Search results for " BYPASS"
showing 10 items of 199 documents
The effect of off-pump coronary artery bypass on mortality after acute coronary syndrome: A meta-analysis
2012
Background Patients requiring surgical revascularisation for acute coronary syndrome (ACS) form a clinically heterogeneous group ranging from haemodynamic stability to cardiogenic shock. Whilst 'off-pump' revascularisation (OPCAB) is often considered, patient selection and operative timing remain controversial. This study aims to identify whether OPCAB may confer a mortality benefit over ONCAB in revascularisation for ACS. Secondly, we review the impact of OPCAB on completeness of revascularisation (CR) and long-term re-intervention. Methods A systematic literature review identified 9 studies (1 randomised controlled trial) of which 8 fulfilled criteria for meta-analysis. Outcomes for a tot…
The Evolution of Cardiovascular Surgery in Elderly Patient: A Review of Current Options and Outcomes
2014
Due to the increase in average life expectancy and the higher incidence of cardiovascular disease with advancing age, more elderly patients present for cardiac surgery nowadays. Advances in pre- and postoperative care have led to the possibility that an increasing number of elderly patients can be operated on safely and with a satisfactory outcome. Currently, coronary artery bypass surgery, aortic and mitral valve surgery, and major surgery of the aorta are performed in elderly patients. The data available show that most cardiac surgical procedures can be performed in elderly patients with a satisfactory outcome. Nevertheless, the risk for these patients is only acceptable in the absence of…
Blood transfusion and ischaemic outcomes according to anemia and bleeding in patients with non-ST-segment elevation acute coronary syndromes: Insight…
2020
Background: The benefits and risks of blood transfusion in patients with acute myocardial infarction who are anemic or who experience bleeding are debated. We sought to study the association between blood transfusion and ischemic outcomes according to haemoglobin nadir and bleeding status in patients with NST-elevation myocardial infarction (NSTEMI).Methods: The TAO trial randomized patients with NSTEMI and coronary angiogram scheduled within 72h to heparin plus eptifibatide versus otamixaban. After exclusion of patients who underwent coronary artery bypass surgery, patients were categorized according to transfusion status considering transfusion as a timevarying covariate. The primary isch…
Changes in lymphocyte subsets after cardiac surgery in children.
2001
Children undergoing cardiopulmonary bypass (CPB) operations have an increased risk of developing severe infections. Impairment of the immune system may contribute to the development of sequelae such as capillary leaks, pulmonary dysfunction and auto-immune reactions. The objective of this study was to investigate the impact of cardiac surgery with CPB on the immune system of infants and young children. We conducted a prospective study to investigate the changes in circulating lymphocyte subpopulations in a sample of 21 consecutive infants and young children undergoing cardiac surgery for congenital heart disease. The following statistically significant (P<0.05) results were obtained: leucoc…
Multidetector Computed Tomography Angiography (MD-CTA) of Coronary Artery Bypass Grafts – Update 2017
2017
Coronary artery bypass grafting (CABG) is still an important therapeutic approach in the treatment especially of advanced coronary artery disease. In this study, we elucidate the current role of multidetector computed tomography angiography (MD-CTA) in imaging patients after CABG surgery.This study is based on recent reports in the literature (2007 - 2016) on imaging of CABG using 64-slice MD-CT scanners and beyond. We included 13 reports that compared ECG-gated MD-CTA with conventional invasive coronary angiography (ICA) as the reference standard for the assessment of graft patency and for the detection of 50 % stenoses. These studies had to provide absolute values for true-positive, true-…
0057 : Preoperative Growth Differentiation Factor 15 (GDF15) as a novel biomarker of acute kidney injury after cardiac bypass surgery
2015
ObjectivePreviously, we demonstrated that preoperative plasma GDF15 levels significantly improved the prognostic value of the EuroSCORE for mortality after cardiac surgery. Despite the strong correlation between GDF15 and renal function, no data are available regarding the potential interest of preoperative GDF15 levels to improve the prediction of acute kidney injury (AKI) after coronary artery bypass grafting (CABG).Design134 patients operated on for CABG of whom 50 underwent offpump surgery at our university hospital were included in this prospective, observational study. Exclusion criteria were age 80 years, previous atrial fibrillation/flutter, previous severe renal failure (estimated …
Decreased Esophageal Sensitivity to Acid in Morbidly Obese Patients: A Cause for Concern?
2017
Background/Aims: To evaluate esophageal sensitivity to acid between morbidly obese (MO) patients and non-MO controls with abnormal esophageal acid exposure. Methods: We conducted a cross-sectional study of 58 patients: 30 MO (cases) and 28 non-MO (controls). Esophageal symptoms and esophageal sensitivity to 0.1 M hydrochloric acid solution (Bernstein test) were compared between MO and non- MO patients with a prior diagnosis of abnormal esophageal acid exposure. Results: MO patients were less symptomatic than non-MO controls (14% vs 96%; odds ratio [OR], 0.006; 95% confidence interval [CI], 0.001 to 0.075; p=0.000). MO patients were more likely to present with decreased esophageal sensitivit…
0058 : Low circulating levels of Growth Differentiation Factor 15 (GDF-15) before coronary artery bypass surgery may predict post-operative atrial fi…
2015
BackgroundPost-operative atrial fibrillation (POAF) following cardiac surgery has a high prevalence and is associated with considerable morbidity.AimsTo assess the role of GDF-15, a member of the TGFβsuperfamily, as a potential new predictor of POAF after off-pump (OFP) and on-pump (ONP) coronary artery bypass graft (CABG) surgery.MethodsThis observational study recruited the first 50 patients planned for OFP surgery and the first 50 patients planned for ONP surgery. Patients referred for CABG with the following exclusion criteria: age 80 years, previous atrial fibrillation/flutter, previous treatment with Amiodarone, previous cardiac surgery, emergency surgery. Included patients were equip…
Anthropometric parameters and permanent remission of comorbidities 10 years after open gastric bypass in a cohort with high prevalence of super-obesi…
2017
Abstract Background and aim Roux-en-Y gastric bypass (RYGB) is an effective treatment for weight loss in patients with morbid obesity. However, few studies have assessed its long-term efficacy in super-obese patients. The study objective was to analyse the long-term effectiveness of RYGB and its effect on improvement of comorbidities after 10 years of follow-up, and to compare the results depending on baseline BMI ( 2 vs ≥50 kg/m 2 ). Patients and methods A retrospective study was conducted in 63 patients referred for RYGB with a 10-year or longer follow-up period. Mean BMI before surgery was 55 kg/m 2 . Results Mean BMI decreased to 38.1 kg/m 2 at 10 years of follow-up. The success rates a…
Myocardial Protection by Retrograde Cardioplegic Perfusion in the Presence of Acute Coronary Artery Obstruction: An Experimental Study
1992
To investigate retrograde delivery of cardioplegic solutions as a means of enhancing myocardial protection in the presence of coronary artery occlusion, a two-part experimental model was devised. In part 1 (in vitro) the possibility of retroperfusing the entire myocardium during acute occlusion of the left anterior descending artery (LAD) was assessed. In part 2 (in vivo) acute LAD occlusion was performed in dogs, and during 2 hours of aortic cross-clamping crystalline cardioplegic solution was infused at 20-minute intervals. In group I the infusion was antegrade, via the aortic root, and in group II it was retrograde, via the coronary sinus. Thereafter the LAD snare was released and the do…