Transitional Rehabilitation in CABG Patients

2019 ◽  
Author(s):  
Keyword(s):  
Cabg Patients

scholarly journals Cerebral microbleed distribution following cardiac surgery can mimic cerebral amyloid angiopathy

2021 ◽  
Vol 3 (2) ◽  
pp. e000166
Author(s):  
Michele De Sciscio ◽  
Paul De Sciscio ◽  
Wilson Vallat ◽  
Timothy Kleinig
Keyword(s):  
Cardiac Surgery ◽  
Valve Replacement ◽  
Cerebral Amyloid Angiopathy ◽  
Artery Bypass ◽  
Area Under The Curve ◽  
Subcortical White Matter ◽  
Amyloid Angiopathy ◽  
Receiver Operator Curve Analysis ◽  
Cerebral Amyloid ◽  
Cabg Patients

Background and aimsHaving anecdotally noted a high frequency of lobar-restricted cerebral microbleeds (CMBs) mimicking cerebral amyloid angiopathy (CAA) in patients with previous cardiac surgery (especially valve replacement) presenting to our transient ischaemic attack (TIA) clinic, we set out to objectively determine the frequency and distribution of microbleeds in this population.MethodsWe performed a retrospective comparative cohort study in consecutive patients presenting to two TIA clinics with either: (1) previous coronary artery bypass grafting (CABG) (n=41); (2) previous valve replacement (n=41) or (3) probable CAA (n=41), as per the Modified Boston Criteria, without prior cardiac surgery. Microbleed number and distribution was determined and compared.ResultsAt least one lobar-restricted microbleed was found in the majority of cardiac surgery patients (65%) and 32/82 (39%) met diagnostic criteria for CAA. Valve replacement patients had a higher microbleed prevalence (90 vs 51%, p<0.01) and lobar-restricted microbleed count (2.6±2.7 vs 1.0±1.4, p<0.01) than post-CABG patients; lobar-restricted microbleed count in both groups was substantially less than in CAA patients (15.5±20.4, p<0.01). In postcardiac surgery patients, subcortical white matter (SWM) microbleeds were proportionally more frequent compared with CAA patients. Receiver operator curve analysis of a ‘location-based’ ratio (calculated as SWM/SWM+strictly-cortical CMBs), revealed an optimal ratio of 0.45 in distinguishing cardiac surgery-associated microbleeds from CAA (sensitivity 0.56, specificity 0.93, area under the curve 0.71).ConclusionLobar-restricted microbleeds are common in patients with past cardiac surgery, however a higher proportion of these CMBs involve the SWM than in patients with CAA.

Factors associated with return to work after coronary artery bypass grafting (CABG)

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Raynaldo
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Coronary Artery ◽  
Return To Work ◽  
Coronary Artery Bypass ◽  
Functional Capacity ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Factors Associated ◽  
Cabg Patients

Abstract Funding Acknowledgements Type of funding sources: None. Background. Postoperative CABG patients will generally experience improvement in symptoms and functional capacity. Post-CABG patients are expected to be productive again in order to have a positive impact on both patient and the society socio-economically, in addition to other parameters such as morbidity, mortality and serious adverse events. Purpose to determine the factors that associated with return to work in CABG patients in one General Hospital. Methods. We analyzed data from Adam Malik Hospital registry of 68 patients who had undergone CR after coronary artery bypass graft (CABG) in 2017-2020. The outcomes assessed were work status in 6 month after CABG. Patients’ characteristics, sociodemographic, clinical parameters of functional capacity using 6 minutes of walk test (6MWT), T2DM, Hypertension and cholesterol level were assessed. Factors associated with return to work were identified using multivariable logistic regression. Results We identified 68 patients undergoing isolated CABG (2017–2020). One year after discharge for CABG, 40 (58.8%) patients had returned to the workforce. Factors associated with return to work  were identified using bivariate logistic regression. Diabetes mellitus (odds ratio, 10.192; 95% confidence interval, 0.063–0.515). Conclusion Almost 2 from 3 patients after CABG returned to work within 6 months. Diabetes mellitus and functional capacity were associated with a lower likelihood of returning to work.

