in octogenarians. However, literature consists of only seldom reports of coronary artery bypass grafting in patients above 90 years of age. In this report, we present our management strategy in a 105-year-old patient who underwent coronary artery bypass grafting at our institution.

Download Full-text