scholarly journals Coronary Artery Bypass Grafting Complicated by Post-operative Coronavirus Infection -- Two Similar Presentations with Dissimilar Outcomes

2021 ◽  
Author(s):  
Siddharth Pahwa ◽  
Harideep Samanapally ◽  
Mike O. Udoh ◽  
Jiapeng Huang ◽  
Mark Slaughter
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Surgical Procedures ◽  
Artery Bypass ◽  
Case Series ◽  
Adverse Outcomes ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Increased Risk

Patients diagnosed with COVID-19 infection undergoing surgical procedures have been reported to have increased post-operative complications and mortality. These findings are important when considering cardiac surgical procedures, specifically coronary artery bypass grafting (CABG). This case series describes the clinical course following a CABG procedure in two patients that went on to develop COVID-19 infection post-operatively, having previously tested negative. We aim to illustrate the similarities in clinical presentation, but differences in eventual outcomes for both patients and hypothesize the reasons for the differences. Patients with comorbidities such as advanced age, diabetes mellitus, obesity, hypertension, and COPD are possibly at increased risk of adverse outcomes should they contract the infection, and special care should be taken in this population. Early institution of VV-ECMO may be beneficial, but further studies are needed in this matter.

Lowest hematocrit on bypass and adverse outcomes associated with coronary artery bypass grafting

2001 ◽  
Vol 71 (3) ◽  
pp. 769-776 ◽  
Author(s):  
Gordon R DeFoe ◽  
Cathy S Ross ◽  
Elaine M Olmstead ◽  
Stephen D Surgenor ◽  
Mary P Fillinger ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Adverse Outcomes ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

scholarly journals Prediction of Transfusions After Isolated Coronary Artery Bypass Grafting Surgical Procedures

2017 ◽  
Vol 103 (3) ◽  
pp. 764-772 ◽  
Author(s):  
Donald S. Likosky ◽  
Theron A. Paugh ◽  
Steven D. Harrington ◽  
Xiaoting Wu ◽  
Mary A.M. Rogers ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Surgical Procedures ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Postoperative depression in patients after coronary artery bypass grafting (CABG) – a review of the literature

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Paweł Stanicki ◽  
Julita Szarpak ◽  
Małgorzata Wieteska ◽  
Agnieszka Kaczyńska ◽  
Joanna Milanowska
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Response To Treatment ◽  
Bypass Grafting ◽  
Negative Consequences ◽  
Oxidative Stress Biomarkers ◽  
Artery Bypass Grafting ◽  
Increased Risk

<b>Introduction:</b> Ischemic heart disease is the most common cause of death in the world. The lives of patients with vascular defects can be saved by coronary artery bypass grafting (CABG). However, it is associated with an increased risk of developing depression after surgery. <br><b>Meterial and Methods:</b> The aim of the study is to present the results of the latest research on postoperative depression after CABG, including studies describing the course of the disease, its consequences for the patient’s prognosis and treatment. The publications available on the PubMed platform published after 2011 were reviewed. <br><b>Results:</b> Depression before and after CABG affects 30–40% of patients, mostly women. Established after surgery and untreated, it persists for many years. The level of anxiety in patients decreases systematically after surgery. Indicators that may correlate with the patient’s postoperative depression, including cortisol, high sensitivity C-reactive protein (hsCRP) and oxidative stress biomarkers, are being investigated. The occurrence of depression in patients after CABG has a number of negative consequences. Those include: weaker response to treatment, greater chance of relapse, and increased readmission frequency and mortality. Treatment of patients with this disorder involves the use of antidepressants (most often SSRIs – selective serotonin reuptake inhibitor) and/or various types of psychotherapy with cognitive behavioral therapy (CBT) at the forefront. <br><b>Conclusions:</b> Depression following CABG decreases the quality of life and worsens patient prognosis. It is necessary to detect this condition early after surgery and to apply treatment, taking into account the cardiological disorders of the patient.