scholarly journals The beneficial effects of physical preoperative and postoperative training for the cognitive function in cardiosurgical patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O Trubnikova ◽  
I Tarasova ◽  
E Moskin ◽  
Y Argunova ◽  
D Kupriyanova ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cognitive Function ◽  
Physical Training ◽  
Training Group ◽  
Aerobic Exercise Training ◽  
Funding Source ◽  
Beneficial Effects ◽  
Preoperative Training ◽  
Cabg Patients ◽  
Cycling Training

Abstract Background and aim The cardiac surgery patients have an increased risk of postoperative cognitive dysfunction (POCD). The positive healing effects of physical exercise was demonstrated early in patients with cognitive impairment. The aim of the study was to evaluate the effect of physical preoperative and postoperative training for the cognitive function in patients undergoing on-pump coronary artery bypass grafting (CABG). Methods We analyzed the neurophysiological data from 125 male coronary artery disease (CAD) patients who participated in two sub-studies: the patients with a short preoperative course of treadmill training (n=33) and with postoperative aerobic exercise training (n=92). The study of preoperative physical training included CABG-candidates, which were divided into 2 groups: with (n=17) and without training (n=16). The preoperative physical training consisted of a 5–7 day course of intensive training on a treadmill. The study with postoperative aerobic exercise training enrolled CAD patients, undergoing on-pump CABG, which were divided into 2 groups: with supervised cycling training (n=39) and without training (n=53). Three-week trainings course began on the 14-th day after CABG. The patients with and without preoperative and postoperative physical training were comparable in terms of preoperative characteristics and intraoperative parameters. The patients were underwent the neuropsychological and EEG examination to assess postoperative changes in neurophysiological performance. Results The patients with preoperative treadmill training had the POCD incidence at 7–10 days after GABG in 44% cases vs. 74% - in the group without training. The relative risk of POCD developing in the patients with preoperative training was: OR=0.24, 95% CI: 0.07–0.81, Z=2.297, p=0.02. Additionally, the patients with preoperative training demonstrated a lower power in the theta (4–6 Hz) and beta1 (13–20 Hz) frequency ranges 7–10 days after CABG. The patients with postoperative cycling training also demonstrated better cognitive function at 1 month after CABG compared to the patients without training. The incidence of POCD was 21% in the cycling training group vs. 44% – in the group without training. The relative risk of POCD developing was: OR=0.23, 95% CI: 0.09–0.60, Z=3.041, p=0.0024. Also, it was found that the postoperative cycling training group showed a lower percentage theta power increase at 1 month after CABG. Conclusion Both the short preoperative and three-week postoperative physical training course can produce beneficial effects on the postoperative neurophysiological status in CABG patients. The engagement of physical training in the rehabilitation program of CABG patients can improve cognitive functioning after cardiac surgery. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): RFBR and Kemerovskaya region

scholarly journals Prognostic utility of early systolic lengthening by speckle tracking in patients undergoing coronary artery bypass graft

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
P Brainin ◽  
S Lindberg ◽  
F Olsen ◽  
S Pedersen ◽  
A Iversen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Speckle Tracking ◽  
Prognostic Value ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Positive Strain ◽  
All Cause Mortality ◽  
Cabg Patients

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Independent Research Fund Denmark Background Early systolic lengthening (ESL), a paradoxical stretch of myocardial fibers, has been linked to myocardial viability and contractile dysfunction. We assessed the long-term prognostic potential of ESL in coronary artery bypass graft (CABG) patients. Methods We retrospectively included patients (n = 709; mean age 68 years; 85% men) who underwent speckle tracking echocardiography (median 15 days) prior to CABG. Endpoints were cardiovascular death (CVD) and all-cause mortality. We assessed amplitude of ESL (%), defined as peak positive strain, and duration of ESL (ms), determined as time from Q-wave on the ECG to peak positive strain. We applied Cox proportional hazards models adjusted for the clinical risk tool, EuroSCORE II. Results During median follow-up of 3.8 years [IQR 2.7 to 4.9 years], 45 (6%) experienced CVD and 80 (11%) died. In survival analyses adjusted for EuroSCORE II, amplitude of ESL was associated with CVD (HR 1.37 [95%CI 1.13 to 1.66], P = 0.001) and all-cause mortality (HR 1.31 [95%CI 1.13 to 1.54], P = 0.001). Similar findings applied to duration of ESL and CVD (HR 1.17 [95%CI 1.08 to 1.26], P &lt; 0.001) and all-cause mortality (HR 1.14 [95%CI 1.07 to 1.21], P &lt; 0.001). The prognostic value of ESL amplitude was modified by sex (P interaction &lt; 0.05), such that it was greater in women for both endpoints (Figure 1A-B). When adding ESL duration to EuroSCORE II, the net reclassification index improved significantly for both CVD and all-cause mortality. Conclusions Assessment of ESL provides independent and incremental prognostic information in addition to the EuroSCORE II for CVD and all-cause mortality in CABG patients. The prognostic value was greater in women. Abstract Figure. Prognostic value of ESL amplitude by sex

