scholarly journals Preoperative Aspirin Use and Outcomes in Off-pump Coronary Artery Bypass Grafting Surgery

2018 ◽  
Vol 33 (1) ◽  
pp. 16-21
Author(s):  
Md Rezaul Karim ◽  
Tawfiq Ahmed ◽  
Rownak Khurshid ◽  
Shahriar Moinuddin ◽  
Md Kamrul Hasan
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Artery Bypass ◽  
Perioperative Period ◽  
Operative Blood Loss ◽  
Off Pump ◽  
Transfusion Requirements ◽  
Increased Risk ◽  
Pump Cabg ◽  
Group B

Introduction: Aspirin, the most widely used platelet function inhibitor extremely effective at blocking the production of thromboxane in platelets, rendering the platelets incapable of functioning normally, and thus preventing thrombosis. The practice of empirically discontinuing aspirin preoperatively should be abandoned because evidence strongly supports continued use of aspirin in patients for secondary prevention of CAD, CVD, or PVD when undergoing surgery.Methods and Materials: This Observational study was conducted at Department of Cardiac Surgery, NICVD, Dhaka, who underwent off pump CABG (OPCAB), divided in two groups, Group A: 24 patients who stopped and Group B: 24 patients who are continuing aspirin throughout the perioperative period. Post operative blood loss, requirement of blood transfusion, post-operative MI, ICU stay, Total hospital stay (days) and early post-operative complication (Stroke, New arrhythmia in ECG, 30 days mortality) were recorded and included in the study.Results: The key finding of the present study is that preoperatively continued aspirin use was not associated with increased risk of post-operative blood loss, blood transfusion requirements and need for re exploration after OPCAB.Conclusions: Preoperative aspirin therapy should be continued till off-pump CABG without interruption.Bangladesh Heart Journal 2018; 33(1) : 16-21

scholarly journals Evaluation of Neurocognitive Dysfunction after Coronary Artery Bypass Surgery

2018 ◽  
Vol 10 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Tawfiq Ahmed ◽  
Md Rezaul Karim ◽  
Jahangir Haider Khan ◽  
Shahriar Moinuddin
Keyword(s):  
Coronary Artery ◽  
Postoperative Period ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Neurocognitive Dysfunction ◽  
Off Pump ◽  
Group A ◽  
Pump Cabg ◽  
Group B

Objective: The Neurological injury is an important complication after coronary artery bypass surgery (CABG). The incidence of neurocognitive impairment after cardiac surgery varies from 20% to 80%. In this study we tried to analyze this difference of neurologic dysfunction between On-pump CABG and Off-pump CABG (OPCAB).Methods:This is a case control study done in National Institute of Cardiovascular Disease (NICVD), Dhaka during the period of July 2012 to June 2014. Sixty Patients with Ischemic heart disease were the study population. Group- A includes 30 patients underwent on pump CABG, Group-B 30 patients underwent OPCAB. All the patients of both the groups were followed up to 2 month’s postoperatively to find out any neurological and neurocognitive dysfunctionby observing motor function, sensory function,Mini Mantel state (MMS) Examination, orientation, memory, attention and calculation, recall and language test.Results: Neurocognitive dysfunction in the early postoperative period is significantly different among the groups.Neurocognitive dysfunction was more in Group A in comparison to Group B, On 3rd and 8th POD the MINI Mental Scores were found to be significantly lower in On-pump group than those in Off-pump group (22.0 ± 5.28 vs. 25.67 ± 3.34, p = 0.002 and 25.93 ± 3.11 vs. 26.63 ± 2.50, p = 0.023 respectively).This neurocognitive dysfunction gradually improved by the end of two month postoperative period. Only 6.66% patient in Group-A was found neurocognitically dysfunctional and was referred to neurophysician for further treatment. In case of OPCAB Group, no patient suffered fromneuorocognitive dysfunction.Conclusion: This study has convincingly shown cardio-pulmonary bypass (CPB) has had detrimental effect on neurocognitive function in patients who underwent CABG.Cardiovasc. j. 2018; 10(2): 186-193

P1832Myocardial injury assessed by T1 mapping after on-pump and off-pump coronary artery bypass grafting. a pre-specified analysis of mass V trial

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A R Dallazen ◽  
W Hueb ◽  
P C Rezende ◽  
G A B Boros ◽  
F F Ribas ◽  
...  
Keyword(s):  
Coronary Artery ◽  
T1 Mapping ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Off Pump ◽  
Native T1 ◽  
Before And After ◽  
Group A ◽  
Pump Cabg ◽  
Group B

