The presence of a dedicated cardiac surgical intensive care service impacts clinical outcomes in adult cardiac surgery patients

ConclusionsImplementation of a dedicated cardiac surgical intensive care service leads to significant improvements in clinical outcomes. The greatest benefit is seen in patients undergoing coronary artery bypass, the most common cardiac surgical operation in the United States. Thus, developing a cardiac surgical intensive care service may be a worthwhile initiative for any cardiac surgical program.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research

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AbstractThe impact of platelet parameters on the cardiovascular risk is still debated. Gender differences in platelet volume indexes and turnover have been previously reported, potentially conditioning their role in the development of coronary artery disease (CAD). However, few studies have addressed, so far, the impact of gender on the immature platelet fraction (IPF) and count (IPC) and their relationship with CAD. We enrolled consecutive patients undergoing coronary angiography in a single centre. IPF and platelet indexes were measured at admission. Significant CAD was defined as the presence of at least one coronary st...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Abstract BACKGROUND: Microplegia has been studied during isolated coronary artery bypass grafting (CABG) and valve surgery, but not in more complex operations. Objectives of this study were to demonstrate safety and effectiveness of microplegia relative to Buckberg cardioplegia during these operations. METHODS: From 1/2012-1/2017, 242 patients underwent multi-component operations with simplified microplegia delivered via syringe pump and 10,512 with modified Buckberg cardioplegia. Operations included aortic root, arch, or ascending aorta replacement in 424 (94%), aortic valve surgery in 324 (72%), and concomi...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
ConclusionsPatients with CMS were more likely to present with increased comorbidities. Patients with CMS undergoing CABG were at risk for worse short ‐term secondary postoperative outcomes and reduced long‐term survival. The data supports the need for further investigation for risk reduction surrounding operative revascularization.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionsPostoperative complications are associated with an increased risk of both early and late mortality and all-cause rehospitalization, particularly during the “value” window within 90 days of CABG. These findings underscore the need to develop avoidance strategies as well as cost-adjustment methods for each of these complications.
Source: American Heart Journal - Category: Cardiology Source Type: research
Publication date: April 2020Source: American Heart Journal, Volume 222Author(s): Tim Kinnaird, Sean Gallagher, James C. Spratt, Peter Ludman, Mark de Belder, Samuel Copt, Richard Anderson, Simon Walsh, Colm Hanratty, Nick Curzen, Adrian Banning, Mamas MamasBackgroundComplex high-risk and indicated revascularization using percutaneous coronary intervention (CHIP-PCI) is an emerging concept that is poorly studied.ObjectiveTo define temporal changes in CHIP-PCI volumes, and the relationship between operator CHIP-PCI volume and patient outcomes.Methods and ResultsData were analyzed on all CHIP-PCI procedures undertaken for sta...
Source: American Heart Journal - Category: Cardiology Source Type: research
AbstractBackgroundMany of the patients who are undergoing Coronary Artery Bypass Graft have diabetes mellitus or metabolic syndrome and are at risk for hyperglycemia events.ObjectiveThe present study aimed to compare conventional glucose control with adjusted tight control in patients undergoing on-pump CABG.MethodsThis double –blind randomized clinical trial study was conducted in Shiraz, Iran, from September 2017–March 2018. Two consecutive groups of 75 patients undergoing elective on- pump coronary artery bypass graft surgery.InterventionThe patients were divided into adjusted tight control of the blood gluc...
Source: Journal of Diabetes and Metabolic Disorders - Category: Endocrinology Source Type: research
Authors: Wang Z, Gong Y, Fan F, Yang F, Qiu L, Hong T, Huo Y Abstract Objectives: To evaluate the optimal revascularization strategy for patients with coronary artery disease (CAD) and end stage renal disease (ESRD) in the drug-eluting stent (DES) era.Methods: One hundred and twelve patients with ESRD treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) were enrolled from 2007 to 2017. All patients were dialysis-dependent, of which 26 received CABG and 86 underwent PCI. The primary endpoint was all-cause mortality. Secondary endpoints were major adverse cardiovascular even...
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
Publication date: Available online 7 January 2020Source: American Heart JournalAuthor(s): Tim Kinnaird, Sean Gallagher, James C. Spratt, Peter Ludman, Mark de Belder, Samuel Copt, Richard Anderson, Simon Walsh, Colm Hanratty, Nick Curzen, Adrian Banning, Mamas MamasAbstractBackgroundComplex high-risk and indicated revascularisation using percutaneous coronary intervention (CHIP-PCI) is an emerging concept that is poorly studied.ObjectivesTo define temporal changes in CHIP-PCI volumes, and the relationship between operator CHIP-PCI volume and patient outcomes.Methods and ResultsData were analysed on all CHIP-PCI procedures ...
Source: American Heart Journal - Category: Cardiology Source Type: research
AbstractPurposeWe evaluated whether longer term hemodialysis (HD) is associated with a higher incidence of vasoplegic syndrome (VS) after cardiac surgery.MethodsThis retrospective, single-center cohort study included 562 consecutive patients who underwent cardiac surgery in a tertiary hospital from January 2015 to December 2016. We assessed VS occurrence and its relationship with HD duration and other risk factors. To assess the effect of the HD duration on VS occurrence, we constructed ordinal variables: HD  = 0 (non-HD), 0 
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
In this study, benefits of minimized bypass in CABG were evaluated under particular consideration of patient body mass index and surgeon impact. From 2004 to 2014, 5164 patients underwent coronary bypass surgery (CABG). Conventional cardiopulmonary bypass (CCPB) was used in 2376 patients, minimized cardiopulmonary bypass (MCPB) in 2788 cases. Multivariate regression models were used in the entire cohort and in a propensity score-matched subgroup after expert CABG to figure out clinical differences such as mortality, postoperative renal function, and thromboembolic events. Overall mortality was 1.5% (n = 41) i...
Source: Heart and Vessels - Category: Cardiology Source Type: research
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