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Combined coronary and carotid artery disease: what to operate on first? or both at the same time?
Heart disease and stroke rank amongst the top four leading causes of death in the United States.1 Studies have demonstrated a positive correlation between the two, even suggesting that carotid artery disease may predict the presence of coronary artery disease (CAD).2,3 In fact, some have found that the prevalence of carotid artery stenosis (CAS) in those undergoing coronary artery bypass grafting (CABG) may be as high as 8-14%.4 Despite such co-existence, there remains no clear consensus Guidelines for revascularization in patients with co-existing CAD and CAS.
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 20, 2023 Category: Anesthesiology Authors: Sherman Yu, Mark A. Chaney Tags: Case Conference Source Type: research

Predictors and outcomes of stroke after isolated coronary artery bypass grafting. A single-center experience in 20,582 patients
Stroke remains a devastating complication after cardiac surgical procedures despite advances in perioperative monitoring and management. The purpose of this study was to determine the predictors of stroke in a large, contemporary coronary surgery population.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 12, 2023 Category: Anesthesiology Authors: Vincent J. Kroeze, Jules R Olsthoorn, Albert H.M. van Straten, Anouk Princee, Mohamed A. Soliman-Hamad Tags: Original Article Source Type: research

Single Versus Multiarterial Grafts for Coronary Artery Bypass Graft Surgery: Analysis of Recent Data
ACCORDING TO THE Centers for Disease Control and Prevention, there are 37.3 million people with diabetes mellitus (DM) in the United States.1 The main cause of death for patients with DM, types 1 and 2, is coronary artery disease (CAD), with a 2- to 4-fold increased risk of mortality for heart disease.2 The trend of increased morbidity and mortality in patients with DM is likely due to its more complex and diffuse CAD pattern.3 Coronary artery bypass grafting (CABG) remains the gold standard compared to percutaneous coronary intervention for CAD in patients with DM, with reductions in mortality, myocardial infarction, and ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 12, 2023 Category: Anesthesiology Authors: Kenneth R. Hassler, Harish Ramakrishna Tags: Expert Review Source Type: research

Single vs Multi-Arterial Grafts for CABG - Analysis of Recent Data
According to the Center for Disease Control and Prevention (CDC) there are 37.3 million people with diabetes mellitus (DM) in the United States.1 The main cause of death for DM patients, type 1 and 2, is coronary artery disease (CAD), with a 2 to 4-fold increased risk of mortality for heart disease.2 The trend of increased morbidity and mortality in DM patients is likely due to its more complex and diffuse CAD pattern.3 Coronary artery bypass grafting (CABG) remains the gold standard when compared to percutaneous coronary intervention (PCI) for CAD in DM with a reduction in mortality, myocardial infarction, and stroke as d...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 12, 2023 Category: Anesthesiology Authors: Kenneth R. Hassler, Harish Ramakrishna Tags: Expert Review Source Type: research

The Validation of Cardiac Index and Stroke-Volume Variation Measured by the Pulse-Wave Transit Time-Analysis Versus Conventional Pulse-Contour Analysis After Off-Pump Coronary Artery Bypass Grafting: Observational Study
To compare the reliability of cardiac index (CI) and stroke-volume variation (SVV) measured by the pulse-wave transit-time (PWTT) method using estimated continuous cardiac output (esCCO) technique with conventional pulse-contour analysis after off-pump coronary artery bypass grafting (OPCAB).
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 11, 2023 Category: Anesthesiology Authors: Evgeniia V. Fot, Alexey A. Smetkin, Dmitriy A. Volkov, Tatyana N. Semenkova, Konstantin V. Paromov, Vsevolod V. Kuzkov, Mikhail Y. Kirov Tags: Original Article Source Type: research

The validation of cardiac index and stroke volume variation measured by the pulse wave transit time analysis vs. conventional pulse contour analysis after off-pump coronary artery bypass grafting: observational study
To compare the reliability of cardiac index (CI) and stroke volume variation (SVV) measured by pulse wave transit time method using estimated continuous cardiac output (esCCO) technique with conventional pulse contour analysis after off-pump coronary artery bypass grafting (OPCAB).
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 11, 2023 Category: Anesthesiology Authors: Evgeniia V. Fot, Alexey A. Smetkin, Dmitriy A. Volkov, Tatyana N. Semenkova, Konstantin V. Paromov, Vsevolod V. Kuzkov, Mikhail Y. Kirov Tags: Original Article Source Type: research

New-onset Atrial Fibrillation after Cardiac Surgery is a Significant Risk Factor for Long-term Stroke: An 8-Year Prospective Cohort Study
This study sought to determine the incidence and significance of new-onset atrial fibrillation as a risk factor for long-term stroke and mortality after cardiac surgery.Design: A prospective cohort study.Setting: 2 large tertiary public hospitalsParticipants: The study comprised 3008 patients who underwent coronary artery bypass grafting and/or valve surgery from 2008 to 2012.Interventions: None.Measurements and Main Results: new-onset atrial fibrillation was analysed as a risk factor for postoperative stroke using a multivariable logistic regression model following adjustment for potential confounders.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 8, 2021 Category: Anesthesiology Authors: Kevin K.P. Wang, Weiling Liu, Sophia T.H. Chew, Lian Kah Ti, Liang Shen Source Type: research

