scholarly journals Echocardiographic parameters of left ventricular non-systolic function predict length of stay following coronary artery bypass graft -- a prospective observational study

2021 ◽  
Author(s):  
samhati Mondal ◽  
Nauder Faraday ◽  
Weidong Gao ◽  
Sarabdeep Singh ◽  
Sachidanand Hebbar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Hospital Stay ◽  
Coronary Artery Bypass ◽  
Prospective Observational Study ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Echocardiographic Parameters ◽  
Systolic Phase

Background: Abnormal left ventricular (LV) echocardiographic parameters during non-systolic phase, with or without a diagnosis of heart failure, is a common finding that can be easily diagnosed by intra-operative transesophageal echocardiography (TEE). However, its association with duration of hospital stay after coronary artery bypass (CAB) is unknown. Objective: To determine if Abnormal left ventricular (LV) echocardiographic parameters during non-systolic phase is associated with length of hospital stay after coronary artery bypass surgery (CAB). Method: Prospective observational study at a single tertiary academic medical center Result: Median time to hospital discharge was significantly longer for subjects with abnormal left ventricular (LV) echocardiographic parameters during non-systolic phase (9.1/IQR 6.6-13.5 days) than those with normal LV non-systolic function (6.5/IAR 5.3-9.7days) (P< 0.001). The probability of hospital discharge was 34% lower (HR 0.66/95% CI 0.47-0.93) for subjects with abnormal LV function even during non-systole despite a normal LV systolic function, independent of potential confounders, including a baseline diagnosis of heart failure Conclusions and Relevance: In patients with normal systolic function undergoing CAB, non-systolic LV dysfunction is associated with prolonged duration of postoperative hospital stay. This association cannot be explained by baseline comorbidities or common post-operative complications.

scholarly journals Preoperative Factors Influencing the Results of Coronary Artery Bypass Grafting with Reduced Left Ventricular Myocardial Contractility

2020 ◽  
pp. 38-42
Author(s):  
S. A. Rudenko ◽  
Y. V. Kaschenko ◽  
L. A. Klimenko ◽  
N. S. Osipenko ◽  
A. V. Rudenko ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Myocardial Contractility ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Myocardial infarction remains one of the most common causes of disability in patients. Prior myocardial infarction in 15–30% of cases leads to decrease in left ventricle (LV) contractility. Isolated drug therapy is ineffective in most cases – impressions of the coronary arteries require revascularization, including coronary artery bypass grafting. Data on the choice of optimal tactics in such patients is also limited. In addition, there is no consensus on the prognosis of mortality and management of this group of patients. Materials and methods. The study included 190 patients with the left ventricular ejection fraction (EF LV) of 35% or less, who underwent CABG at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine in the period from 01.01.2015 to 31.12.2018. The age of patients ranged from 29 to 83 years (61.13 ± 8.87). There were 170 men (89.47%) and 20 women (10.53%). Our data suggests that patients with low EF LV have complications typical of coronary artery bypass grafting, but the incidence of these complications is higher and increases with the EF LV decrease (except for the central nervous system (CNS) complications where there is no correlation). At the same time, such indicators as the duration of mechanical ventilation, the number of days of stay in the intensive care unit and the total number of days of stay in the hospital are increasing. The following complications most often arose in the postoperative period: acute heart failure, respiratory failure, renal failure. Based on our data, we came to the following conclusions: in patients with reduced LV myocardial contractility, the main complications after coronary artery bypass grafting were congestive heart failure, respiratory failure, renal failure and CNS complications. Among them, regardless of the level of EF LV, the most common were acute heart failure and complications of the respiratory system. The most significant factors of preoperative condition of patients with reduced LV myocardial contractility, which increase the risk of postoperative complications and increased mortality are: EF LV 30% and below, patient age over 60 years, creatinine rise to >200 mmol/L, pulmonary hypertension over 50 mmHg. Concomitant mitral regurgitation (moderate or severe) requires obligatory intraoperative correction.

scholarly journals Utility of perioperative B-type natriuretic peptide in off-pump bypass surgery

2014 ◽  
Vol 11 (1) ◽  
pp. 19-25
Author(s):  
Dikshya Joshi ◽  
Zhi Gang Guo
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Stay ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Background and Aims: This study was performed to determine clinical relevance of perioperative B-type natriuretic peptide (BNP) in patients undergoing off-pump coronary artery bypass grafting. Methods: 145 consecutive patients undergoing off-pump coronary artery bypass grafting during 8-month period were enrolled in this study. The relationship between the plasma BNP and various clinical parameters was examined. Postoperatively their main clinical endpoints including requirement of mechanical ventilator support, length of intensive care unit stay and hospital stay was closely monitored. Results: Mean preoperative BNP levels were significantly higher in patients whose left ventricular ejection fraction was less than 0.50 (P<0.00083), and New York Heart Association class (III, IV) (P<0.02). The determinants of preoperative higher level of BNP can be related to the advanced age of the patients, r=0.387 (P<0.01) and left ventricular end diastolic diameter, r=0.200 (P<0.05). Postoperative 12-hour BNP correlated significantly with the duration of mechanical ventilation, rho=0.84 (P<0.05), and postoperative hospital stay for 10 days or more, rho=0.202 (P<0.05). Logistic regression analyses showed a significant association between 12-hour BNP and the requirement of mechanical ventilation, Wald=3.956 (P<0.049, 95% CI_1.023- 20.476). Conclusion: Plasma BNP concentration is a valuable biochemical marker, is easy to measure and can effectively predict postoperative outcome in off-pump coronary artery bypass grafting. Baseline BNP had strong correlation with the age and ventricular function of the patient. Postoperatively, elevated 12-hour BNP indicated prolonged ventilation and longer duration of hospital stay. DOI: http://dx.doi.org/10.3126/njh.v11i1.10977   Nepalese Heart Journal 2014;11(1): 19-25

