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The Effect of Optimising Cerebral Tissue Oxygen Saturation on Markers of Neurological Injury during Coronary Artery Bypass Graft Surgery
Background: Surgical revascularisation of the coronary arteries is a cornerstone of cardiothoracic surgery. Advanced age and the incidence of preoperative co-morbidity in patients presenting for coronary artery bypass graft surgery increases the potential for stroke and other perioperative outcomes. It is hypothesised that by using interventions during cardiac surgery to improve cerebral oxygenation, the risk of patients enduring adverse neurological outcomes would be reduced.Methods: Forty patients (mean age 55.3, standard deviation 9.74 and range from 39 to 72 years) undergoing on-pump coronary artery bypass graft surger...
Source: Heart, Lung and Circulation - August 2, 2013 Category: Cardiology Authors: Yakeen Harilall, Jamila Kathoon Adam, Bruce Mclure Biccard, Anu Reddi Tags: Original Articles Source Type: research

Standardizing definitions for hybrid coronary revascularization
The optimal revascularization strategy for patients with multivessel coronary artery disease remains controversial. Coronary artery bypass grafting (CABG) surgery is still considered the criterion standard, but percutaneous coronary intervention (PCI) has become the preferred strategy for most patients with coronary artery disease. Numerous studies have compared outcomes after CABG and multivessel PCI. In general, it is accepted that CABG surgery has the advantage of superior long-term freedom from repeat revascularization, as well as a survival benefit in certain high-risk groups, but that these benefits come at the expen...
Source: The Journal of Thoracic and Cardiovascular Surgery - November 25, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Ralf E. Harskamp, Johannes O. Bonatti, David X. Zhao, John D. Puskas, Robbert J. de Winter, John H. Alexander, Michael E. Halkos Tags: Editorial Source Type: research

Efficacy of Prophylactic Intra‐Aortic Balloon Pump Therapy in Chronic Heart Failure Patients Undergoing Cardiac Surgery
This study investigated the efficacy of prophylactic intraoperative intra‐aortic balloon pump (IABP) usage in chronic heart failure patients with severely reduced left ventricular function undergoing elective cardiac surgery. Between January 2008 and December 2012, 107 patients with severely reduced left ventricular ejection fraction (LVEF <35%) received prophylactic intraoperative IABP implantation during open‐heart surgery. Surgical procedures performed were isolated coronary artery bypass grafting (CABG) in 35 patients (32.7%), aortic valve replacement in 12 (11.2%), mitral valve repair or replacement in 15 (14.0...
Source: Artificial Organs - February 1, 2014 Category: Transplant Surgery Authors: Yalin Yildirim, Simon Pecha, Mathias Kubik, Yousuf Alassar, Tobias Deuse, Samer Hakmi, Hermann Reichenspurner Tags: Thoughts and Progress Source Type: research

Surgical Aortic Valve Replacement in Very Elderly Patients Aged 80 Years and Over: Evaluation of Early Clinical Outcomes
Background: An increasing number of very elderly patients aged ≥80 years will require aortic valve replacement (AVR) for severe aortic stenosis (AS). Many are classified as high-risk surgical candidates. Transcatheter aortic valve implantation (TAVI) has been proposed as an alternative to surgical AVR (SAVR) for high-risk patients. We evaluated early clinical outcomes of very elderly patients undergoing SAVR to optimise TAVI candidate selection.Methods: We conducted a retrospective case review of 132 consecutive patients aged ≥80 years undergoing isolated SAVR (49 patients) or combined SAVR/CABG (83 patients) during Fe...
Source: Heart, Lung and Circulation - September 9, 2013 Category: Cardiology Authors: Edwin Ho, Manu N. Mathur, Peter W. Brady, David Marshman, Russell J. Brereton, Donald E. Ross, Ravinay Bhindi, Peter S. Hansen Tags: ORIGINAL ARTICLES Source Type: research

Perioperative outcomes after on- and off-pump coronary artery bypass grafting.
Abstract Although numerous reports describe the results of off-pump coronary artery bypass grafting (CABG) at specialized centers and in select patient populations, it remains unclear how off-pump CABG affects real-world patient outcomes. We conducted a large, multicenter observational cohort study of perioperative death and morbidity in on-pump (ON) versus off-pump (OFF) CABG. We reviewed Veterans Affairs Surgical Quality Improvement Program data for all patients (N=65,097) who underwent isolated CABG from October 1997 through April 2011 (intention-to-treat data were available from 2005 onward). The primary outco...
Source: Texas Heart Institute Journal - April 1, 2014 Category: Cardiology Authors: Bakaeen FG, Chu D, Kelly RF, Holman WL, Jessen ME, Ward HB Tags: Tex Heart Inst J Source Type: research

