Micra Transcatheter Pacing System Implant under Direct Visualization During Minimally Invasive Tricuspid Valve Surgery

Atrioventricular nodal conduction abnormalities are common after open heart surgery and more so during or after valve surgery. The incidence of atrioventricular (AV) block after tricuspid valve (TV) surgery is higher than what is observed following coronary artery bypass surgery or left sided valve interventions due to the proximity of the TV annulus to the AV node and hence requirements for cardiac pacing are high. However, the mechanical interference between pacing leads and TV leaflet mobility and coaptation can result in regurgitation rendering such an approach counterintuitive. We report a case of Micra Transcatheter pacing system (TPS) implant under direct visualization at the time of tricuspid valve surgery performed via a right mini-thoracotomy approach.

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Late Cardiac Tamponade by Chylous Pericardial Effusion after Coronary Artery Bypass Surgery: Case Report

The Heart Surgery Forum ◽

10.1532/hsf98.20101155 ◽

2011 ◽

Vol 14 (3) ◽

pp. 195 ◽

Cited By ~ 2

Author(s):

Anders Albåge ◽

Gösta Eggertsen ◽

Paolo Parini

Keyword(s):

Coronary Artery ◽

Pericardial Effusion ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Heart Surgery ◽

Artery Bypass ◽

Open Heart Surgery ◽

Successful Outcome ◽

Pericardial Fenestration

Chylopericardium is an uncommon but serious complication after open heart surgery that often necessitates surgical treatment. We describe a case of continuous and severely symptomatic chylous pericardial effusion after coronary artery bypass grafting in which the diagnosis was established by lipid electrophoresis. Initial conservative management failed, and ligation of the thoracic duct and pericardial fenestration were finally required for a successful outcome.

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Comparison of the effects of centrifugal versus roller pump on the immune response in open-heart surgery

Perfusion ◽

10.1177/026765919501000408 ◽

1995 ◽

Vol 10 (4) ◽

pp. 249-256 ◽

Cited By ~ 6

Author(s):

J. Perttilä ◽

M. Salo ◽

O. Peltola

Keyword(s):

Immune Responses ◽

Centrifugal Pump ◽

Coronary Artery Bypass Surgery ◽

Heart Surgery ◽

Artery Bypass ◽

Open Heart Surgery ◽

Pokeweed Mitogen ◽

C Reactive Protein ◽

Roller Pump ◽

Reactive Protein

We compared the effects of a centrifugal pump with those of a roller pump on immune responses in 26 coronary artery bypass surgery patients during cardiopulmonary bypass (CPB). The patients were randomly allocated into a (Biomedicus) centrifugal pump group and a (Stöckert) twin roller pump group. Leucocyte and differential counts; percentages of lymphocyte subpopulations (CD3-, CD4-, CD8-, CD16-, CD20- and CD25-positive lymphocytes) and monocytes (CD14); phytohaemagglutinin-, concanavalin A-, and pokeweed mitogen-induced and unstimulated proliferation of separated lymphocytes; unstimulated and pokeweed mitogen-stimulated production of IgG, IgM, or IgA; and plasma fibronectin, C-reactive protein and serum albumin concentrations were measured preoperatively, immediately before CPB, immediately before aortic declamping and on the first postoperative morning. Significant changes were seen in these variables, but no differences occurred between the groups.

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Effect of Melatonin on Incidence Rate of Delirium in Elderly Patients Undergoing Open-Heart Surgery without a Pump: A Clinical Trial

Elderly Health Journal ◽

10.18502/ehj.v5i1.1197 ◽

2019 ◽

Author(s):

Fatemeh Hosseini Kasnavieh ◽

Hassan Rezaeipandari ◽

Mehdi Hadadzadeh ◽

Mahmood Vakili ◽

Fatemeh Hosseini Biouki

Keyword(s):

Clinical Trial ◽

Coronary Artery ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Heart Surgery ◽

