scholarly journals Influence of Hypertension on Early outcome after Coronary Artery Bypass Surgery

2012 ◽  
Vol 7 (1) ◽  
pp. 13-15
Author(s):  
Md Aslam Hossain ◽  
Rezwanul Hoque ◽  
Md Saifullah Khan ◽  
Asit Baran Adhikary ◽  
Mostafizur Rahman ◽  
...  

Influence of hypertension on early outcome after coronary bypass surgery was studied during the period from January 2004 to December 2004, in the Department of cardiovascular surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. Sixty patients undergoing conventional coronary artery bypass grafting in cardioplegic arrested heart were divided equally into two groups, 30 patients with hypertension(Group A) and 30 patients without hypertension(Group B). Study showed that in hypertensive group, 60.00% developed postoperative complications, whereas it is 13.30% of non-hypertensive group. Twenty percent of group A and none of the Group-B patients developed sternal wound infection. Leg infections were 39% and 13.3% in Group A and Group B respectively. Two patients from the Group A developed stroke during postoperative period, but none of the Group B patient had the same problem. Duration of average postoperative ventilation was 2.35 times greater in hypertensive patients than non-hypertensive patients. Mean postoperative hospital stay for Group A and Group B patients being 13.20 and 10.90 days respectively. The study showed that hypertensive patients were at higher risk of developing postoperative complications compared to patients without hypertension. DOI: http://dx.doi.org/10.3329/uhj.v7i1.10203 UHJ 2011; 7(1): 13-15

2002 ◽  
Vol 10 (3) ◽  
pp. 219-222 ◽  
Author(s):  
Mustafa Güden ◽  
Belhhan Akpinar ◽  
Ertan Sagğbaş ◽  
İlhan Sanisoğlu ◽  
Emine Cakali ◽  
...  

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.


Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Ronald M Babka ◽  
James Petress ◽  
Richard Briggs ◽  
Robert Helsel ◽  
John Mack

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.


Author(s):  
Noriyoshi Yashiki ◽  
Go Watanabe ◽  
Shigeyuki Tomita ◽  
Satoru Nishida ◽  
Tamotsu Yasuda ◽  
...  

Background In recent years, the invasiveness of coronary reconstruction has been markedly reduced. Awake off-pump coronary artery bypass (AOCAB), coronary bypass surgery with thoracic epidural anesthesia (TEA) without general anesthesia and cardiopulmonary bypass), has been reported in the literature. Because the details of this technique are still unclear, we evaluated its usefulness by examining the autonomic neural state and the incidence of arrhythmia. Methods Fifty-five patients who underwent elective coronary artery bypass grafting (CABG) between April and December 2003 were included in the study. Patients who underwent CABG under high TEA alone comprised group A, those who underwent CABG under general anesthesia combined with TEA comprised group B, and those who underwent CABG under general anesthesia alone comprised group C. Holter electrocardiography was performed before and after surgery, and perioperative electrocardiograms were recorded (before surgery and during surgery, postoperative days 0–3, and postoperative day 7). On obtained electrocardiograms, the autonomic neural state was evaluated by analysis of heart rate variability, and the incidence of atrial fibrillation. Results Concerning the autonomic neural state, sympathetic inhibition was observed during TEA in both groups A and B. After discontinuation of TEA, sympathetic activity recovered. Vagal activity was not inhibited in group A, but decreased during surgery and gradually recovered after surgery in group B. Evaluation of the balance between sympathetic and vagal activities showed that sympathetic activity became predominant rapidly on postoperative day 2 in group B but gradually after surgery in group A. The incidence of postoperative atrial fibrillation was the highest in group B. Conclusions In AOCAB, because there is no vagal inhibition, vagal dominance can be maintained after surgery. This may be associated with the lower incidence of postoperative atrial fibrillation in group A compared with group B. Further studies are necessary to evaluate the details of AOCAB.


2018 ◽  
Vol 10 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Tawfiq Ahmed ◽  
Md Rezaul Karim ◽  
Jahangir Haider Khan ◽  
Shahriar Moinuddin

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


2017 ◽  
Vol 35 ◽  
pp. e8
Author(s):  
Wahyu Aditya ◽  
Nani Hersunarti ◽  
Rita Zahara ◽  
Aria Kekalih ◽  
Rarsari Soerarso ◽  
...  

2011 ◽  
Vol 5 ◽  
pp. CMC.S7170 ◽  
Author(s):  
Feridoun Sabzi ◽  
Abdol Hamid Zokaei ◽  
Abdol Rasoul Moloudi

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.


2019 ◽  
Vol 13 (1) ◽  
pp. 18-24
Author(s):  
Ramy Mahrose ◽  
Ahmed M. Elsayed ◽  
Mohamed S. Elshorbagy

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.


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