Secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after simultaneous and hybrid surgical treatment

Aim. To compare secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after different surgical treatment strategies (simultaneous and hybrid).Methods. Secondary neurological outcomes were evaluated in 43 patients with coronary and brachiocephalic artery disease in the early postoperative period after (1) carotid endarterectomy and on-pump coronary artery bypass surgery; (2) percutaneous coronary intervention and carotid endarterectomy. Demographic, clinical, instrumental data were collected. Neuropsychological assessment was performed using the Mini-Mental State Examination and Frontal Assessment Battery. Memory, attention and neurodynamics were measured using the “Status-PF” software at days 2–3 before the surgery and at days 5–7 after it. The presence of postoperative cognitive dysfunction was estimated on the basis of criteria defined as a 20% decline on 20% of the tests. Statistical analysis was performed using the software package “Statistica 10.0”.Results. Patients who underwent hybrid intervention demonstrated improved attention and memory in the early postoperative period. Complex visual-motor reaction significantly increased in patients after simultaneous surgery. Attention differed significantly in both groups. Thus, patients from the hybrid group processed more characters per 1 and 4 minutes while completing the Bourdon proof reading test. The total number of processed characters prevailed in the hybrid group. Cognitive processing speed was higher in the hybrid group according to the brain performance test. The incidence of early postoperative cognitive dysfunction was 60% in patients after simultaneous surgery and 11% in patients after hybrid surgery (p = 0.006, OR±SE 12.5±3.2).Conclusion. Hybrid intervention has shown its superiority over simultaneous intervention in terms of low rate of early cognitive impairment, thereby confirming the necessity to take into account the obtained results while selecting the optimal surgical treatment in patients with coronary and brachiocephalic artery disease present with cognitive deficits at baseline.

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Perioperative evaluation of kidney function for patients with complicated forms of coronary artery disease

Ukrainian Journal of Nephrology and Dialysis ◽

10.31450/ukrjnd.4(68).2020.08 ◽

2020 ◽

pp. 52-58

Author(s):

O. Gogayeva ◽

V. Lazoryshynets ◽

A. Rudenko ◽

L. Dzakhoieva ◽

O. Yuvchyk

Keyword(s):

Coronary Artery Disease ◽

Acute Kidney Injury ◽

Coronary Artery ◽

Kidney Function ◽

Postoperative Period ◽

Kidney Injury ◽

Perioperative Period ◽

Early Postoperative Period ◽

Chronic Obstructive ◽

Artery Disease

The study aimed to analyze kidney function for patients with complicated forms of coronary artery disease (CAD) in the perioperative period. Methods. It was a retrospective analysis of 110 high-risk patients with complicated forms of CAD, who were operated on and discharged from the National M. Amosov Institute for the period from 2009 till 2019 years. Kidney function was evaluated by glomerular filtration rate (GFR), calculated online with СKD-EPI formula. Results. Among the included patients there were 86 (78.1%) patients with metabolic syndrome, 81 (73.59%) patients with disorders of glucose metabolism, 82 (74.5%) subjects with chronic obstructive pulmonary disease and 38 (34.5%) patients had chronic kidney disease (CKD) 3-5 stage. Preoperative risk stratification with EuroScore II scale was 9.4%. All operations performed in cardiopulmonary bypass; Custodial cardioplegia was used in 53 (48.1%) patients. The average perfusion time was 111 minutes, average cross-clamping time was 73.9 minutes. Acute kidney injury in the early postoperative period had 9 (8.1%) patients. Conclusions. At the admittance 38 (34.5%) patients with complicated forms of CAD had CKD 3-5 st. Analysis of the GFR dynamic in the early postoperative period shown a decrease in GFR in 71.05% of patients. Transient acute kidney injury with 50% sCr growth had 9 (8.1%) patients but didn’t require hemodialysis.