Brain Oxygen Supply in Older Adults During Coronary Artery Bypass Grafting
The neurological complications after cardiovascular surgery are relatively frequent, and they generate high increases of morbidity and mortality [1, 2]. This problem is especially relevant for elderly patients, because neurological complications, including stroke, often lead to high mortality and poor long-term outcomes [3].
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 9, 2020 Category: Anesthesiology Authors: Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Vladimir V. Lomivorotov, Vladimir Shmyrev, Alexander Chernyavskiy Tags: Original Article Source Type: research

Incorporating Indices of Postoperative Glycemic Variability in Postoperative Outcome Prediction Modeling: How Accurate Can it Get?
PERIOPERATIVE hyperglycemia, as well as the amplitude and frequency of glycemic variation are associated with increased morbidity and mortality after cardiac surgery, regardless of diabetic state.1,2 In patients undergoing coronary artery bypass grafting surgery, early postoperative hyperglycemia (blood glucose concentration [BGC]>250 mg/dL) significantly increases the risks of postoperative complications (nonfatal stroke, myocardial infarction, sepsis, death).3
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 29, 2020 Category: Anesthesiology Authors: Kai Yin Hwang, Nian Chih Hwang Tags: Editorial Source Type: research

Intraoperative Stroke During Robotic Totally Endoscopic Coronary Artery Bypass
THE INCIDENCE OF stroke after coronary artery bypass graft (CABG) surgery is between 1% and 5% and is one of the most detrimental complications.1 Off-pump CABG is associated with a lower stroke rate than traditional on-pump CABG (0.7% v 1.4%).2 Stroke after CABG is associated with increased morbidity and mortality and increased cost secondary to longer hospital stays and rehabilitation. The authors ’ presented case demonstrates the complexity of perioperative management of a patient scheduled for elective off-pump total endoscopic coronary artery bypass (TECAB) grafting with recent transient ischemic attack (TIA), stroke...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 7, 2019 Category: Anesthesiology Authors: Jennette D. Hansen, Mark A. Chaney, Michael Essandoh, Jean Starr, BobbieJean Sweitzer Tags: Case Conference Source Type: research

Short-Term Outcomes After Off-Pump or On-Pump Coronary Artery Bypass Grafting in the Octogenarian Patients
Despite large randomized controlled trials demonstrating similar outcomes for of-pump or on-pump coronary artery bypass grafting, the debate between proponents of each technique remains current.1 On-pump technique improves surgical exposure on a nonbeating heart but exposes the patient to a powerful inflammatory response and to ischemic stroke owing to cross clamping and cannulation. Off-pump coronary artery bypass (OPCAB) may reduce blood transfusion, postoperative length of hospital stay, postoperative neurocognitive decline, and systemic anticoagulation, but heart repositioning may be associated with hemodynamic instabi...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 2, 2019 Category: Anesthesiology Authors: B érénice Tiquet, Jean David Blossier, Isabelle Orsel, Frank Pihan, Alessandro Piccardo, Jean Phillippe Marsaud, David Vandroux Tags: Letter to the Editor Source Type: research

A New Approach to Detect Nonconvulsive Seizures in Patients in a Cardiac Surgery Intensive Care Unit by Monitoring Heart Rate Variability
CORONARY ARTERY BYPASS GRAFTING (CABG) surgery has been associated with different neurologic complications such as intracerebral hemorrhage, seizures, delirium, cognitive impairment, and peripheral neuropathy.1,2 Specifically, the incidence of seizures after cardiac surgery varies between 0.5% and 7.6%.3 Seizures are due mainly to thromboembolic ischemic stroke, cerebral air embolism, or specific drugs.4 When seizures occur, recurrence rates range between 40% and 66%, and an association with an abnormal outcome has been reported.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2019 Category: Anesthesiology Authors: Alessandro Forti, Marika Falla, Tommaso Scquizzato, Giacomo Strapazzon Tags: Case Report Source Type: research

Off-Pump Versus On-Pump Coronary Artery Bypass Grafting —A Systematic Review and Analysis of Clinical Outcomes
Surgical coronary artery bypass grafting (CABG) is the standard of care for revascularization of left main or three-vessel coronary artery disease. The off-pump coronary artery bypass graft (OPCAB) procedure avoids the use of cardiopulmonary bypass. Theoretically, OPCAB may improve long-term outcomes by reducing the rates of perioperative myocardial injury, stroke, neurocognitive impairment, and cardiac-related mortality. Several high-quality clinical trials have been conducted since OPCAB became popular in the 1990s and have demonstrated no benefit of OPCAB over traditional CABG with respect to these outcomes despite favo...
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 9, 2018 Category: Anesthesiology Authors: Shahzad Shaefi, Aaron Mittel, Dan Loberman, Harish Ramakrishna Tags: Expert Review Source Type: research

Pharmacokinetics of Magnesium in Cardiac Surgery: Implications for Prophylaxis Against Atrial Fibrillation
Postoperative atrial fibrillation (POAF) is the most common cardiovascular complication in patients undergoing cardiac surgery. The risk of POAF depends on the type of procedure, and ranges from 30% in patients undergoing coronary artery bypass surgery to 50% in those undergoing combined procedures. Patients who develop POAF have an increased risk of a number of other complications, including stroke and a prolonged hospital stay, and have a higher risk of death during long-term follow-up.1 The precise mechanism of POAF is unknown, but it is obvious that numerous preoperative, intraoperative, and postoperative factors might...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 4, 2017 Category: Anesthesiology Authors: Vladimir V. Lomivorotov, Sergey M. Efremov, Alexander M. Karaskov Tags: Editorial Source Type: research

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