Artery Bypass ◽

Open Heart Surgery ◽

Control Group ◽

Open Heart

Introduction: Delirium has been considered as the most common cognitive disorder after major surgery. Melatonin therapy is effective in reducing the incidence of delirium after open heart surgery with pain relief mechanism and adjustment of the sleep cycle and the absence of specific side effects. This study was conducted to determine the effectiveness of melatonin on prevention of delirium after coronary artery bypass surgery. Methods: The double blind randomized controlled clinical trial recruited 140 patients, equally decided, who underwent coronary artery bypass surgery in Afshar Hospital, Yazd city, 2016. All participants of the two groups were evaluated for the presence of delirium on the day of surgery and three days after by the Confusion Assessment Method for ICU (CUM-ICU). Respectively, The intervention and control group received 3 mg melatonin and 3 mg placebo orally before and after the operation. Data were analyzed by Chi-square, T-test, paired t-test and Cochran tests. Results: The incidence of delirium in the melatonin and the control group was 35.7% and 5.7% on the day of operation, 68.6% and 31.4% three days after the operation, respectively. The results showed that there was a significant difference in the frequency of cognitive test of CAM-ICU on day of surgery and three days after surgery between the two groups (p <0.001). Conclusion: Despite the efficacy of melatonin therapy in reducing delirium, further studies on the effects of other effective drugs on the treatment of delirium, such as antipsychotics and receptor blockers, should be considered.

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Development and Evaluation of Preoperative Teaching Materials for CABG/Valve Surgery Patients

Journal of Doctoral Nursing Practice ◽

10.1891/2380-9418.12.1.73 ◽

2019 ◽

Vol 12 (1) ◽

pp. 73-92

Author(s):

Patricia A. McLaughlin

Keyword(s):

Heart Surgery ◽

Assessment Tool ◽

Perioperative Complications ◽

Artery Bypass ◽

Open Heart Surgery ◽

Valve Surgery ◽

Open Heart ◽

Patient Anxiety ◽

Teaching Materials ◽

Improvement Project

BackgroundPatients often experience anxiety and feel overwhelmed by the prospect of undergoing open-heart surgery. Randomized controlled trials have found preoperative education materials and counseling to reduce levels of patient anxiety, depression, and perioperative complications following coronary artery bypass grafting (CABG)/valve surgery.ObjectiveThe purposes of this performance improvement project were to develop preoperative teaching materials for cardiac surgery inpatients and evaluate their usability.MethodsExisting CABG/valve teaching materials were evaluated. A new booklet was developed through an iterative process. An expert panel reviewed the final draft using the patient education materials assessment tool for printable materials (PEMAT-P). Patients were surveyed for usability and usefulness.ResultsExpert reviewer results for using the PEMAT-P tool for understandability and actionability were 99% and 100%. Of 62 teaching booklets and patient preparedness questionnaires distributed, N = 11 (17.7%) were returned. Nearly all respondents (90.9%) agreed or strongly agreed for questions related to how well the booklet prepared them for surgery. Likewise, 90.9% of respondents agreed or strongly agreed with statements about design and content of the booklet. The hospital consumer assessment of healthcare providers and systems performance reports from October 1, 2016 to December 31, 2016 showed improvement for discharge information (96.2% from 92.2%), symptom to look for (100% from 94.9%), and care transitions (66.2% from 54.3%).ConclusionsThe development and implementation of evidence-based preoperative teaching materials help patients and families prepare for open-heart surgery and self-care after discharge.Implications for NursingNurses' utilization of preoperative teaching materials improves patient satisfaction, preparedness, and usefulness.

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Coronary Artery Bypass Surgery in a Patient with a Functional Single Lung

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230501300419 ◽

2005 ◽

Vol 13 (4) ◽

pp. 377-379 ◽

Cited By ~ 1

Author(s):

Levent Yazicioglu ◽

Atilla Aral ◽

Ozge Uymaz ◽

Hakki Akalin

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Heart Surgery ◽

Operative Mortality ◽

Artery Bypass ◽

Open Heart Surgery ◽

Postoperative Management ◽

Open Heart ◽

Mortality And Morbidity

Destructed lung and pneumonectomy are associated with anatomic and physiologic changes that may interfere with the conduct of subsequent open heart surgery. Here we report a case of an autopneumonectomized patient who required open heart surgery. The preoperative, intraoperative and postoperative management of this patient was unique. Open heart procedures on patients with a single lung can be performed with acceptable operative mortality and morbidity.

