scholarly journals Postoperative morbidity differences between proximal and distal knee saphenous harvesting in coronary artery bypass graft surgery

2021 ◽  
Vol 6 (2) ◽  
pp. 131-135
Author(s):  
Ismail Selçuk ◽  
◽  
Nehir Selçuk ◽  
Bülent Barış Güven
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Artery Bypass ◽  
Wound Complications ◽  
Compression Stocking ◽  
Compression Stockings ◽  
Group A ◽  
Group B ◽  
Level Group

Objectives. Coronary artery bypass grafting (CABG) is the most common procedure in cardiac surgery and the great saphenous vein (GSV) are the preferred conduits. The effects of saphenous vein incision (SVI) harvesting site choice on SVI wound complications, pretibial edema, and the need for compression stockings were evaluated retrospectively in patients undergoing CABG surgery. Materials and Methods. A total of 1900 patients operated for CABG between 2003 and 2021 in our clinic were included in this study, with GSV harvest performed at below-knee level (Group-A, n:841) and above-knee level (Group-B, n:1059). SVI was made 2 cm superior and 1 cm anterior to the medial malleolus in group-A; and 3 cm superior to medial epicondyle, extending to 3 cm inferior to the inguinal ligament in group-B. Examination for edema was made with 4-5 seconds of thumb pressure at the ankle level, then the depth of the pit was measured. Results. Ankle edema (Group-A n:132, Group-B n:25), the use of compression stockings (Group-A n:97, Group-B n:13), and paresthesia (Group-A n:51, Group-B n:10) were different between the two groups and the differences were statistically significant. However, prolonged wound healing (Group-A n:11, Group-B n:38), superficial wound infection (Group-A n:6, Group-B n:11), hematoma (Group-A n:4, Group-B n:9), and lymphorrhea (Group-A n:4, Group-B n:7) incidences were not statistically different between the two groups. Conclusions. Among patients with GSV extracted using the open conventional surgery technique, pretibial edema, paresthesia, and compression stocking use were observed less frequently in patients with preoperative doppler-ultrasonography evaluation and above-knee saphenous harvest.

scholarly journals Predictors of Atrial Fibrillation following Coronary Artery Bypass Grafting

2011 ◽  
Vol 5 ◽  
pp. CMC.S7170 ◽  
Author(s):  
Feridoun Sabzi ◽  
Abdol Hamid Zokaei ◽  
Abdol Rasoul Moloudi
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Univariate Analysis ◽  
Bypass Graft ◽  
Multivariate Logistic Regression Analysis ◽  
Categorical Variables ◽  
Group A ◽  
Group B

Background Atrial fibrillation (AF) is a frequent and serious complication of coronary artery bypass graft (CABG) surgery. Methods: We undertook a retrospective review of the records of patients undergoing CABG at Imam Ali Hospital between February 1, 2003 and February 1, 2006. The patients were divided in two groups, ie, Group A (AF) and Group B (no AF). The association between the occurrence of AF following CABG and other variables was compared with respect to continuous or categorical variables by t-test and χ2-test. Results Multivariate logistic regression analysis of potentially predictive factors in univariate analysis showed that opium use, type of operation, and crossclamp time were predictors of AF following CABG. Conclusion This study identifies some new predictors of postoperative AF, control of which could lead to a lower incidence of AF and reduced morbidity, mortality, and resource utilization for patients undergoing cardiac surgery.

scholarly journals Bisoprolol Versus Corticosteroid and Bisoprolol Combination for Prevention of Atrial Fibrillation After On-Pump Coronary Artery Bypass Graft Surgery

2019 ◽  
Vol 13 (1) ◽  
pp. 18-24
Author(s):  
Ramy Mahrose ◽  
Ahmed M. Elsayed ◽  
Mohamed S. Elshorbagy
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Group A ◽  
Pump Coronary Artery Bypass ◽  
Group B

