A Case Report on Concomitant Coronary Artery Bypass Operation and Renal Transplantation

2014 ◽  
Vol 17 (3) ◽  
pp. 180
Author(s):  
Yucel Ozen ◽  
Sabit Sarikaya ◽  
O. Atlas ◽  
D. Cekmecelioglu ◽  
Kann Kirali ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Renal Transplantation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Asymptomatic Patients ◽  
Artery Disease

Renal transplantation is successfully implemented in patients undergoing coronary bypass surgery. We performed concomitant coronary bypass surgery and renal transplantation in a patient found to have a left main coronary artery lesion after coronary angiography, which was performed in our clinic during preoperative evaluation of renal transplantation. We suggest the application of coronary-artery bypass grafting (CABG) or stent implantation 2 months after renal transplantation in asymptomatic patients with coronary artery disease. But, if severe coronary artery disease is detected in symptomatic patients, we suggest the concurrent application CABG and renal transplantation.

Transient liver dysfunction increases surgical site infections after coronary surgery

2018 ◽  
Vol 26 (6) ◽  
pp. 439-445 ◽  
Author(s):  
Rakan I Nazer ◽  
Khalid A Alburikan ◽  
Anhar Ullah ◽  
Ali M Albarrati ◽  
Mazen Hassanain
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Liver Dysfunction ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Surgical Site Infections ◽  
Perioperative Period ◽  
Coronary Bypass Surgery ◽  
Cardiac Procedures

Background Surgical site infections can have a significant impact on cardiac surgical outcome. The liver plays an important role in infection prevention. This study aimed to retrospectively determine whether transient postoperative liver dysfunction after coronary bypass surgery increased surgical site infections. Methods A modified version of the Schindl scoring scale for liver dysfunction was adapted to objectively quantify transient liver dysfunction in the first 7 days after on-pump coronary artery bypass grafting. A retrospective analysis of clinical outcomes at 30 months postoperatively was performed on data of 575 patients who underwent coronary artery bypass between 2014 and 2016. The patients were categorized into a liver dysfunction group (Schindl score ≥ 4) and a non-liver dysfunction group (Schindl score < 4). Results The liver dysfunction group (47.3%) had significantly more patients who were obese, current smokers, and had diabetes, renal impairment, and peripheral vascular disease. Surgical site infections occurred predominantly in the liver dysfunction group (12.1% vs. 0.3%, p < 0.001). The independent predictors of surgical site infection were liver dysfunction, body mass index > 30 kg m−2, and coronary bypass surgery combined with other cardiac procedures. Conclusions Surgical wound infections can be precipitated by multiple factors before, during, and after coronary bypass surgery. Transient liver dysfunction in the perioperative period is associated with an increased rate of surgical infections even after adjusting for known risk factors. Considering this factor as well as other known risks may help to identify and stratify patients with a potentially higher risk of surgical site infections.

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