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Early postoperative cognitive dysfunction after simultaneous coronary artery bypass grafting and carotid endarterectomy

European Heart Journal ◽

10.1093/ehjci/ehaa946.2693 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

O Maleva ◽

I Syrova ◽

O Trubnikova ◽

O Barbarash

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Postoperative Period ◽

Artery Bypass ◽

Postoperative Cognitive Dysfunction ◽

Early Postoperative Period ◽

Cognitive Status ◽

Funding Source ◽

Bypass Grafting ◽

The Mean

Abstract Purpose To assess cognitive status after simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CEE). Material & methods. Changes in cognitive status and the incidence of POCD were evaluated in the early postoperative period after simultaneous CABG and CEE. 53 patients with polyvascular disease (PolyVD) undergoing CABG and CEE were included in the study. Patients were assigned to two groups. 25 patients without mild cognitive impairment (MCI), the mean age of 64.3±7.9 years, were included in Group 1 and 28 patients with MCI, the mean age of 65.3±6.75 years, were included in Group 2. Neuropsychological testing was performed on days 2 before surgery and on days 7 after surgery using the psycho-physiological testing software “Status PF”. Attention was assessed with the Bourdon's test or proofreading test. Memory was estimated with the 10 numbers memorizing test, 10 words memorizing test, and 10 syllables memorizing test. The assessment of neurodynamics included the measurement of the complex visual-motor reaction time (VMRT), brain performance (BP), and functional mobility of the nervous processes (FMNP). The presence of POCD was estimated as a 20% decline on 20% of the tests. A reference range for neuropsychological indicators (13 indicators of the test battery) was set at the intervals corresponding to the ranges between the quartiles [Q25; Q75] in healthy people. Thus, cognitive status scale includes low cognitive status with the values ranging from 0 to 0.34, below the average - from 0.35 to 0.51, the average - from 0.52 to 0.7, and high cognitive status >0.7 to 1.0. Early postoperative cognitive dysfunction (POCD) was diagnosed as a 20% decline in memory, attention, and neurodynamics from the baseline on 20% of the tests passed. Statistical analysis was performed using the “Advanced” software package. Results At baseline, cognitive status in patients without MCI was below the average (0.38±0.2), whereas in MCI patients it was lower by 32% and corresponded to low (0.26±0.1; p=0.03). Cognitive status did not differ significantly between both groups in the postoperative period, but a trend towards its decrease was determined (0.34±0.2 vs. 0.27±0.13, p>0.5). However, the incidence of early POCD in patients without MCI was 14 (56%), and in patients with MCI - 20 (71%) patients. Conclusion At baseline, patients with PolyVD, regardless of the presence of MCI, according to the results of the comprehensive examination, showed low and below the average cognitive status. Simultaneous CABG and CEE does not prevent the deterioration of cognitive functions in patients with PolyVD in the early postoperative period. Patients with PolyVD undergoing myocardial and brain revascularization have a high risk of worsening cognitive disorders and need to individual approach to make a reasonable choice of the optimal surgical strategy. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Institute

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DIRECT RESULTS OF CORONARY BYPASS GRAFTING OF PATIENTS WITH THE REDUCED MYOCARDIAL CONTRACTILITY IN TERMS OF MYOCARDIAL PERFUSION SCINTIGRAPHY AND ECHOCARDIOGRAPHY

10.35805/bsk2021iii005 ◽

2021 ◽

pp. 5-9

Author(s):

Abrol Mansurov

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Surgical Treatment ◽

Myocardial Perfusion ◽

Myocardial Perfusion Scintigraphy ◽

Stress Test ◽

Myocardial Revascularization ◽

Early Postoperative Period ◽

Perfusion Scintigraphy ◽

Artery Disease

This article provides an analysis of the results of surgical treatment of patients with various forms of coronary artery disease, the study of the quality and reliability of myocardial revascularization, assessment of patency and functional viability of coronary grafts in the early postoperative period using echocardiography and myocardial perfusion scintigraphy. The retrospective material of our study is based on the results of surgical treatment of 130 patients with coronary artery disease who were operated on in the IHD department over the past year. All patients underwent examination according to a standard protocol: electrocardiography, 24-hour Holter monitoring, selective coronary ventriculography and shuntography, echocardiography, perfusion scintigraphy before and after surgery, drug stress test to assess myocardial perfusion and contractility and its differentiation (ischemia, scarring) with hypoperfusion.