Background:The most common cardiac arrhythmia that happens after on-pump Coronary Artery Bypass Graft (CABG) surgery is Atrial Fibrillation (AF). It is combined with several postoperative complications such as increased incidence of stroke, increased hospital stay and increased costs.Objectives:The aim of this study was to look for safe, effective, reliable and well tolerated tools for the prevention of atrial fibrillation after on pump coronary artery bypass surgery.Patients and Methods:The study enclosed 176 patients (the age ranges from 40 to 79 years) and scheduled for elective on-pump CABG operations without concomitant procedures. The patients were selected randomly into two equal groups. Group (A) in which bisoprolol was used to prevent atrial fibrillation after surgery. Group (B) in which bisoprolol and hydrocortisone were used for prevention of atrial fibrillation after surgery. For each patient, the following data were collected: gender, preoperative diseases, cardiopulmonary bypass time, intraoperative cross clamp time, Left internal mammary Artery usage, incidence of postoperative atrial fibrillation, death, myocardial infarction chest infection and C-reactive protein amount in plasma.Results:There was a statistically significant decrease in the occurrence of atrial fibrillation in group (B) when compared to corresponding values in group (A). Also, group (B) showed a statistically significant decrease in length of hospital stay in comparison to group (A). C-reactive protein concentrations on the 1stand 2ndpostoperative days were lower significantly in group (B) than in group (A). There were no statistically significant differences between both groups regarding gender, preoperative diseases, cardiorespiratory bypass time, intraoperative cross clamp time, Left internal mammary artery usage, death, myocardial infarction and chest infection.Conclusion:This study demonstrated that using bisoprolol and hydrocortisone combination showed greater benefit than the use of bisoprolol only for prevention of postoperative AF after on-pump coronary artery bypass graft surgery.

scholarly journals Effect of Pre-operative Amiodarone on Atrial Fibrillation after Off-Pump Coronary Artery Bypass Surgery

2018 ◽  
Vol 33 (1) ◽  
pp. 67-73
Author(s):  
AKM Manzurul Alam ◽  
Istiaq Ahmed ◽  
Manzil Ahmad ◽  
Abdullah Al Mamun Hossain ◽  
Md Mohashin Reza ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Serum Electrolytes ◽  
Off Pump ◽  
Function Test ◽  
Group A ◽  
Pump Coronary Artery Bypass ◽  
Group B

Background: Atrial Fibrillation (AF) is common in early recovery period after cardio-thoracic surgery. There have been several pharmacological and nonpharmacological strategies suggested for prevention against AF after coronary artery bypass grafting. The purpose of this study was to evaluate the effect of oral amiodarone in the prevention of atrial fibrillation in patients who underwent off pump coronary artery bypass graft (OPCAB).Methods: This interventional study was conducted from February 2017 to January 2018 in the department of cardiac surgery, National Institute of Cardiovascular Disease (NICVD) Dhaka, Bangladesh. By purposive sampling a total of 100 patients having sinus rhythm who will undergo OPCAB were selected for the study. Among them 50 patients (Group-A) got amiodarone (600mg/day started 3 days prior to surgery) and 50 patients (Group-B) did not get amiodarone. Two (2) patients of group-A were excluded from the study due to conversion to on pump from off pump during operation. So, finally group A had 48 patients and group- B had 50 patients. Preoperative electrocardiography (ECG), serum electrolytes (e.g. potassium & magnesium), thyroid function test, liver function test and echocardiogram were done in all patients under study. Per-operative occurrence of AF was assessed on operation theatre monitor. Each patient was evaluated by continuous ECG up to 5th post-operative day (POD). Serum potassium & magnesium were measured in every alternative day up to 5th POD. ECG with long lead tracing was done for all patients on the day of hospital discharge & was recorded. Data were analyzed by SPSS 24.0 (Statistical Package for the Social Sciences) and tested by student T-test and Chi-square test. P < 0.05 was considered significant.Results: Pre-operative baseline characteristics were similar in both groups. Per-operative and postoperative AF occurred more frequently in group B than group A. Those were 10(20.83%) and 32(64.0%) peroperative, 9(18.75%) and 31(36.0%) immediate postoperative period respectively in group A and group B. The result was statistically significant (P value<.05). Post-operative amiodarone used in all patients who developed AF irrespective of groups. This also decreased AF significantly. There were statistically no significant difference found in postoperative serum electrolytes and use of inotropes, anti-arrhythmic drugs. All patients recovered well.Conclusion: This study concluded that preoperative oral administration of amiodarone can prevent the occurrence of atrial fibrillation in patients undergone Off Pump Coronary Artery Bypass (OPCAB).Bangladesh Heart Journal 2018; 33(1) : 67-73