Abstract Background Myocardial structural damage may occur during coronary artery bypass grafting (CABG) surgery and is identified by the significant release of cardiac biomarkers. However, the evidence of these structural myocardial changes after CABG by current imaging methods remains unknown. To evaluate myocardial structure, we used the T1 mapping of cardiac magnetic resonance (CMR) before and after on-pump and off-pump CABG. Methods Patients with multivessel coronary artery disease and preserved ventricular function were included and underwent on or off-pump CABG. CMR and T1 mapping were performed using the MOLLI technique (modified Look-Locker inversion-recovery). Values of native T1 and extracellular volume fraction (ECV) were compared before and after on and off-pump procedures. Results Of 110 eligible patients, 34 were excluded due to the presence of new late enhancement or edema. Of 76 patients remained, 32 (42%) underwent on-pump (Group A) and 44 (58%) off-pump CABG (Group B). All baseline characteristics were similar between groups, besides the Syntax Score that was higher in Group A (25 × 21, p=0.002). For group A, native T1 before and after procedures was 1013 ms (998–1043) and 1004 ms (793–1048), p=0.19, and ECV was 26.4 (23.9–27.6) and 31.2 (27.6–33.9), p<0.001. For group B, native T1 before and after procedures was 1015 ms (970–1044) and 992 ms (867–1051), p=0.003, and ECV 27.5 (25.3–29.9) and 30.3 (26.5–34.3), p=0.02. The comparison of native T1 difference before and after procedures between groups A and B was not significant (Delta T1 −9.8 (−102 to 51.8) × −25.4 (−119 to 51,2), p=0.87. However, the difference of ECV between groups was statistically significant (ECV Delta 3.8 (2.2 to 7.1) × 1.3 (−1.1 to 4.9), p=0.039, respectively, for groups A and B. Figure 1 Conclusion In this sample, T1 mapping identified significant myocardial structural changes in both surgical revascularization procedures. Additionally, a marked myocardial injury generated by ECV changes were observed after on-pump CABG.

scholarly journals Evaluations of topical application of tranexamic acid on post-operative blood loss in off-pump coronary artery bypass surgery

2014 ◽  
Vol 8 (2) ◽  
pp. 224 ◽  
Author(s):  
AliAkbar Rahimianfar ◽  
MohammadHassan Abdollahi ◽  
MohammadHossein Moshtaghiyoon ◽  
Mahdi Haddadzadeh ◽  
Asefeh Fekri ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Operative Blood Loss ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Preoperative Particle and Glue Embolization of Meningiomas: Indications, Results, and Lessons Learned from 117 Consecutive Patients

2013 ◽  
Vol 73 (2) ◽  
pp. ons244-ons252 ◽  
Author(s):  
Anouk Borg ◽  
Jinendra Ekanayake ◽  
Richard Mair ◽  
Thomas Smedley ◽  
Stefan Brew ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Transfusion Requirement ◽  
Lessons Learned ◽  
Direct Result ◽  
Embolic Agent ◽  
Operative Blood Loss ◽  
Indirect Measure ◽  
Blood Transfusion Requirement ◽  
Transfusion Requirements

Abstract BACKGROUND: Preoperative embolization of meningiomas remains contentious, with persisting uncertainty over the safety and efficacy of this adjunctive technique. OBJECTIVE: To evaluate the safety of presurgical embolization of meningiomas and its impact on subsequent transfusion requirement with respect to the extent of embolization and technique used. METHODS: One hundred seventeen consecutive patients between 2001 and 2010 were referred for embolization of presumed intracranial meningioma before surgical resection. Glue and/or particles were used to devascularize the tumor in 107 patients, all of whom went on to operative resection. The extent and nature of embolization-related complications, degree of angiographic devascularization, and the intraoperative blood transfusion requirements were analyzed. RESULTS: Mean blood transfusion requirement during surgery was 0.8 units per case (range, 1-14 units). Blood transfusion was significantly lower in patients whose meningiomas were completely, angiographically devascularized (P = .035). Four patients had complications as a direct result of the embolization procedure. These included intratumoral hemorrhage in 2, sixth cranial nerve palsy in 1, and scalp necrosis requiring reconstructive surgery in 1 patient. CONCLUSION: The complication rate was 3.7%. No relationship between the embolic agent and the degree of devascularization was observed. Achieving a complete devascularization resulted in a lower blood transfusion requirement, considered an indirect measure of operative blood loss. This series demonstrates that preoperative meningioma embolization is safe and may reduce operative blood loss. We present distal intratumoral injection of liquid embolic as a safe and effective alternative to more established particle embolization techniques.

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.

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