Intraoperative Epiaortic Ultrasound Scanning Guides Operative Strategies and Identifies Patients at High Risk during Coronary Artery Bypass Grafting

2009 ◽  
Vol 4 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Jefferson M. Lyons ◽  
Vinod H. Thourani ◽  
John D. Puskas ◽  
Patrick D. Kilgo ◽  
Kim T. Baio ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Propensity Score ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Risk Of Death ◽  
Increased Risk ◽  
Grade 3

Objective Epiaortic ultrasound (EU) reliably reveals ascending aortic atherosclerosis (AAA), allowing strategies to minimize the risk of embolization or plaque disruption during coronary artery bypass grafting. Our objective was to delineate if EU-guided intervention improved outcomes. Methods Patients undergoing coronary artery bypass grafting (2004–2007) were categorized by EU grade (grade 1–2 [mild] vs. 3–5 [moderate/severe]) and the use of an aortic clamp. A propensity score estimated probability of clamp use was based on 45 risk factors. Multiple logistic regression models measured the association between outcomes—death, stroke, myocardial infarction, and major adverse cardiac and cerebrovascular events (MACCE)—and the primary variables (grade and clamp use), adjusted for propensity score. Results Grade was available in 4278 patients. Patients with grade 3 to 5 AAA had an increased risk of death (adjusted odds ratios (AOR) 3.11; P < 0.001), stroke (AOR 2.12; P < 0.001), and MACCE (AOR 2.58; P < 0.001). Aortic clamping (any clamp, all grades) led to a higher risk of stroke (AOR 2.77; P = 0.032). EU altered aortic manipulation in 530 patients (12.4%). In this group, patients with high grade aortas had similar rates of death, stroke or MACCE, when compared with patients with low-grade aortas. Conclusions EU alters surgical strategy. Patients with grade 3 to 5 AAA are at increased risk of death, stroke, and MACCE compared with patients with grade 1 to 2 AAA. Clamping the aorta (any grade) increases the risk for stroke. Aortic clamping should be avoided in patients with grade 3 to 5 AAA, but EU may minimize morbidity and mortality if a clamp must be used.

Early Antiplatelet Therapy in Coronary Artery Bypass Grafting a Calculated Benefit

2010 ◽  
Vol 5 (5) ◽  
pp. 317-325 ◽  
Author(s):  
Gregory D. Trachiotis
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Antiplatelet Therapy ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Bypass Grafting ◽  
Platelet Activity ◽  
Artery Bypass Grafting ◽  
Increased Risk

Studies have demonstrated that antagonists of platelet activity, including aspirin and clopidogrel, reduce the risk of major adverse events in patients with acute coronary syndromes. Although antiplatelet agents also convey an increased risk of bleeding, particularly in patients proceeding to coronary artery bypass graft surgery, in most cases, the benefits of early initiation of antiplatelet therapy outweigh the risks. The purpose of this review is to distinguish perceived and actual risk versus the benefit associated with early antiplatelet therapy to help clinicians make informed decisions on using these agents in an acute setting where patients may require coronary artery bypass grafting.

scholarly journals Role of Preexisting Proarrhythmic Atrial Remodeling in Post-Coronary Artery Bypass Grafting Atrial Fibrillation

2021 ◽  
Vol 31 (3) ◽  
pp. 597-607
Author(s):  
Alkora Ioana BALAN ◽  
◽  
Irina PINTILIE ◽  
Cristina SOMKEREKI ◽  
Marcel PERIAN ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
P Wave ◽  
Postoperative Outcomes ◽  
Atrial Remodeling ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Increased Risk

Introduction: Due to its deleterious effects, early identifi cation of patients at risk of postoperative AF (POAF) is of critical importance. Preexisting proarrhythmic atrial remodeling could contribute to this increased risk. Therefore, we aimed to evaluate the presence of preexisting proarrhythmic atrial remodeling and its impact on POAF occurrence in patients undergoing coronary artery bypass grafting (CABG). Methods: Data regarding atrial structural (atrial size and histology), electrical (P-wave and atrial action potential parameters, mRNA expression of several AF-related genes), and autonomic (heart rate variability parameters) proarrhythmic remodeling were compared between patients with (AF; n=11) and without (no-AF; n=19) POAF. Impact of POAF on postoperative outcomes was also evaluated. Results: No signifi cant difference was observed in atrial electrical parameters between the two groups (all p>0.05). However, compared with no-AF, AF patients had more important subepicardial adipose infi ltration (p=0.02) and higher markers of parasympathetic and sympathetic modulation (both p=0.03). Patients with POAF had longer hospital stay and more often presented postoperative renal dysfunction (both p=0.04). Conclusion: These fi ndings suggest that preexisting atrial structural (i.e., increased atrial subepicardial adiposity) and autonomic (i.e., sympatho-vagal coactivation) alterations could favor the occurrence of POAF. At its turn, POAF was associated with altered postoperative outcomes in CABG patients.

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