Effects of Intravenous Triiodothyronine during Coronary Artery Bypass Surgery

2002 ◽  
Vol 10 (3) ◽  
pp. 219-222 ◽  
Author(s):  
Mustafa Güden ◽  
Belhhan Akpinar ◽  
Ertan Sagğbaş ◽  
İlhan Sanisoğlu ◽  
Emine Cakali ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Double Blind Study ◽  
Group A ◽  
Group B

A prospective randomized and double-blind study was performed to evaluate whether perioperative triiodothyronine administration has any effect on cardiovascular performance after coronary artery bypass surgery. Sixty patients were assigned to 2 groups of 30 each. When crossclamping ended, group A received an intravenous bolus of triiodothyronine, followed by infusion for 6 hours. Group B received a placebo. Serum triiodothyronine levels and hemo-dynamic parameters were serially measured. Mean postoperative cardiac index was slightly, but not significantly, higher in group A, whereas systemic vascular resistance was significantly lower in group A. Compared with preoperative values, serum triiodothyronine levels dropped significantly in group B at the end of cardiopulmonary bypass and remained low 12 hours postoperatively, while levels rose significantly in group A. No significant differences were detected between the groups in the incidence of arrhythmia, the need for inotropic support, intensive care unit stay, mortality, and morbidity. Perioperative administration of triiodothyronine increased cardiac output slightly and decreased systemic vascular resistance, but it had no effect on operative outcome. Routine use after coronary surgery is thus not recommended.

Antegrade-Retrograde Cardioplegia for Myocardial Protection during Coronary Artery Bypass Graft Surgery

1998 ◽  
Vol 6 (3) ◽  
pp. 188-194
Author(s):  
Tarek A Abdel Aziz ◽  
Najib Al Khaja ◽  
Mohamed A Ali ◽  
Ali S Maklad ◽  
Mohamed F Bassiouny ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Myocardial Damage ◽  
Artery Bypass Graft ◽  
Retrograde Cardioplegia ◽  
Group A ◽  
Group B

This prospective randomized clinical study was designed to assess and compare the use of combined antegrade-retrograde cardioplegia versus antegrade cardioplegia in providing adequate myocardial preservation during coronary artery bypass graft surgery. Fifty patients undergoing elective coronary artery bypass grafting were randomly divided into 2 groups according to the route of cardioplegic delivery: group A (25 patients) received antegrade cold crystalloid cardioplegia; group B (25 patients) received combined antegrade-retrograde cold crystalloid cardioplegia. The groups were compared by clinical and electrocardiographic criteria and biochemical markers of ischemic myocardial damage. There was a highly significant statistical difference between the groups in terms of spontaneous recovery of sinus rhythm (40% of patients in group A versus 96% in group B). The use of direct current shock to restore sinus rhythm was higher in group A (60%) compared with group B (4%). Low cardiac output occurred in 20% of patients in group A and in 16% of patients in group B but this difference was not statistically significant. No bundle-branch block was found in group B whereas the incidence was 8% in group A. Significantly higher levels of biochemical markers of myocardial damage were obtained in group A at 10 minutes, 4 hours, and 12 hours after declamping. These results indicate that combined antegrade-retrograde cardioplegia is superior to antegrade cardioplegia for myocardial protection during coronary artery bypass graft surgery.

Incidence and Clinical Implications of Postoperative Atrial Fibrillation in patients Undergoing On-Pump and Off-Pump Coronary Artery Bypass Grafting

2021 ◽  
Vol 15 (6) ◽  
pp. 1216-1217
Author(s):  
U. Ullah ◽  
A. Ahmad ◽  
M. A. R. Mirza ◽  
W. Rehman ◽  
M. Mehmood
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Postoperative Atrial Fibrillation ◽  
Clinical Implications ◽  
Off Pump ◽  
Group A ◽  
Pump Cabg ◽  
Group B

