scholarly journals Long term survival of ventricular septal rupture (VSR) closure concomitant with CABG in post-acute myocardial infarction patient

2020 ◽  
Vol 1 (2) ◽  
pp. 50
Author(s):  
Irien E. Hernawati
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Artery Bypass ◽  
Acute Myocardial Infarction Patient ◽  
Bypass Grafting ◽  
Ventricular Septal Rupture ◽  
Term Survival ◽  
Apical Portion ◽  
Common Location

Abstract. Ventricular Septal Rupture (VSR) is a serious complication of acute myocardial infarction. This incidence continues to decline with the thrombolytic and PCI era, but the mortality rate is still high. VSR occurs most frequently after anterior AMI. VSR can occur in the apical, mid or basal of the septum. The most common location is in the apical portion of the septum. The timing of VSR closure surgery depends on the state of the patient's hemodynamic and VSR diameter. Various studies have suggested that VSR closure concomitant with Coronary Artery Bypass Grafting (CABG) provide a better outcome.

Abstract 14484: The Association of Pre-operative Glycemic Control With Long-term Survival in Diabetic Patients After Coronary Artery Bypass Grafting

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Muhammad Sheikh ◽  
Salil V Deo ◽  
Varun Sundaram ◽  
Brigid Wilson ◽  
Jayakumar Sahadevan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Term Survival ◽  
Long Term Survival ◽  
Group Iii ◽  
Insulin Dependence

Introduction: We analyzed the national Veteran Affairs (VA) data to evaluate the association of preoperative glycated Hemoglobin (HbA1c) and long-term outcome after isolated coronary artery bypass grafting (CABG). Methods: Between January 2007 - December 2014, Veterans with diabetes mellitus (DM) that underwent isolated CABG were divided on into three groups (I: HbA1c < 8%, II: HbA1c 8 - 10% and III: HbA1c > 10%). Demographic and clinical differences between groups were evaluated with the t-test or chi-square test. The relationship of preoperative HbA1c and long-term survival was evaluated with a multivariable proportional hazards model; restricted cubic splines were used to model non-linear effects. The cumulative incidence of secondary end-points (myocardial infarction, urgent revascularization) for each group was modeled as a competing-risk analysis. Results: Overall, 3,210 patients (mean age 64.6 years, male 98.8%; insulin dependent - 53%) with DM underwent isolated CABG. Group III patients were younger (61 vs 65 years in group I). Median HbA1c levels were similar between races (white - 7.3% and blacks - 7.35%). Insulin dependence was higher in group III (79.3%) vs groups I (43.5%) and II (69.9%). In groups I,II and III, 5 and 10 year survival was 76.2%, 74.4%, 75.4% and 38.9%, 36.9% and 30.2% respectively. HbA1c was observed to have a J-shaped association with mortality with values < 6% and > 9% at higher risk of death. Left ventricular systolic dysfunction [HR 1.5 (1.3 - 1.7)], prior myocardial infarction [HR 1.3 (1.2 - 1.5)] and insulin dependence [HR 1.4 (1.2 - 1.5)] were also associated with lower survival. Myocardial infarction was observed in 9.8% , 13.4% and 12.8% patients in groups I, II and III respectively. Conclusions: Pre-operative HbA1c impacts long-term survival among diabetic patients undergoing CABG. We observed a J-shaped relationship between HbA1c and survival with values < 6% and > 9% associated with increased mortality.

scholarly journals The effectiveness of endovascular revascularization of the carotid basin performed before coronary artery bypass grafting in patients with combined atherosclerotic lesions of cerebral and coronary arteries

2020 ◽  
Vol 31 (1) ◽  
pp. 14-18
Author(s):  
S.P. Grigoruk
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Results Of Treatment ◽  
Atherosclerotic Lesions ◽  
Ischemic Attack ◽  
Positive Results

Objective – to determine the effectiveness of endovascular revascularization of the carotid pool (carotid stenting) in patients with combined atherosclerotic lesions of the cerebral and coronary arteries, which showed coronary artery bypass grafting (CABG). Materials and methods. 40 patients with combined atherosclerotic lesions of the cerebral and coronary arteries were included in the study. All patients for 14 days before CABG were stented carotid artery. The number of complications and the treatments results were determined. Survival functions were determined to evaluate long-term treatment outcomes over a 10-year follow-up period. Results. 32.5 % of patients had complications after carotid pool revascularization: angina pectoris – 12.5 %, acute myocardial infarction – 2.5 %, transient ischemic attack – 12.5 %, ischemic stroke – 2.5 %, arterial hypotension – 2.5 %. 98.2 % of patients observed positive results of treatment for neurological status. After revascularization of the coronary pool, 45 % of patients had complications: angina – 27.5 %, cardiac arrhythmia – 27.5 %, acute myocardial infarction – 2.5 %, transient ischemic attack – 7.5 %, ischemic stroke – 7.5 %. 83.5 % of patients received positive results of treatment. The 10-year survival rate after surgery was 19 % [34 %; 7 %]. Decrease in survival function was observed uniformly throughout the observation period: 3-year survival – 83 % [92 %; 67 %], 5-year survival – 56 % [70 %; 39 %].Conclusions. Positive results of treatment in patients with combined atherosclerotic lesions of the cerebral and coronary arteries, which performed stenting of the carotid arteries before CABG, are observed in 98.5 % of patients. Carotid artery stenting before CABG is an effective method of preventing cerebral complications in the early postoperative and distant periods. Long-term results of treatment are accompanied by low rates of 5-year and 10-year survival after revascularization of the carotid and coronary pools.

