scholarly journals Cardiovascular Outcomes in High-Risk Patients Undergoing OPCAB Surgery Compared to Traditional CABG

2021 ◽  
Vol 31 (4) ◽  
pp. 9
Author(s):  
Widya Trianita Suwatri ◽  
Dudy Arman Hanafy ◽  
Sugisman Sugisman
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Kidney Injury ◽  
Morbidity Rate ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Opcab Surgery ◽  
Artery Disease ◽  
Using Data

<p>The benefit of coronary artery bypass graft (CABG) for coronary artery disease (CAD) with Ejection Fraction (EF) 30% and ischemic burden (IB) 10% is still debatable. The objective of this study is to analyze mortality and morbidity in patients with EF 30% and ischemic burden 10% undergoing OPCAB compared to traditional CABG (TCABG).  The retrospective analytic cohort study was performed using data from January 2015–November 2018 at National Cardiovascular Center Harapan Kita Jakarta, Indonesia. 109 patients were included. 35 patients undergoing OPCAB and 74 patients undergoing TCABG. The primary outcomes were mortality rate, morbidity rate, and length of stay. Arrhythmia is statistically lower in OPCAB compared to TCABG (8.6% vs 39.2%; p=0.001). Kidney injury is statistically lower in OPCAB (8.6% vs 27.0 %; p=0.027). Stroke is statistically lower in OPCAB (1.0 % vs 17.6%; p=0,032). There is no significant difference between OPCAB and TCABG in mortality, 5.7% vs 16.2%, (RR=3.20; CI 95%=0.67–15.12; p= 0.126). There was a statistically significant difference in the occurrence of postoperative morbidity in CAD patients with EF &lt;30% and IB&lt;10% who underwent OPCAB surgery compared with patients who underwent TCABG. Mortality that occurred after OPCAB procedure was lower in CAD patients with EF &lt; 30% and IB&lt;10% compared to TCABG although the statistical difference was not significant. Therefore, patients with this condition are more advisable to undergo OPCAB.</p>

scholarly journals Comparison of urinary KIM-1 and NGAL and plasma creatinine in patients undergoing coronary artery bypass graft surgery

2020 ◽  
Vol 10 (1) ◽  
pp. e04-e04
Author(s):  
Maryam Saeedi Ghaheh ◽  
Saeed Mardani ◽  
Afsaneh Malekpour ◽  
Farzaneh Kadkhodaei Elyaderani ◽  
Fatemeh Salehi Choliche ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Serum Creatinine ◽  
Coronary Artery Bypass Graft ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Kidney Injury ◽  
High Ability ◽  
Urinary Ngal ◽  
Artery Bypass Graft ◽  
Significant Difference

Introduction: Serum creatinine level is currently being used as an indicator to detect acute kidney injury (AKI) after cardiac surgery, which is delayed and unreliable. Objectives: This study was conducted to determine the AKI in patients undergoing coronary artery bypass graft (CABG) surgery by measurement of urinary creatinine and plasma kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL). Patients and Methods: In this cross-sectional study, 96 patients undergoing CABG were divided based on their serum creatinine level of the fourth day after procedure into two groups of AKI (an increase of creatinine more than 0.3 mg/dl or more than 150 % of its baseline level) and non-AKI. In both groups urinary KIM-1 and urinary NGAL were measured on the first day of surgery (first 24 h). Results: No significant difference was observed in baseline creatinine between the two groups (P>0.05). However postoperative serum creatinine, creatinine changes, urinary NGAL and KIM1 showed significant difference between the groups (P<0.05). Serum creatinine was positively correlated with KIM-1 (r = 0.666, P<0.001) and NGAL (r = 0.660, P<0.001). KIM-1 and NGAL had high ability to detect AKI [area under the ROC (receiver operating characteristic) curve of 0.929 and 0.838, respectively]. The NGAL at cut-off point of 97.4 had 86% sensitivity and 80% specificity and KIM-1 at cut-off point of 14.8 had 84% sensitivity and 89% specificity. Conclusion: KIM-1 and NGAL had high ability to detect AKI. However, KIM-1 had higher detection ability than that of NGAL.

scholarly journals Outcome of off-pump coronary artery bypass graft (OPCAB) surgery: Analysis of 129 cases

2016 ◽  
Vol 31 (1) ◽  
pp. 23-25
Author(s):  
AKM Manzurul Alam ◽  
Istiaq Ahmed ◽  
Manzil Ahmed ◽  
Al Mamun Hossain
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Cabg Surgery ◽  
Off Pump ◽  
Opcab Surgery ◽  
Pump Coronary Artery Bypass

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, including Bangladesh. Besides medical and interventional treatment, coronary artery bypass graft (CABG) surgery in an effective modality for the management of a subset of CAD patients. Off-pump coronary artery bypass graft (OPCAB) surgery is a recent modification of conventional CABG surgery, which, like other parts of the world, is being increasingly practiced in Bangladesh. But the outcome of this relatively recent surgical approach in our setting is largely unknown. In this study, the outcomes of 129 cases off-pump CABG surgery done in a tertiary cardiovascular centre and a private institute in Dhaka were analyzed. Majority (67, 54.2%) had triple vessel disease (TVD), while 4 (3.2%) patients had left main disease. One, two and three grafts were used in 17 (13.2%),74 (57.4%) and 38 (29.4%) cases respectively. There was no mortality. Post-operative complications occurred in 17 (13.18%) patients; secondary wound infection in 10 (7.75%) and immediate respiratory distress in 7 (5.43%) cases. Ten (7.75%) patients needed secondary stitches.Bangladesh Heart Journal 2016; 31(1) : 23-25