Aim: Post-operative incidence and clinical implications of atrial fibrillation in patients having on-pump and off-pump CABG. Place of Study: Department of Cardiovascular & Thoracic Surgery, Shaikh Zayed Hospital, Lahore. Study Duration: 1 year Design of Study: Quasi-experimental study Methodology: 140 cases were selected. Non-probability purposive sampling technique was used. Grouping: Group A (Off-pump) and Group B (On-pump). Results: In group A, cases showed atrial fibrillation and in group B 23(32.9%) cases were noted. The incidence of postoperative atrial fibrillation was low in off-pump CABG as compare to on pump CABG.Clinical implications of postoperative AF such as, length of ICU & hospital stay, cerebrovascular events, wound infections and mortality of the cases are significantly reduced by using off-pump CABG. Conclusion: Incidence of P/O atrial fibrillation is low in off-pump CABG as compare to on pump CABG Keywords: Coronary Artery Bypass Graft (CABG), Atrial Fibrillation, on pump CABG.

Thoracoscopic Transmyocardial Laser Revascularization: Is Prior Coronary Artery Bypass Grafting a Contraindication?

2007 ◽  
Vol 2 (3) ◽  
pp. 112-115 ◽  
Author(s):  
Gary S. Allen ◽  
Jason Budde
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Airway Injury ◽  
Transmyocardial Laser Revascularization ◽  
Port Access ◽  
Group A ◽  
Group B

Objective Recently, thoracoscopic techniques have been used to perform transmyocardial laser revascularization (TMR) in patients who are not suitable candidates for coronary artery bypass graft (CABG) surgery or percutaneous coronary interventions. Whether or not prior CABG contraindicates a port access–only approach to TMR is unclear. This study compares patients with and without prior CABG who have undergone thoracoscopic TMR. Methods Between May 2003 and October 2005, 23 consecutive patients (6 without prior CABG, group A; and 17 with prior CABG, group B) underwent thoracoscopic TMR, using a holmium:yttriumaluminum-garnet (Ho:YAG) laser system. Either 3 or 4 port incisions (each ≤2 cm in length) were used, depending on the patient's anatomy. Procedural success was defined as the ability to create all intended channels without conversion to thoracotomy. Results Patient demographics were not significantly different between group A and group B (mean age, 65.8 ± 4.3 years versus 67.4 ± 2.4 years, Canadian Cardiovascular Society angina class 3.7 ± 0.2 versus 3.9 ± 0.1, and Parsonnet score 12.0 ± 3.2 versus 20.5 ± 2.4). Fourteen (82.4%) group B patients had a prior left internal mammary artery to left anterior descending artery graft, of which 12 (85.7%) were patent. One patient in group A had an airway injury at intubation that led to an extended hospital stay of 30 days. One patient in group A (16.7%) and one patient in group B (5.9%) required a blood transfusion (P = NS). Adhesion lysis time in group B ranged from 0 to 68 minutes (mean, 27 ± 5.6 minutes). Neither group had a conversion to thoracotomy or any deaths through a mean combined follow-up of 12 months. Conclusions A port access approach is safe and reproducible for patients who are candidates for sole therapy TMR. Prior CABG, including patent grafts, is not a contraindication to thoracoscopic TMR.

Conventional haemofiltration during routine coronary bypass surgery

Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Ronald M Babka ◽  
James Petress ◽  
Richard Briggs ◽  
Robert Helsel ◽  
John Mack
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Postoperative Blood Loss ◽  
Group A ◽  
The Mean ◽  
Group B

The use of conventional ultrafiltration during cardiopulmonary bypass (CPB) has been well recognized as an efficient modality of therapy to reverse the effects of deliberate haemodilution. Routine use of the haemofilter was prospectively studied on 60 patients undergoing coronary artery bypass surgery. Group A consisted of 30 patients on whom the ultrafiltrator was used and compared to group B who did not receive the ultrafiltration technique. The COBE 1200 ultrafiltration device was used. The results of the study demonstrated that, in group A, the mean total amount of ultrafiltrate collected during bypass was 2510 ± 804 ml per patient. The mean 24-h postoperative blood loss was 440 ± 192 ml in group A and 451 ± 136 ml in group B. The average bank blood transfused was 0.6 ± 1.3 units per patient in group A and 0.75 ± 1.5 units per patient in group B. Postoperative weight gain in group A averaged 3.5 ± 3.45 lb per patient, compared to 4.8 ± 3.7 lb per patient in group B. Postoperative length of stay averaged 6.4 ± 1.5 days per patient in group A and 6.4 ± 2.1 days per patient in group B. Overall patient charges averaged $33 706 ± 8348 per patient in group A and $33 041 ± 7674 per patient in group B. It was concluded that routine use of ultrafiltration during routine coronary artery bypass surgery with CPB offers no improvement in the quality of care nor does it decrease the patient’s overall charges.

