scholarly journals Comparative Evaluation of ‘Will Bleed, Papworth, Track and Trust’ Bleeding Risk Scores in Diabetic Isolated Coronary Bypass Graft Surgery Patients and Laying the Foundations for Optimum Risk Score for Bleeding After Coronary Bypass Graft Surgery

2021 ◽  
Author(s):  
engin akgül ◽  
Abdulkerim Ozhan
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Risk Score ◽  
Blood Product ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
Scoring Systems ◽  
Diabetic Patients ◽  
Coronary Bypass Graft

Background: One of the most undesired complications after open heart operations is bleeding. In our study, we set ourselves two different goals: examining ‘Papworth, Will-Bleed, Track and Trust’ bleeding scoring systems to determine the most predictive one among diabetic patients undergoing isolated coronary bypass surgery, and determining the variables that should be included in the new scoring systems to be established for this patient group. Methods: The files of 297 diabetic patients who underwent isolated coronary artery bypass operation between 2017-2019 were retrospectively reviewed. Patients who underwent emergency surgery with a beating heart, those with reoperated open hart surgery, those with ticagrelor use, and those who died within the first 24 postoperative hours were excluded from the study. Drainage from the thorax and mediastinal tubes and blood product transfusions to the patients within the first 24 hours were noted and analyzed according to scoring systems. Results: Scoring systems are evaluated based on ‘European Multicenter Study on Coronary Artery Bypass Grafting Bleeding Severity (E-CABG)’. In this study including diabetic patients only, Papworth was better predictive of E-CABG bleeding Grade 2-3. We found that Will-Bleed, Track, Trust, the other scoring systems we examined had discriminatory value in terms of E-CABG bleeding Grade 2-3 in our study group. Among the parameters in the scoring systems, we concluded that gender, preoperative hemoglobin (or hematocrit) value, preoperative platelet count, use of antiplatelets until less than five days prior to the operation, and preoperative creatinine (or eGFR) values should be included in the scoring system we aim to establish in the future, called the “Optimum Risk Score for Bleeding (ORS).” Conclusion: Considering the possible risks of bleeding and blood product transfusion, scoring systems that will provide accurate results for patient blood management will be lifesaving and increase the cost-effectiveness of the treatment.

scholarly journals Coronary-Coronary bypass graft as a safe and an alternative technique for revascularization of coronary arteries

2020 ◽  
Author(s):  
Reda Bzikha ◽  
Gautier Charles Henri
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
Respiratory Morbidity ◽  
Artery Bypass Graft ◽  
Coronary Bypass Graft ◽  
Conventional Coronary Artery Bypass

Coronary–coronary bypass graft was first performed by Rowland and Grooters. This technique can be performed between two segments of the same coronary artery using saphenous vein grafts or free arterial grafts in on/off-pump coronary artery bypass grafting, also can be an alternative safe technique in some cases as calcified ascending aorta, porcelain aorta and insufficient graft length. The coronarycoronary bypass graft can provide nearly the same flow rate as conventional coronary artery bypass graft, another advantage this technique is that we can use to decrease sternal and respiratory morbidity. we performed this technique to a 55-year-old woman to whom coronary angiography showed critical three-vessel disease, using a free segment of right internal mammary artery, combined to conventional coronary artery bypass graft. The postoperative course was uneventful with the absence of ischemic lesions and the grafts were patent at 6 months after procedure.

scholarly journals Subclavian-coronary bypass graft re-operation according to the MICS technique in a patient with angina relapse

2019 ◽  
pp. 94-96
Author(s):  
I. Yu. Sigaev ◽  
M. A. Keren ◽  
A. V. Kazaryan ◽  
I. V. Pilipenko ◽  
G. G. Getsadze
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Median Sternotomy ◽  
Coronary Bypass ◽  
Patient Comfort ◽  
Successful Implementation ◽  
Coronary Bypass Graft ◽  
Selection Of

Coronary artery bypass graft (CABG) using short-scar incision (without median sternotomy) allows minimizing the invasiveness of the intervention, reducing the risks of postoperative complications, and also ensuring patient comfort and quick social and physical rehabilitation. The successful implementation of such operations is due not only to surgical skills and the integration of technological achievements into practice, but also to the appropriate selection of patients. The article presents a clinical case of successful re-operation of the subclavian-coronary artery bypass grafting on a beating heart using antero-lateral thoracotomy approach in a patient with angina relapse after CABG.