What is the optimal revascularization technique for isolated disease of the left anterior descending artery: minimally invasive direct coronary artery bypass or percutaneous coronary intervention?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, ‘What is the optimal revascularization technique for isolated disease of the left anterior descending artery (LAD) in terms of patient survival, morbidity such as myocardial infarction (MI) and need for repeat target vessel revascularization: minimally invasive direct coronary artery bypass graft (MIDCAB) or percutaneous coronary intervention (PCI)?’ Altogether 504 papers were found using the reported search, of which 13 represented the best evidence to answer the clinical question. Outcome param...
Source: Interactive CardioVascular and Thoracic Surgery - June 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Patel, A. J., Yates, M. T., Soppa, G. K. R. Tags: Adult Cardiac Source Type: research

Relationship Between Tricuspid Annular Excursion and Velocity in Cardiac Surgical Patients
Objectives: The primary objective of this study was to establish the relationship among tricuspid annular velocity (S’), tricuspid annular plane systolic excursion (TAPSE), and stroke volume (SV) in a cardiac surgical population with and without right ventricular (RV) dysfunction. The secondary objective was to assess the effect of ephedrine on these relationships in a population without RV dysfunction.Design: Prospective, nonrandomized, unblinded study.Setting: Single tertiary-level, university-affiliated hospital.Participants: Twenty-seven patients undergoing elective coronary artery bypass grafting with no evidence of...
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 21, 2014 Category: Anesthesiology Authors: Raymond Hu, C. David Mazer, Claude Tousignant Tags: Original Articles Source Type: research

Early goal-directed therapy based on endotracheal bioimpedance cardiography: a prospective, randomized controlled study in coronary surgery
The objective was to compare the impact of an early goal-directed hemodynamic therapy based on cardiac output monitoring (Endotracheal Cardiac Output Monitor, ECOM) with a standard of care on postoperative outcome following coronary surgery. This prospective, controlled, parallel-arm trial randomized 100 elective primary coronary artery bypass grafting patients to a study group (ECOM; n = 50) or a control group (control; n = 50). In the ECOM group, hemodynamic therapy was guided by respiratory stroke volume variation and cardiac index given by the ECOM system. A standard of care was used in the control. Goal-directed t...
Source: Journal of Clinical Monitoring and Computing - November 9, 2014 Category: Information Technology Source Type: research

Ticagrelor: A Review of Its Use in Adults with Acute Coronary Syndromes
Abstract Ticagrelor (Brilique™, Brilinta®), a cyclopentyl-triazolopyrimidine, is an orally active, reversible, and selective adenosine diphosphate (ADP) receptor antagonist indicated for use in patients with acute coronary syndromes (ACS). Ticagrelor has a faster onset of action and provides greater inhibition of platelet aggregation than clopidogrel. In the large well-designed, PLATO study in adult patients with ACS, 12 months’ treatment with ticagrelor was more effective than clopidogrel in reducing the incidence of the primary composite endpoint of myocardial infarction, stroke, or cardiovascular (CV) dea...
Source: American Journal of Cardiovascular Drugs - February 12, 2015 Category: Cardiology Source Type: research

Protective effects of corticosteroids in coronary artery bypass graft surgery alone or combined with valvular surgery: an updated and comprehensive meta-analysis and systematic review.
Abstract This systematic review with meta-analysis sought to determine the protective effects of corticosteroids on clinical outcomes following coronary artery bypass grafting (CABG). Medline, Embase, Elsevier and Sciences online database as well as Google scholar literature were used for selecting appropriate studies with randomized controlled design. The effect sizes measured were odds ratio (OR) for categorical variables and weighted mean difference with 95% confidence interval (CI) for calculating differences between mean values of duration of hospitalization in intervention and control groups. Values of P <...
Source: Hand Surgery - March 3, 2015 Category: Surgery Authors: Ali-Hassan-Sayegh S, Mirhosseini SJ, Haddad F, Karimi-Bondarabadi AA, Shahidzadeh A, Weymann A, Popov AF, Sabashnikov A Tags: Interact Cardiovasc Thorac Surg Source Type: research