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Myocardial stunning in patients with coronary artery disease before and after treatment by method of coronary artery bypass grafting (own studies)

Journal of Education, Health and Sport ◽

10.12775/jehs.2022.12.01.004 ◽

2022 ◽

Vol 12 (1) ◽

pp. 43-54

Author(s):

V. Kundina ◽

T. Babkina

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Postoperative Period ◽

Systolic Function ◽

Systolic Dysfunction ◽

Early Postoperative Period ◽

Inferior Wall ◽

Before And After ◽

Artery Disease

Aim of the study: Determination of quantitative radiological indicators of myocardial revascularization effectiveness in patients with coronary artery disease in the early postoperative period. Materials and methods of research: For the implementation of the clinical objectives, 62 patients with coronary artery disease, heart failure, with preserved systolic function and systolic dysfunction were examined in the early postoperative period (up to 7 days). The patients' age ranged from 40 to 79 years, the average age of the examined was 59.6 ± 8.2 years. 35 (56%) patients had HF with LV systolic dysfunction with EF of 49% or less. 27 (44%) patients had preserved systolic function - ejection fraction greater than or equal to 50%. Results: In the group before treatment, the average value of MV was 69.4% CI 95% [65.3%; 73.5%], and after treatment the value of MV was 75.0% CI 95% (70.8%; 79.3%], p = 0.0000. Percentage of RFP inclusion in the anterior wall was 69.5% CI [66.2%; 72.8%] before treatment and significantly improved to 72.3% CI [69.1%; 75.4%] after treatment (p = 0.023). Lateral wall had a parameter value of 73.9% CI [70.7%; 77.1%] before treatment and improved perfusion up to 77.2% CI [74.3%; 80.2%] (p = 0.018). Parameter values for the intraventricular septum were 64.5% CI [60.7%; 68.3%] before treatment and 69% CI [65.2%; 72.8%] after treatment (p = 0.000034) and for the inferior wall those were 54.0% CI (49.7%; 58.3%] and 61.7% CI (57.9%); 65.6%] before and after treatment respectively (p = 0.000032). Conclusion: The determination of quantitative radiological parameters proposed as a result of this study is extremely important for the early postoperative period (7-10 days) for determination of stunned myocardial reserve and late stage of patients` management (1-1.5 years) for determination of hibernation reserve and final assessment of CABG effectiveness.

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Frailty syndrome as an independent predictor of unfavorable outcome in patients undergoing coronary artery bypass grafting

European Heart Journal ◽

10.1093/ehjci/ehaa946.3242 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Krivoshapova ◽

O.L Barbarash ◽

E.A Wegner ◽

N.A Terentyeva ◽

I.I Grigorieva ◽

...

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Postoperative Period ◽

Artery Bypass ◽

Early Postoperative Period ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Risk Of Death