Outcomes and Predictors of Mortality and Stroke after On-Pump and Off-Pump Coronary Artery Bypass Surgery in Octogenarians

2013 ◽  
Vol 8 (4) ◽  
pp. 269-275 ◽  
Author(s):  
Shahzad G. Raja ◽  
Jaymin Shah ◽  
Manoraj Navaratnarajah ◽  
Fouad Amin ◽  
Mohamed Amrani
Keyword(s):  
Coronary Artery ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Mortality And Morbidity ◽  
Off Pump ◽  
Predictors Of Mortality ◽  
Major Complications ◽  
Significant Difference ◽  
Pump Cabg

Objective Octogenarians, as the fastest growing stratum of the population and with the highest prevalence of coronary artery disease, are being increasingly referred for coronary artery bypass grafting (CABG). The general perception is that the presence of comorbidities and the propensity for neurological injury expose them to a higher risk for mortality and morbidity after conventional on-pump CABG, and therefore, off-pump CABG should be preferentially offered to octogenarians to improve outcomes. This study evaluates the in-hospital outcomes and predictors of mortality and stroke in octogenarians undergoing on- and off-pump CABG at our institution. Methods From January 2000 to December 2010, a total of 290 octogenarians underwent off-pump (n = 217) and on-pump (n = 73) CABG. Their data were prospectively entered into the cardiac surgery database (Patients Analysis & Tracking System; Dendrite Clinical Systems, Ltd, Oxford, England, United Kingdom) and analyzed retrospectively. Outcome measures included in-hospital mortality, major complications, and length of stay. Multivariate analysis was performed to identify predictors of combined outcome of in-hospital mortality and stroke. Results The mean ± SD age of the patients was 82 ± 2.0 years. Preoperative demographics were similar for the on-pump and off-pump groups. The patients who underwent off-pump CABG had a lower number of distal anastomoses performed compared with the patients who underwent on-pump CABG [mean difference, 0.2; 95% confidence interval (CI), 0.02–0.4; P = 0.03]. However, the ratio of grafts (received/needed) was the same in both groups. In-hospital mortality for the entire cohort was 7.2%, with no significant difference between the groups for death (6.0% vs 11.0%; P = 0.08), stroke (2.8% vs 2.8%; P = 1.0), other major complications, and length of hospital stay. Independent predictors of combined outcome identified from the multiple logistic model included heart failure [odds ratio (OR), 4.4; 95% CI, 1.5–13.0; P = 0.008], diabetes (OR, 2.6; 95% CI, 1.0–6.0; P = 0.046), nitrate infusion (OR, 2.9; 95% CI, 1.1–8.0; P = 0.04), postoperative renal failure requiring hemofiltration (OR, 8.6; 95% CI, 3.5–21.1; P < 0.001), and postoperative ventricular arrhythmias (OR, 7.3; 95% CI, 1.9–27.8; P = 0.009). Conclusions Both on-pump and off-pump CABG are reasonable revascularization strategies in octogenarians. Careful patient selection and individualized treatment decisions can minimize postoperative mortality and morbidity in octogenarians undergoing on- and off-pump CABG.

scholarly journals Letter to the Editor Chronic kidney disease in patients with significant left main coronary artery disease qualified for coronary artery bypass graft operation

2015 ◽  
Vol 2 ◽  
pp. 446-452 ◽  
Author(s):  
Malgorzata Zalewska-Adamiec ◽  
Hanna Bachorzewska-Gajewska ◽  
Jolanta Malyszko ◽  
Jacek S. Malyszko ◽  
Pawel Kralisz ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Left Main ◽  
Main Coronary Artery Disease ◽  
Artery Disease

scholarly journals Cardiovascular complications and acute ischemic stroke after the treatment with epinephrine in an anaphylactic patient

2019 ◽  
Vol 5 (1) ◽  
pp. 32-34
Author(s):  
Ataman Köse ◽  
Akif Yarkaç ◽  
Gülten Bozali ◽  
Seyran Bozkurt Babuş ◽  
Ersin Altınsoy
Keyword(s):  
Coronary Artery ◽  
Emergency Service ◽  
Case Reports ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cardiovascular Complications ◽  
Acute Ischemia ◽  
Epinephrine Administration ◽  
Cerebrovascular Complications ◽  
Artery Disease

Anaphylaxis is a serious clinical condition that can affect all ages and many systems (skin, gastrointestinal system, respiratory and cardiovascular systems). There are a few case reports of cardiac and cerebrovascular complications due to the anaphylaxis and/or the treatment with epinephrine. A 69-year-old female patient with known coronary artery disease (CAD), coronary artery bypass graft (CABG), and diabetes mellitus (DM) was admitted to the emergency department. She was brought to the emergency service with the complaints of shortness of breath, swelling of the tongue and lip, widespread itching and nausea after the use of amoxicillin-clavulonic acid due to soft tissue infection. The patient was considered as having anaphylaxis. 0.5 mg intramuscular (IM) epinephrine was administered. Following the emergency electrocardiography (ECG), the rate was 140/min and the rhythm was evaluated as atrial fibrillation. We present a case of cardiovascular complications and acute ischemia stroke following intramuscular epinephrine administration with anaphylactic diagnosis in this study. As a result, anaphylaxis management is extremely important in elderly patients with preexisting cardiovascular conditions.

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