Validation of Renal Risk Score Models for Coronary Artery Bypass Surgery in Diabetic Patients

2019 ◽  
Vol 28 (5) ◽  
pp. 800-806
Author(s):  
Mehmet Kalender ◽  
Taylan Adademir ◽  
Deniz Çevirme ◽  
Mehmet Atay ◽  
Kamil Boyacioglu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Risk Score ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Diabetic Patients

Obesity in Diabetic Patients Undergoing Coronary Artery Bypass Graft Surgery Is Associated with Increased Postoperative Morbidity

2006 ◽  
Vol 104 (3) ◽  
pp. 441-447 ◽  
Author(s):  
Wei Pan ◽  
Katja Hindler ◽  
Vei-Vei Lee ◽  
William K. Vaughn ◽  
Charles D. Collard
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Postoperative Outcomes ◽  
Diabetic Patients ◽  
Artery Bypass Graft ◽  
Increased Risk

Background Despite the fact that obesity is a known risk factor for cardiovascular disease, many studies have failed to demonstrate that obesity is independently associated with an increased risk of cardiovascular morbidity and mortality in nondiabetic patients undergoing coronary artery bypass graft surgery. The authors investigated the influence of obesity on adverse postoperative outcomes in diabetic and nondiabetic patients after primary coronary artery bypass surgery. Methods A retrospective cohort study of patients undergoing primary coronary artery bypass surgery (n = 9,862) between January 1995 and December 2004 at the Texas Heart Institute was performed. Diabetic (n = 3,374) and nondiabetic patients (n = 6,488) were classified into five groups, according to their body mass index: normal weight (n = 2,148), overweight (n = 4,257), mild obesity (n = 2,298), moderate obesity (n = 785), or morbid obesity (n = 338). Multivariate, stepwise logistic regression was performed controlling for patient demographics, medical history, and preoperative medications to determine whether obesity was independently associated with an increased risk of adverse postoperative outcomes. Results Obesity in nondiabetic patients was not independently associated with an increased risk of adverse postoperative outcomes. In contrast, obesity in diabetic patients was independently associated with a significantly increased risk of postoperative respiratory failure (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.41-3.61; P < 0.001), ventricular tachycardia (OR, 2.27; 95% CI, 1.18-4.35; P < 0.02), atrial fibrillation (OR, 1.56; 95% CI, 1.03-2.38; P < 0.04), atrial flutter (OR, 2.38; 95% CI, 1.29-4.40; P < 0.01), renal insufficiency (OR, 1.66; 95% CI, 1.10-3.41; P < 0.03), and leg wound infection (OR, 5.34; 95% CI, 2.27-12.54; P < 0.001). Obesity in diabetic patients was not independently associated with an increased risk of mortality, stroke, myocardial infarction, sepsis, or sternal wound infection. Conclusion Obesity in diabetic patients is an independent predictor of worsened postoperative outcomes after primary coronary artery bypass graft surgery.

Risk Score for Predicting In-Hospital/30-Day Mortality for Patients Undergoing Valve and Valve/Coronary Artery Bypass Graft Surgery

2013 ◽  
Vol 95 (4) ◽  
pp. 1282-1290 ◽  
Author(s):  
Edward L. Hannan ◽  
Michael Racz ◽  
Alfred T. Culliford ◽  
Stephen J. Lahey ◽  
Andrew Wechsler ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Risk Score ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft

scholarly journals Peroperative epicardial ultrasonography of distal coronary artery bypass graft anastomoses using a stabilizing device. A feasibility study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jan Jesper Andreasen ◽  
Dorte Nøhr ◽  
Alex Skovsbo Jørgensen ◽  
Poul Erik Haahr
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Learning Curve ◽  
Coronary Artery Bypass ◽  
Feasibility Study ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
Artery Bypass Graft ◽  
Pump Cabg

Abstract Background Widespread use of intraoperative epicardial ultrasonography (ECUS) for quality assessment of coronary artery bypass graft anastomoses during coronary artery bypass grafting (CABG) has not occurred - presumably due to technological and practical challenges including the need to maintain stable and optimal acoustic contact between the ultrasound probe and the target without the risk of distorting the anastomosis. We investigated the feasibility of using a stabilizing device during ultrasound imaging of distal coronary bypass graft anastomoses in patients undergoing on-pump CABG. Imaging was performed in both the longitudinal and transverse planes. Methods Single-centre, observational prospective feasibility study among 51 patients undergoing elective, isolated on-pump CABG. Ultrasonography of peripheral coronary bypass anastomoses was performed using a stabilizing device upon which the ultrasound transducer was connected. Transit-time flow measurement (TTFM) was also performed. Descriptive statistical tests were used. Results Longitudinal and transverse images from the heel, middle and toe were obtained from 134 of 155 coronary anastomoses (86.5%). After the learning curve (15 patients), all six projections were obtained from 100 of 108 anastomoses scanned (93%). Failure to obtain images were typical due to a sequential curved graft with anastomoses that could not be contained in the straight cavity of the stabilizing device, echo artefacts from a Titanium clip located in the roof of the anastomoses, and challenges in interpreting the images during the learning curve. No complications were associated with the ECUS procedure. The combined ECUS and TTFM resulted in immediate revision of five peripheral anastomoses. Conclusions Peroperative use of a stabilizing device during ultrasonography of coronary artery bypass anastomoses in on-pump surgery facilitates imaging and provides surgeons with non-deformed longitudinal and transverse images of all parts of the anastomoses in all coronary territories. Peroperative ECUS in addition to flow measurements has the potential to increase the likelihood of detecting technical errors in constructed anastomoses. Trial registration The study was registered on September 29, 2016, ClinicalTrials.gov ID: NCT02919124.

Sign in / Sign up

Export Citation Format

Share Document