scholarly journals 462 Factors Associated with Longer Post-Operative Hospital Stay Following First Time Coronary-Artery-Bypass-Graft (CABG)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
L Ishak ◽  
K Morcos ◽  
P Curry
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Hospital Stay ◽  
Renal Dysfunction ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Left Ventricular ◽  
Artery Bypass Graft ◽  
First Time

Abstract Prolonged post-operative hospital stay is associated with worse patient healthcare outcomes. Aim To identify parameters which correlate with longer post-operative hospital stay (POHS) following first time Coronary-Artery-Bypass-Graft (CABG) Method Data was collected retrospectively on 50 patients who underwent a first time CABG between 12/02/2020 – 21/09/2020 at the Golden Jubilee National Hospital (GJNH). Data included patient demographics, body-mass-index (BMI), presence of co-morbidities, peri-operative blood results, pre-operative renal dysfunction, left ventricular systolic dysfunction (LVSD), severity of left main stem disease, New York Heart Association (NYHA) Functional Classification score, number of grafts, cross-clamp time and bypass time. Results The mean POHS was 7.5 days. Patients with a POHS&gt;7.5 days had a total mean POHS twice as long (12.07 vs 5.7 days, p &lt; 0.001). They spent more time in intensive care unit (2.6 vs 0.97 days, P = 0.05), high dependency unit (2.5 vs 1.2 days, p = 0.005) and ward (7 vs 3.5 days, p = 0.001) compared to the shorter POHS group. They had a higher mean age (69 vs 65, p = 0.036), lower mean CrCl (80.32 vs 95.14, p = 0.141), higher mean renal dysfunction severity grades (0.8 vs 0.28, p = 0.014), higher mean LVSD severity grades (0.33 vs 0.17, p = 0.35) and higher mean NYHA scores (2.2 vs 1.88, p = 0.17). More of the patients had renal dysfunction (p = 0.01), were on ≥ 2 anticoagulants (p = 0.028), had sub-optimal pre-operative bloods (p = 0.075) and required blood transfusion post-operatively (p = 0.02). One patient in the longer POHS group died. Conclusions Longer POHS was associated with older age, worse renal function, presence of co-morbidities, sub-optimal peri-operative blood levels and requirement for post-operative blood transfusions.

Ejection Fraction Recovery after Coronary Artery Bypass Grafting for Ischemic Cardiomyopathy

2021 ◽  
Author(s):  
Vasileios Ntinopoulos ◽  
Nestoras Papadopoulos ◽  
Dragan Odavic ◽  
Achim Haeussler ◽  
Omer Dzemali
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Ischemic Cardiomyopathy ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Ventricular Systolic Function

Abstract Background Controversy exists about left ventricular systolic function recovery after coronary artery bypass grafting in patients with ischemic cardiomyopathy. The aim of this study is to evaluate the temporal evolvement of left ventricular systolic function after coronary artery bypass surgery in patients with ischemic cardiomyopathy. Patients and Methods A total of 50 patients with coronary artery disease and left ventricular ejection fraction (LVEF) ≤35% underwent isolated coronary artery bypass grafting in a single center in the period 2017 to 2019. We performed a retrospective analysis of the echocardiographic and clinical follow-up data at 3 months and 1 year postoperatively. Results Median LVEF preoperatively was 25% (20–33%), mean patient age was 66 ± 8.2 years, 33 (66%) patients were operated off-pump, and 22 (44%) procedures were non-elective. There was no in-hospital myocardial infarction, stroke, and repeat revascularization. Three (6%) patients underwent re-exploration for bleeding or tamponade. In-hospital mortality was 8% and 1-year mortality was 12%. At 1 year postoperatively, there was no repeat revascularization, no myocardial infarction, 1 (2.6%) patient had a transient ischemic attack, and 10 (20%) patients required an implantable defibrillator. There was a statistically significant median ejection fraction increase at 3 months (15% [5–22%], p < 0.0001) and 1 year (23% [13–25%], p < 0.0001) postoperatively, with an absolute increase ≥10% in 32 (74.4%) and 30 (78.9%) patients at 3 months and 1 year, respectively. Conclusion Patients with ischemic cardiomyopathy undergoing coronary artery bypass surgery show continuous recovery of left ventricular systolic function in the first postoperative year.

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