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Risk and benefits of temporary pacemaker electrodes in adult open-heart surgery—a systematic review

The Cardiothoracic Surgeon ◽

10.1186/s43057-021-00064-1 ◽

2022 ◽

Vol 30 (1) ◽

Author(s):

Malene S. Enevoldsen ◽

Per Hostrup Nielsen ◽

J. Michael Hasenkam

Keyword(s):

Heart Surgery ◽

Artery Bypass ◽

Open Heart Surgery ◽

Valve Surgery ◽

Open Heart ◽

Temporary Pacing ◽

Number Of Patients ◽

Temporary Pacemaker ◽

Pacemaker Electrodes ◽

Significant Factors

Abstract Background To assess the achieved risk and benefits of inserting temporary epicardial pacemaker electrodes after open-heart surgery for potential treatment of postoperative cardiac arrhythmias, and to investigate the extent of its use in clinical practice. Main text A systematic search was conducted in PubMed and repeated in Embase and Scopus using the PRISMA guidelines. The search identified 905 studies and resulted in 12 included studies, where the type of surgery, study design, total number of included patients, number of patients having temporary pacemaker electrodes inserted, number of patients requiring temporary pacing, primary reason for pacing, significant factors predicting temporary pacing, registered complications and study conclusion were assessed. Eight papers concluded that routine insertion of temporary pacemaker electrodes in all postoperative patients is unnecessary. One paper concluded that they should always be inserted, while three papers concluded that pacing is useful in the postoperative period, but did not recommend a frequency of which they should be inserted. Conclusions The literature suggests that the subgroup of younger otherwise healthy patients without preoperative arrhythmia having isolated coronary artery bypass grafting surgery or single valve surgery should not routinely have temporary pacemaker electrodes inserted.

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Coronary Artery Bypass Graft Surgery in Tanzania: 5 Years of Experience at Jakaya Kikwete Cardiac Institute

10.21203/rs.3.rs-73049/v1 ◽

2020 ◽

Author(s):

Mohamed Yakubu Janabi ◽

Evarist Nyawawa ◽

Bashir Nyangasa ◽

William Ramadhani Ramadhan ◽

Ramadhani Hassan Hamis ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Heart Surgery ◽

Heart Diseases ◽

Artery Bypass ◽

Bypass Graft ◽

Open Heart Surgery ◽

World Health

Abstract Cardiac surgery is not widely available in most developing countries, and most patients have no choice but to live in morbid conditions and managed conservatively or the few who are referred abroad for surgical procedures costs the respective countries millions of hard earned foreign currency. The World Health Organization projects that over the next ten years the continent of Africa will experience the largest increase in death rates from cardiovascular disease. The Jakaya Kikwete Cardiac Institute (JKCI) is a government owned National Specialized and Teaching Hospital that serves patients from all the regions of the United Republic of Tanzania with a population of nearly 60,000,000 people and also serves beyond the borders (Rwanda, Burundi, DR Congo, South Sudan, Comoro, Malawi and Zambia) for advanced cardiovascular medical, intervention, vascular and open heart surgery, the Institute was established in 2015. Methods: Here we report all patients who underwent coronary artery bypass surgery grafting only performed at the Centre since its inauguration in 2015- till 2019. Data were collected for basic demography, diagnosis, investigations, clinical and surgical outcome parameters. Results: A total of 85 patients with heart diseases and underwent coronary artery bypass surgery grafting (CABG) are analysed in this study. There were 64 (75%) male and 21 (25%) female patients. Their age ranged from 41–85 years old with almost half 42 (49%) of the cohort being between the age between 61–70 years old. Most of the patients had two or more grafts and an internal mammary artery graft was used over 80% of the procedures. The overall 30-day mortality was 7.1%, incidence of stroke 0.2%, duration of mechanical ventilation was an average of 9.98 hours and intensive care unit (ICU) stay post CABG was an average of 6.48 days and final discharge from the centre ranged from 10–16 days.Conclusion: This study has demonstrated that coronary artery bypass surgery grafting in low/middle income country is safe and feasible. A sustainable program demands highest level of governmental support as seen in this case, and a dedicated multidisciplinary team with profound know how in cardiac pathologies. Furthermore, a need for good local data to know the prevalence of coronary disease is mandatory to determine the magnitude of coronary artery disease in each country.

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