scholarly journals Thoracic epidural analgesia improves lung function in CABG patients

2005 ◽  
Vol 52 (S1) ◽  
pp. A48-A48 ◽  
Author(s):  
Paul K. Tenenbein ◽  
Doug Maguire ◽  
Roland Debrouwere ◽  
Peter C. Duke ◽  
Stephen E. Kowalski
Keyword(s):  
Lung Function ◽  
Epidural Analgesia ◽  
Thoracic Epidural Analgesia ◽  
Thoracic Epidural ◽  
Cabg Patients

A151 PREOPERATIVE PREDICTIVE FACTORS OF MYOCARDIAL ISCHEMIA PRIOR TO BYPASS IN CABG PATIENTS

1990 ◽  
Vol 73 (3A) ◽  
pp. NA-NA
Author(s):  
M. Fischler ◽  
A. Ceddaha ◽  
S. Schlunberger ◽  
L. Raffin ◽  
C. Dubois
Keyword(s):  
Myocardial Ischemia ◽  
Predictive Factors ◽  
Cabg Patients

Improvement of cognitive test performance in patients undergoing primary CABG and other CPB-assisted cardiac procedures

Perfusion ◽  
2008 ◽  
Vol 23 (5) ◽  
pp. 267-273 ◽  
Author(s):  
JM van den Goor ◽  
BK Saxby ◽  
JG Tijssen ◽  
KA Wesnes ◽  
BA de Mol ◽  
...  
Keyword(s):  
Cognitive Functions ◽  
Test Performance ◽  
Artery Bypass ◽  
Cardiac Surgical Procedures ◽  
Cognitive Test ◽  
Cardiac Procedures ◽  
Patient Groups ◽  
Cognitive Test Performance ◽  
Composite Scores ◽  
Cabg Patients

Cardiac surgical procedures assisted by cardiopulmonary bypass (CPB) impair cognitive functions. Several studies, however, showed that cognitive functions were unaffected in patients undergoing either primary coronary artery bypass grafting (CABG) or more complex surgery assisted by CPB. Therefore, we conducted a straightforward study to compare patient groups who differed significantly in terms of risk factors such as prolonged CPB times. Consecutive patients (n = 54) were included, undergoing either non-primary CABG, e.g. valve and/or CABG, (n = 30) or primary CABG (n = 24), assisted by CPB. Cognitive function was determined pre-operatively on the day of hospital admission, and post-operatively after one and six months using the Cognitive Drug Research computerized assessment battery. Data from the fourteen individual task variables were summarized in four composite scores: Power of Attention (PoA), Continuity of Attention (CoA), Quality of Episodic Memory (QoEM), and Speed of Memory (SoM). In the non-primary CABG patients, both CoA and QoEM improved after 1 month (p = 0.001 and p = 0.016, respectively), whereas, after 6 months, CoA (p = 0.002), QoEM (p = 0.002) and SoM (p < 0.001) were improved. In primary CABG patients, CoA improved at one month after surgery (p = 0.002) and, after six months, not only CoA (p = 0.003), but also QoEM and SoM were improved (p = 0.001 and p = 0.030, respectively). The test performance was similar in non-primary and primary CABG patients after surgery. Our present study shows a post-operative improvement of cognitive composite scores after cardiac surgery assisted by CPB in both non-primary CABG and in primary CABG patients.

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