scholarly journals Effect of Adenosine on Myocardial Protection as an Adjunct to Cardioplegia during Coronary Artery Bypass Surgery

2018 ◽  
Vol 14 (1) ◽  
pp. 21-23
Author(s):  
Md Rumman Idris ◽  
MA Quashem ◽  
Md Kamrul Hasan ◽  
Md Rezaul Karim
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Myocardial Protection ◽  
Artery Bypass ◽  
High Potassium ◽  
Postoperative Arrhythmia ◽  
Blood Cardioplegia ◽  
Cold Blood ◽  
Group A ◽  
Group B

Background: Adenosine (ADO) has been known to have beneficial effects against tissue injury after myocardial ischemia. So, this study was carried out to investigate the cardio protective effect of exogenous ADO pretreatment as an adjunct to cold blood cardioplegia during coronary artery bypass surgery.Materials and methods: 50 patients (25 in each group) with coronary artery disease undergoing CABG were randomly assigned to both groups: Group A received regular institutional high-potassium ([K+] 20 mol/ 1) cold (12 °C) blood cardioplegia and Group B received 250 ug/ kg adenosine pretreatment followed by antegrade high-potassium cold (12 °C) blood cardioplegia after clamp-on. Clinical outcomes were observed before, during and after the operation.Results: There was no difference regarding operative parameters in two groups. Time to arrest was significantly shorter in group B compared to Group A, indicating that adenosine has the potential to enhance the efficacy of cardioplegic arrest. Plasma level markers of myocardial damage: cardiac Troponin I (cTnl) obtained from serial venous blood samples were significantly lower in group B during cTnl at 10 min after declamping of cross clamp and 12 hours post-operative period than group A. There was significantly decreased requirement of inotrope in group B during 1st 24 hrs. Other postoperative outcomes (mechanical ventilation, ICU stay, postoperative arrhythmia and in hospital mortality were similar in both groups.Conclusion: Decreased level of cardiac enzymes and lower inotropic requirement suggests that a optimal myocardial protection with less cellular damage is obtained with adenosine pretreatment as adjunct to cold blood cardioplegia.University Heart Journal Vol. 14, No. 1, Jan 2018; 21-23

scholarly journals Simulation Training in Minimally Invasive Direct Coronary Artery Bypass Grafting

2020 ◽  
Vol 23 (6) ◽  
pp. E774-E780
Author(s):  
Song Wu ◽  
Yuan-hao Fu ◽  
Hong Zhao ◽  
Yun-peng Ling
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Simulation Training ◽  
Artery Bypass ◽  
Simulator Training ◽  
Bypass Grafting ◽  
Group A ◽  
Group B

Background: To evaluate the effect of minimally invasive direct coronary artery bypass (MIDCAB) simulator for cardiac residency training. Methods: A total of 26 resident surgeons who had never trained for coronary artery anastomosis participated in this training program. They received coronary artery anastomosis training on off-pump coronary artery bypass grafting (OPCAB) simulator for 15 h. After training, their performance of anastomosis was evaluated on the OPCAB simulator according to 12 items and a 5-point global rating scale. Based on the total score of assessment, those with an individual score of 12-36 formed group A, while group B was composed of the remaining trainees. The two groups then received another 15 h coronary artery anastomosis training on the MIDCAB simulator, and the performance was assessed. Results: Trainees improved their performance of coronary artery anastomosis after training on the OPCAB simulator. Group A was composed of 7 trainees with an individual with a total score of 12–36 points and group B was composed of the remaining 19 trainees. After MIDCAB simulator training, significant differences were noted in the pre- and post-training values in the A group (P < .001), and the assessment value of group A was significantly better than those of group B (P < .05). No significant difference was detected between pre- and post-training values in group B after MIDCAB simulator training (P > .05). Conclusion: We concluded that trainees who performed well in OPCAB simulation training can also perform better in MIDCAB, and our designed MIDCAB simulator was useful for residency training.

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