Frontal Planar QRS/T Angle Can Be a Prognostic Factor in the Early Postoperative Period of Patients Undergoing Coronary Bypass Surgery

2015 ◽  
Vol 17 (6) ◽  
pp. 288 ◽  
Author(s):  
Kubilay Karabacak ◽  
Murat Celik ◽  
Yalcin Gokoglan ◽  
Murat Kadan ◽  
Erkan Kaya ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Postoperative Period ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Early Postoperative Period ◽  
Absolute Difference ◽  
Group 2 ◽  
Group 1

<p><b>Background:</b> Wide QRS/T angle reflects the ventricular repolarization heterogeneity and has been found in association with cardiac morbidity and mortality in various study populations. However, literature data about the availability of QRS/T angle in patients undergoing cardiac surgery has not yet been available.</p><p><b>Methods:</b> A total of 157 patients who underwent isolated coronary artery bypass surgery were included in this study. A preoperative 12-lead ECG was obtained one day before surgical procedure. The absolute difference between the frontal QRS wave axes and T-wave axes was defined as frontal planar QRS/T angle. Afterwards, patients were divided into two groups according to their frontal planar QRS/T angle (the cut-off value as 90�).</p><p><b>Results:</b> Group 1 consisted of 109 patients with frontal planar QRS/T angle of <90, and the remaining 48 patients with frontal planar QRS/T angle 90 were placed into group 2. Mean EuroSCORE was much higher in group 2. There were significant differences for positive inotropic agent usage (27.5% for group 1 versus 58.3% for group 2, <i>P</i> < .001) and the prevalence of postoperative atrial fibrillation (11.9% for group 1 versus 31.2% for group 2, <i>P</i> = .004) between the two groups. In multivariate logistic regression analysis, used to determine the independent predictors of positive inotropic usage in the early postoperative period, only frontal planar QRS/T angle (OR: 0.989, 95% CI: 0.981-0.997, <i>P</i> = .008) and EuroSCORE (OR: 0.792, 95% CI: 0.646-0.971, <i>P</i> = .025) were found to be statistically significant.</p><p><b>Conclusion:</b> We found that frontal planar QRS/T angle might be an important preoperative parameter in predicting the need for inotropic drugs in the early postoperative period following coronary artery bypass surgery.</p>

scholarly journals Posthypoxic encephalopathy in patients undergoing coronary artery bypass surgery: clinical, neuropsychological, and neuroimaging aspects

2019 ◽  
Vol 11 (3) ◽  
pp. 35-42
Author(s):  
O. A. Portik ◽  
Yu. N. Tsarevskaya ◽  
A. Yu. Efimtsev ◽  
T. M. Alekseeva ◽  
G. E. Trufanov
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Extracorporeal Circulation ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Cognitive Status ◽  
Beating Heart ◽  
Group 2 ◽  
Group 1

Posthypoxic encephalopathy is a frequent complication after coronary artery bypass surgery (CABG), which includes stroke, early postoperative delirium, and postoperative cognitive dysfunction (PCD). The more pronounced prevalence and severity of the latter during surgery using extracorporeal circulation are currently being discussed.Objective: to analyze various types of cerebral dysfunction in patients undergoing CABG and to determine the role of perioperative factors in its development.Patients and methods. The investigation enrolled 53 patients who had undergone elective CABG for coronary heart disease. Group 1 included 20 patients who had undergone beating-heart surgery; Group 2 comprised 33 patients, in whom CABG had been performed using extracorporeal circulation (ECC). Neuropsychological testing and brain magnetic resonance imaging (MRI) (structural and functional techniques) were carried out.Results and discussion. Posthypoxic encephalopathy was diagnosed in 10 and 67% of patients in Group 1 and 2, respectively (p=0.05); these were precisely all the three types of brain dysfunction which were observed in Group 2 patients. Factors, such as over 70 years of age; median level of education; smoking; body mass index >30 kg/m2 ; ejection fraction <50%; class III effort angina; >210-min surgery duration; >55-min aortic ligation; and >115-min ECC, showed a statistically significant association with the onset of PCD (p<0.05). In Group 2, MRI revealed a weaker positive functional relationship of the medial prefrontal cortex with the posterior cingulate gyrus (<0.005); 18% of patients were found to have acute ischemic zones.Conclusion. Surgical myocardial revascularization using ECC is associated with a greater likelihood of PCD than beating-heart CABG. The factors that favored the development of PCD, such as increased age, low preoperative cognitive status, smoking, and long-term use of ECC, were identified when applying ECC. 