Abstract Purpose To assess the prevalence of frailty in the preoperative period and to evaluate its effect on the risk of complications and adverse outcomes in patients undergoing coronary artery bypass grafting (CABG). Methods 303 patients undergoing preoperative management for elective primary CABG were recruited in the study. The study cohort was divided into three groups depending on the PRISMA-7 scores suggesting the presence or absence of frailty and the presence of prefrailty. Statistical analysis was performed using the commercially available software package STATISTICA 8.0.360.0 for Windows (StatSoft, Inc., USA) and SPSS Statistics v. 17.0.0. Results 46 (15%) patients had frailty, while 49 (16%) patients were diagnosed with prefrailty. 208 (69%) patients did not have any signs of frailty. All three groups had significant age differences, therefore only elderly patients aged of 67.0±6.5 years with frailty were allocated for subsequent analysis (prefrailty group - 62.3±7.4 years old, patients without frailty - 60.0±7.7 years, p=0.003). Patients with frailty or prefrailty more often suffered from diabetes mellitus (patients without frailty - 19.2%, prefrailty group - 30.6% and frailty group - 28.3%, p=0.05), arterial hypertension (69.2%, 93.9% and 95.7%, respectively, p<0.001), atrial fibrillation or flutter (7.2%, 14.3% and 19.6%, respectively, p=0.03), chronic heart failure class 3–4 (7.2%, 10.2% and 8.7%, respectively, p=0.002), and peripheral arterial disease (22.6%, 38.8% and 58.7%, respectively, p<0.001). Three groups were comparable in main clinical and demographic parameters. There were no significant differences found in the incidence of postoperative atrial fibrillation or flutter (15.9%, 8.2% and 6.5%, respectively, p=0.07) and infections (1.9%, 0% and 4.3%, respectively, p=0.640). The incidence of myocardial infarction in the intra- and early postoperative period after CABG did not differ significantly between the groups (0.5%, 2% and 0%, respectively, p=0.328) as well as the incidence of stroke (2.4%, 2% and 0%, respectively, p=0.640). Patients with frailty and prefrailty had significantly higher cerebrovascular and cardiovascular mortality compared to those without frailty (8.2%, 2.2% and 0.5%, respectively, p=0.001). Conclusion Almost 15% of patients referred to CABG suffered from frailty. The presence of prefrailty or frailty increases the risk of death in the early postoperative period after CABG. Funding Acknowledgement Type of funding source: None

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IMMUNE FUNCTION IN THE EARLY POSTOPERATIVE PERIOD PREDICTS OUTCOME IN CORONARY ARTERY BYPASS GRAFT (CABG) SURGERY

Critical Care Medicine ◽

10.1097/00003246-199012001-00146 ◽

1990 ◽

Vol 18 (Supplement) ◽

pp. S252

Author(s):

Marcus P. Haw ◽

Gregory T. Steltzer ◽

Emma J. Lewis ◽

Bradley C. Borlase ◽

Lynda Kabbash ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Immune Function ◽

Coronary Artery Bypass ◽

Postoperative Period ◽

Artery Bypass ◽

Bypass Graft ◽

Early Postoperative Period ◽

Artery Bypass Graft ◽

Cabg Surgery

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Coronary artery disease. 2. Surgical treatment.

BMJ ◽

10.1136/bmj.1.5740.96 ◽

1971 ◽

Vol 1 (5740) ◽

pp. 96-98 ◽

Cited By ~ 1

Author(s):

B B Milstein

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Surgical Treatment ◽

Artery Disease

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Results of surgical treatment of moderate ischemic mitral regurgitation: A propensity analysis

10.22541/au.160813504.44743381/v1 ◽

2020 ◽

Author(s):

Jiyoung Lee ◽

Kan Kajimoto ◽

Taira Yamamoto ◽

Kenji Kuwaki ◽

Yuki Kamikawa ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Surgical Treatment ◽

Mitral Valve ◽

Propensity Score ◽

Artery Bypass ◽

Long Term Outcomes ◽

Artery Disease ◽

The Impact

Background and Aim of the Study: Ischemic mitral valve regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) is associated with worse long-term outcomes. The aim of this study was to assess the impact of mitral valve repair with CABG in patients with moderate IMR. Method: This observational study enrolled 3,215 consecutive patients from the Juntendo CABG registry with moderate IMR and multivessel coronary artery disease who underwent CABG between 2002 and 2017. The CABG alone and CABG with mitral valve surgery (MVs) groups were compared. The propensity score was calculated for each patient. Long-term all-cause death, cardiac death, and major adverse cardiac and cerebrovascular events (MACCEs) were compared between the two groups. Results: A total of 101 patients who underwent CABG had moderate IMR in our database. Propensity score matching selected 40 pairs for final analysis. MVs was associated with increased risks of postoperative atrial fibrillation, blood transfusion, and longer hospitalization. There were no differences between the two groups in long-term outcomes, including all-cause mortality, cardiac mortality, and the incidence of MACCEs. Conclusions: Surgical treatment of moderate IMR combined with CABG was as safe as CABG alone, with no differences in long-term outcomes. Further studies are needed to determine the effects of MVs in patients with moderate IMR and severe coronary artery disease.

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