scholarly journals Long-term survival benefit of ramipril in patients with acute myocardial infarction complicated by heart failure

Heart ◽  
2021 ◽  
Vol 107 (5) ◽  
pp. 389-395
Author(s):  
Jianhua Wu ◽  
Alistair S Hall ◽  
Chris P Gale
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Life Expectancy ◽  
Survival Benefit ◽  
Ace Inhibition ◽  
Survival Times ◽  
Term Survival ◽  
Long Term Survival

AimsACE inhibition reduces mortality and morbidity in patients with heart failure after acute myocardial infarction (AMI). However, there are limited randomised data about the long-term survival benefits of ACE inhibition in this population.MethodsIn 1993, the Acute Infarction Ramipril Efficacy (AIRE) study randomly allocated patients with AMI and clinical heart failure to ramipril or placebo. The duration of masked trial therapy in the UK cohort (603 patients, mean age=64.7 years, 455 male patients) was 12.4 and 13.4 months for ramipril (n=302) and placebo (n=301), respectively. We estimated life expectancy and extensions of life (difference in median survival times) according to duration of follow-up (range 0–29.6 years).ResultsBy 9 April 2019, death from all causes occurred in 266 (88.4%) patients in placebo arm and 275 (91.1%) patients in ramipril arm. The extension of life between ramipril and placebo groups was 14.5 months (95% CI 13.2 to 15.8). Ramipril increased life expectancy more for patients with than without diabetes (life expectancy difference 32.1 vs 5.0 months), previous AMI (20.1 vs 4.9 months), previous heart failure (19.5 vs 4.9 months), hypertension (16.6 vs 8.3 months), angina (16.2 vs 5.0 months) and age >65 years (11.3 vs 5.7 months). Given potential treatment switching, the true absolute treatment effect could be underestimated by 28%.ConclusionFor patients with clinically defined heart failure following AMI, ramipril results in a sustained survival benefit, and is associated with an extension of life of up to 14.5 months for, on average, 13 months treatment duration.

scholarly journals Incidence, Predictors, and Impact of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting in Military Veterans

2016 ◽  
Vol 43 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Shuab Omer ◽  
Lorraine D. Cornwell ◽  
Ankur Bakshi ◽  
Eric Rachlin ◽  
Ourania Preventza ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Military Veterans ◽  
Survival Rates ◽  
Postoperative Atrial Fibrillation ◽  
Bypass Grafting ◽  
Term Survival ◽  
Long Term Survival

Little is known about the frequency and clinical implications of postoperative atrial fibrillation in military veterans who undergo coronary artery bypass grafting (CABG). We examined long-term survival data, clinical outcomes, and associated risk factors in this population. We retrospectively reviewed baseline, intraoperative, and postoperative data from 1,248 consecutive patients with similar baseline risk profiles who underwent primary isolated CABG at a Veterans Affairs hospital from October 2006 through March 2013. Multivariable logistic regression identified predictors of postoperative atrial fibrillation. Kaplan-Meier analysis was used to evaluate long-term survival (the primary outcome measure), morbidity, and length of hospital stay. Postoperative atrial fibrillation occurred in 215 patients (17.2%). Independent predictors of this sequela were age ≥65 years (odds ratios [95% confidence intervals], 1.7 [1.3–2.4] for patients of age 65–75 yr and 2.6 [1.4–4.8] for patients &gt;75 yr) and body mass index ≥30 kg/m2 (2.0 [1.2–3.2]). Length of stay was longer for patients with postoperative atrial fibrillation than for those without (12.7 ± 6.6 vs 10.3 ± 8.9 d; P ≤0.0001), and the respective 30-day mortality rate was higher (1.9% vs 0.4%; P=0.014). Seven-year survival rates did not differ significantly. Older and obese patients are particularly at risk of postoperative atrial fibrillation after CABG. Patients who develop the sequela have longer hospital stays than, but similar long-term survival rates to, patients who do not.

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