Protective effects of corticosteroids in coronary artery bypass graft surgery alone or combined with valvular surgery: an updated and comprehensive meta-analysis and systematic review
This systematic review with meta-analysis sought to determine the protective effects of corticosteroids on clinical outcomes following coronary artery bypass grafting (CABG). Medline, Embase, Elsevier and Sciences online database as well as Google scholar literature were used for selecting appropriate studies with randomized controlled design. The effect sizes measured were odds ratio (OR) for categorical variables and weighted mean difference with 95% confidence interval (CI) for calculating differences between mean values of duration of hospitalization in intervention and control groups. Values of P < 0.1 for Q-test o...
Source: Interactive CardioVascular and Thoracic Surgery - May 28, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Ali-Hassan-Sayegh, S., Mirhosseini, S. J., Haddad, F., Karimi-bondarabadi, A. A., Shahidzadeh, A., Weymann, A., Popov, A.-F., Sabashnikov, A. Tags: Cardiac - pharmacology, Coronary disease Adult Cardiac Source Type: research

European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG registry): Study Protocol for a Prospective Clinical Registry and Proposal of Classification of Postoperative Complications
DiscussionThe E-CABG registry is expected to provide valuable data for identification of risk factors and treatment strategies associated with suboptimal outcome. These information may improve the safety and durability of coronary artery bypass grafting. The proposed classification of postoperative complications may become a valuable research tool to stratify the impact of such complications on the outcome of these patients and evaluate the burden of resources needed for their treatment.Clinical Trials numberNCT02319083
Source: Journal of Cardiothoracic Surgery - June 30, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Fausto BiancariVito RuggieriAndrea PerrottiPeter SvenarudMagnus DalénFrancesco OnoratiGiuseppe FaggianGiuseppe SantarpinoDaniele MaselliCarmelo DominiciSaverio NardellaFrancesco MusumeciRiccardo GherliGiovanni MariscalcoNicola MasalaAntonino RubinoCarmel Source Type: research

Prophylactic Subclavian Artery Intraaortic Balloon Counter-Pulsation is Safe in High-Risk Cardiac Surgery Patients
The objective of this study was to determine the safety of prophylactic subclavian artery intraaortic balloon pumps (SCA-IABP) in high-risk cardiac surgery patients as a bridge to recovery (BTR). From November 2011 to January 2013, 11 consecutive patients at three institutions underwent prophylactic insertion of a SCA-IABP as a BTR. All patients (n = 11) had preoperative ejection fractions of 30% or less. Patients concurrently underwent one or a combination of the following procedures: coronary artery bypass grafting, mitral valve surgery, aortic valve replacement, left ventricular aneurysm resection, and ventricular/atria...
Source: ASAIO Journal - September 1, 2015 Category: Medical Equipment Tags: Case Series Source Type: research

Safety and efficacy of glucose-insulin-potassium treatment in coronary artery bypass graft surgery and percutaneous coronary intervention
The purpose of this meta-analysis was to evaluate protective effects of glucose–insulin–potassium (GIK) on outcomes after coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). We systematically searched Medline/Pubmed, Elsevier, Embase, Web of Knowledge and Google Scholar. A total of 1206 studies were retrieved during the extensive literature search of all major databases; however, 38 trials reporting the end-point of interest were selected. We performed a pooled analysis of outcomes following PCI: incidence of cardiac arrest [odds ratio (OR) of 0.91; 95% confidence interval (CI): ...
Source: Interactive CardioVascular and Thoracic Surgery - October 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Ali-Hassan-Sayegh, S., Mirhosseini, S. J., Zeriouh, M., Dehghan, A. M., Shahidzadeh, A., Karimi-Bondarabadi, A. A., Sabashnikov, A., Popov, A.-F. Tags: Congestive Heart Failure Adult Cardiac Source Type: research

Topical amiodarone to prevent postoperative atrial fibrillation: Need for further study
Postoperative atrial fibrillation (AF) is a common complication after cardiac surgery that increases hospital stay and the risk of stroke.1 Prophylactic systemic administration of amiodarone in the perioperative period prevents postoperative AF2; however, its challenging side-effect profile limits its routine and widespread use as prophylaxis.3 It was therefore with great interest that we recently read the report by Feng and colleagues4 describing their success in applying a topical amiodarone-releasing hydrogel on the atrial surface during coronary artery bypass grafting operations.
Source: The Journal of Thoracic and Cardiovascular Surgery - January 23, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Jordan Beau, Alexander Kulik Tags: Letter to the editor Source Type: research

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