scholarly journals Off-pump coronary artery grafting in patients with reduced ejection fraction

Author(s):  
Jiechun Huang

The outcome of coronary artery bypass surgery depends on complete revascularization. In our paper, we attempt to demonstrate that Off-pump coronary artery bypass (OPCAB) is applicable to coronary heart disease patients with low LVEF. Low LVEF does not affect cardiac revascularization. Low LVEF is an independent risk factor for the outcome of CABG patients, but it does not mean that the OPCAB procedure leads to poor outcomes. In our hospital, we used on-pump CABG or conventional bypass surgery for coronary heart disease patients with low LVEF before 2010.With the accumulation of cases, OPCAB is now used in more than 95% of coronary artery bypass grafts in our center. Our data suggest that OPCAB is safe and reliable for patients with low LVEF.

2015 ◽  
Vol 96 (2) ◽  
pp. 170-174 ◽  
Author(s):  
S L Blashkova ◽  
A S Galyavich ◽  
E M Vasilevskaya

Aim. To study the prevalence and structure of periodontal disease in in-patients with coronary heart disease preparing for coronary artery bypass surgery.Methods. The study included 144 male in-patients with coronary heart disease who were prepared for coronary artery bypass surgery in the department of cardiac surgery. The diagnosis of periodontal disease was set according to the World Health Organization recommendations based on the comprehensive dental examination. Exclusion criteria were: diabetes mellitus, survived blood transfusions and all teeth missing. A prognostic model based on binary logistic regression method was created for estimation of risk factors on periodontal disease risk.Results.The prevalence of chronic generalized periodontitis in patients with coronary heart disease preparing for coronary artery bypass surgery reaches 73.6%. Mild (51.9%) and moderately severe (48.1%) chronic generalized periodontitis were the most common. Among the risk factors for periodontal disease patients, we have identified older age, smoking, hypertension and survived acute ischemic episodes. For the created model, χ2 value was assessed as 42.7, meaning statistical significance of pConclusion. In in-patients with coronary heart disease, prophylaxis for periodontal disease should be performed to decrease the risk for exacerbations. Using the created prognostic tool in clinical practice may be used for outlining patients with higher risk for periodontal disease.


2021 ◽  
pp. 021849232110195
Author(s):  
Vasileios Ntinopoulos ◽  
Nestoras Papadopoulos ◽  
Achim Haeussler ◽  
Dragan Odavic ◽  
Patricia Fodor ◽  
...  

Background Even though the physiological derangements caused by hypothermia are well described, there is no consensus about its impact on postoperative outcomes. The aim of this study is to assess the effect of postoperative hypothermia on outcomes after off-pump coronary artery bypass surgery. Methods A total of 1979 patients undergoing isolated off-pump coronary artery bypass surgery in a single center in the period 2007–2018 were classified according to their axillary temperature measurement at intensive care unit admission postoperatively to either hypothermic (<36°C) or normothermic (≥36°C). Between-group differences on baseline characteristics and postoperative outcomes were assessed before and after propensity score matching. Results Data analysis showed that 582 patients (29.4%) were hypothermic (median temperature 35.5°C) and 1397 patients (70.6%) were normothermic (median temperature 36.4°C). Using propensity score matching, 567 patient pairs were created. Patients with hypothermia exhibited a higher rate of postoperative transfusion of at least three red cell concentrate units (14.3% vs 9%, p = 0.005), a longer intubation duration (median duration, 6 vs 5 h, p < 0.0001), and a longer intensive care unit stay (median stay, 1.6 vs 1.3 days, p = 0.008). There was no difference in reoperation for bleeding, renal replacement therapy, infections, and mortality between the two groups. Conclusions Even though associated with a higher blood transfusion requirement and a slightly longer intensive care unit stay, mild postoperative hypothermia was not associated with a higher morbidity and mortality.


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