Physical rehabilitation of the patients during the early postoperative period after coronary artery bypass surgery

2016 ◽  
Vol 15 (3) ◽  
pp. 124-130
Author(s):  
V. V Bazylev ◽  
N. V Gal’tseva
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Postoperative Period ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Systolic Function ◽  
Artery Bypass ◽  
Early Postoperative Period ◽  
Physical Rehabilitation ◽  
Control Group

The purpose of the study. To estimate efficacy and safety of controlled cardio workouts on a treadmill in the early postoperative period for patients, who underwent coronary artery bypass surgery (CABS). Materials and methods. In the study there were109 patients having coronary artery disease and preserved systolic function of the left ventricle, who underwent coronary artery bypass surgery. The first group consisted of 59 patients who underwent not only standard cardiac rehabilitation activities in the early postoperative period, but also controlled cardio workouts on a treadmill. The second (control) group consisted of 50 patients with standard activities of physical rehabilitation. Cardio workouts with intensity of 3-6 MET were carried out on a running track before discharge of a patient from hospital, starting on the third-fourth day after surgery. At the same time thorough monitoring of blood pressure (BP), heart rate (HR), ECG were performed. At the end of the stationary phase of physical rehabilitation the patients in both groups filled the questionnaire «SF-36 Health Status Survey». The results. Initially, according to clinical and demographic and perioperative characteristics the compared groups did not differ authentically. At the end of the program of physical rehabilitation for the average value of the total post-operative bed day in the first (8,14 ± 0,99) and the second group (9,22 ± 1,64) statistically significant differences were obtained (р

scholarly journals Relation of creatine kinase isoenzyme MB to postoperative electrocardiographic diagnosis in patients undergoing coronary-artery bypass surgery.

1979 ◽  
Vol 25 (1) ◽  
pp. 93-98 ◽  
Author(s):  
C R Roe ◽  
G S Wagner ◽  
W G Young ◽  
S E Curtis ◽  
F R Cobb ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Myocardial Necrosis ◽  
Early Postoperative Period ◽  
Daily Sampling ◽  
Electrocardiographic Changes

Abstract We compared (a) the frequency of detection of isoenzyme MB of creatine kinase (CK; EC 2.7.3.2) in serum of patients undergoing coronary-artery bypass surgery, (b) the interval during uhich its activity was supranormal in serum, and (c) an index of the amount of CK released into blood ("CK-MB area") with postoperative electrocardiographic changes in 80 patients. The frequency of detection of CK-MB is a function of frequency of sampling during the early postoperative period. Because the duration of appearance and the calculated CK-MB area increased as the electrocardiogram became more specific for infarction (p less than 0.01), a twice-daily sampling schedule proved clinically relevant. Only 5.4% of patients had electrocardiographic evidence of infarction when CK-MB was absent by the second postoperative morning. When CK-MB was still detected at that time, 69.6% of patients had persistent new Q waves, consistent with infarction. In three patients who died postoperatively, significant myocardial necrosis was demonstrated. All three had had persistently increased values for CK-MB, related to electrocardiographic changes of infarction in one patient and ischemic changes in two. Evidently CK-MB is a more sensitive indicator of myocardial necrosis than the electrocardiogram and CK-MB area should be a useful criterion in evaluating methods of intra-operative myocardial protection.

Sign in / Sign up

Export Citation Format

Share Document