scholarly journals Effect of Off-pump Coronary Artery Bypass Graft Surgery in Patients with Diabetes Mellitus

2019 ◽  
Vol 8 (1-2) ◽  
pp. 10-16
Author(s):  
Md Sharif Hasan ◽  
Abdul Hamid ◽  
Ahsan Habibur Rahman ◽  
Nurul Amin ◽  
Tanvir Ahmed ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Postoperative Outcome ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Off Pump ◽  
Artery Disease ◽  
Pump Coronary Artery Bypass

Background & objective : Myocardial revascularization in diabetic patients is challenging. Off pump coronary artery bypass (OPCAB) surgery has been widely used for the treatment of coronary artery disease. The goal of this study was to compare outcomes of OPCAB in diabetic patients relative to non diabetic patients. Methods:The present prospective study was conducted between January 2014 to June 2017. During the period a total of 193 patients (of whom 70 had diabetes and 123 patients were non-diabetics) were included in the study. All of them underwent coronary artery bypass grafting (CABG) without cardiopulmonary bypass surgery. The early clinical outcomes of OPCAB were evaluated during the postoperative hospital stay. Result: Over three-quarters of the patients in both diabetic and non-diabetic groups were ≥ 50 years old with no significant intergroup difference (p = 0.825). Majority(90%) of the patients in either group was male (p = 0.786). Nearly half (48.5%) of the patients in diabetic and 45% in non-diabetic group were overweight or obese (p = 0.557). The smokers weremuch higher in non-diabetic group than that in the diabetics (p = 0.009). The average number of grafts needed was considerably higher in the diabetic group (p = 0.079). All the postoperative outcome variables like pneumonia, stroke, arrhythmia, renal failure requiring dialysis and postoperative mortality in both the groups were almost identical (p > 0.05). Conclusion: Off-pump coronary artery bypassis the preferred choice of revascularization for multi-vessel coronary artery disease in diabetic patients. However, continuous, strict glycemic control is essential to have a good postoperative outcome. Ibrahim Card Med J 2018; 8 (1&2): 10-16

scholarly journals Early Outcome of Off-pump Coronary Artery Bypass Graft Surgery in Patients with Multivessel Coronary Artery Disease

2014 ◽  
Vol 41 (3) ◽  
pp. 8-14
Author(s):  
NU Ahmed ◽  
K Hasan ◽  
SK Raha
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Sweat Glands ◽  
Off Pump ◽  
Artery Disease ◽  
Pump Coronary Artery Bypass ◽  
Vessel Coronary Artery

As there have been appreciable bodies of evidence supporting the theoretical and practical advantages of off-pump coronary artery bypass grafting (OPCAB) over the conventional coronary artery bypass graft (CABG) to avoid the harmful effects of cardiopulmonary bypass (CPB), many cardiac surgeons are using OPCAB as an effective alternative to conventional CABG. This study performed in National Institute of Cardiovascular Diseases (NICVD) evaluated the early surgical outcomes of OPCAB in terms of mortality and major post-operative morbidities and compared them with that of conventional CABG. Total 120 patients with multi-vessel coronary artery disease were allocated into two groups: a) 60 patients who underwent OPCAB and b) another 60 patients who underwent conventional CABG between January 2009 and December 2011. The sex and mean age. A reduced level or complete cessation of sweating can be caused by a variety of factors affecting sweat glands directly or indirectly through alterations in their nerve supply. The most common presentation is the syndrome of heal intolerance with or without features of dysautonomia. An acquired idiopathic form of generalized anhidrosis is characterized by loss of sweating in the absence of any neurological features or destruction of sweat glands. ldiopalhic acquired generalized anhidrosis is a very rare condition in which the pathogenesis is still unknown. Cholinergic urticaria has been associated with some cases of this acquired idiopathic form of generalized anhidrosis.Distributions of patients were similar among two groups. Smoking, diabetes mellitus, hypertension and dyslipidemia were major risk factors. All co-morbid conditions were homogenously distributed between the two groups. Majority of the patients had triple vessel disease. Nearly three-quarter (73.3%) of patients in OPCAB group and 80% in conventional CABG group received 3 grafts (p=0.470. The mean total operative time (258±39.5 minutes versus 306±44.8 minutes; p<0.001), intubation times (7.6±0.3 versus 16.3±0.5 hours; p<0.001), blood losses (377.8±22.3 ml vs. 602.0±18.9 ml, p<0.001); requirements for blood and blood products (689.7±21.1 vs. 1199.3±34.5 ml, p < 0.0010); intensive care unit stays (31.7±0.9 hours versus 41.6±1.5 hours; p<0.001) and hospital stays (6.2±0.2 days versus 8.3±0.3 days; p<0.0010) were all significantly shorter in the OPCAB group. OPCAB is a safe and effective procedure for patients with multi-vessel coronary artery disease and is associated with reduced morbidity and mortality. However, large randomized studies with long-term follow-up may show the real benefits of OPCAB compared with CABG on CPB. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18951 Bangladesh Medical Journal 2012 Vol.41(3): 8-14

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