Penatalaksanaan Fisioterapi Komprehensif Pada Kasus Pasca Coronary Artery By Pass Grafting Et Causa Coronary Artery Disease Involving 3 Vessels (CAD3VD): Case Report

Coronary heart disease is a malfunctioning of the heart caused by stenosis of the heart blood vessels which can affect one or more arteries. In these cases the patient had Triple Vessels Disease (3-VD), where there was ≥50-70% stenosis in most of the main branches of the heart blood vessels, then the patient underwent a revascularization operation Coronary Artery Bypass Grafting (CABG) with a postoperative condition, namely pain. in the sternum and lower right leg, accumulation of pulmonary sputum, decreased thoracic expansion, shortness of breath, decreased activity and functional ability. The management of physiotherapy that is given is chest physiotherapy and active and passive exercises in extremity. After 3 times of therapy, the results obtained from the degree of shortness of T0: 5 to T3: 3, the decrease in pain T0: 6 to T3: 3, then tenderness T0: 6 to T3: 3 and silent pain T0: 4 to T3: 3 increased the difference in thoracic expansion in the axilla T0: 1 cm becomes T3: 2 cm, at ICS T0: 1 cm changes to T3: 2 cm and there has been no increase in the xypoideus process, by 2 cm at T0 and T3. Activity and functional abilities were calculated using the Barthel index on T0 of the total dependency category, changing to T3: weight dependence. Chest physiotherapy and active-passive exercises in extremity can alleviate problems in post-CABG surgery.Keywords: Coronary Artery Bypass Grafting, Chest Physiotherapy, active and pasive exercise in extremity

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Aortic no-touch technique makes the difference in off-pump coronary artery bypass grafting

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2011.04.031 ◽

2011 ◽

Vol 142 (6) ◽

pp. 1499-1506 ◽

Cited By ~ 93

Author(s):

Maximilian Y. Emmert ◽

Burkhardt Seifert ◽

Markus Wilhelm ◽

Jürg Grünenfelder ◽

Volkmar Falk ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Off Pump ◽

The Difference ◽

Pump Coronary Artery Bypass

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Perioperative observation and study of blood flow of different bypass form in right coronary artery bypass grafting

10.21203/rs.3.rs-17758/v1 ◽

2020 ◽

Author(s):

Zhou Zhao ◽

Chun Fu ◽

Li-xue Zhang ◽

Guo-dong Zhang ◽

Yu Chen

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Right Coronary Artery ◽

Statistical Significance ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

The Difference ◽

The Right

Abstract Background: With the aging of China's population, the incidence and mortality of coronary atherosclerotic heart disease (CAD) are increasing year by year, which brings a heavy burden to the family and society [1]. To analyse the strategy of Coronary artery bypass grafting(CABG) in right coronary artery. To compare hemodynamic characteristics of the sequential grafts with those of single grafts and observe the patency rate of those grafts for one week after-operation.Methods: A total of 242 patients (178 male, mean age 62.6±8.8 years ) underment the right coronary artery bypass grafting in our hospital from October 2016 to January 2019 were collected. The blood flow (Q, ml/min) and pulsatility index (PI) and related parameters of grafts are measured and recorded by TTFM in CABG.The patency of grafts were evaluated by coronary computed tomography(CT) for one week after operation.Results: The most common material of graft in right coronary system of CABG is great saphenous vein(92.3%), followed by the radial artery and internal mammary artery. The highest frequency target of right coronary artery is posterior descending artery (PDA)(47.6%),followed by the Right main coronary artery (RCA )(29.1%) and Posterior branch of left ventricle (PL)(23.3%).The proportion of single graft is the largest in right coronary artery in CABG(178 cases，67.9%),followed by the proportion of the graft of PDA-PL (42cases，16.0%) and other sequential grafts among the different coronary artery system (including the system of Left anterior descending artery (LAD) and Left Circumflex (LCX)).The research shows that whether the sequential grafts of PDA-PL or with other sequential grafts among the different system of coronary artery the instantaneous flow of group of sequential grafts is higher than that of single graft, and the difference has statistical significance (P < 0.01) .But there was no statistical difference of the flow between groups of sequential grafts (P = 0.410).Diastolic flow (DF) in the group of sequential grafts of right coronary system is better than that in non-sequential group (P < 0.001), and the difference has statistical significance. There was no statistical difference between the DF of groups of other system of sequential grafts and that of right coronary sequential grafts .Coronary artery CT suggests that there was 11 cases existing poor development grafts or stenosis and occlusion in week after operation,and those phenomenon mainly occurred in the group of a single graft.There was only one case which be occluded in the group of other systems of sequential grafts, and statistically significant difference existed between two groups (P < 0.01).Conclusions: The most common form of CABG in right coronary artery system is non-sequential vein bridge to PDA in our center. Whether the sequential grafts of PDA-PL or other sequential grafts among the different coronary artery system the instantaneous flow of group of sequential grafts is higher than that of single graft. DF in the group of sequential grafts of right coronary system is better than that in non-sequential group.

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Do women benefit more than men from off-pump coronary artery bypass grafting?

Netherlands Heart Journal ◽

10.1007/s12471-019-01333-9 ◽

2019 ◽

Vol 27 (12) ◽

pp. 629-635 ◽

Cited By ~ 1

Author(s):

J. F. ter Woorst ◽

A. H. T. Hoff ◽

M. C. Haanschoten ◽

S. Houterman ◽

A. H. M. van Straten ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Off Pump ◽

Opcab Surgery ◽

The Difference ◽

Pump Coronary Artery Bypass

Abstract Objectives Outcomes after coronary artery bypass grafting (CABG) are worse in women than in men. This study aims to investigate whether off-pump coronary artery bypass (OPCAB) surgery improves the outcomes in women by comparing different outcome measures in both genders. Methods Patients who underwent isolated CABG, either on-pump (ONCAB) or OPCAB, between January 1998 and June 2017 were included. Primary endpoints were 30-day and 120-day mortality. Logistic regression models were constructed to evaluate the effect of the CABG technique on important outcomes such as mortality and the need for blood transfusion. Results The data of 17,052 patients were analysed, 3,684 of whom were women (414 OPCAB) and 13,368 men (1,483 OPCAB). The mean number of grafts was lower in the OPCAB group of both genders (p < 0.001). Postoperatively, both men and women undergoing OPCAB surgery received fewer red blood cell transfusions (p < 0.001) and had higher postoperative haemoglobin levels (p < 0.001) than those undergoing ONCAB. Early mortality occurred less frequently after OPCAB surgery in both genders, although the difference was not significant. However, 120-day mortality was significantly lower after OPCAB surgery in women, even after correction for preoperative risk factors [odds ratio (OR) = 0.356, 95% confidence interval (CI) 0.144–0.882, p = 0.026]. The difference in 120-day mortality was not significant in men (OR = 0.787, 95% CI 0.498–1.246, p = 0.307). Conclusions Women undergoing CABG benefit more from OPCAB surgery than from ONCAB surgery in terms of 120-day mortality. This difference was not found in men in our patient population.

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