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Specialty: Anesthesiology
Procedure: Coronary Artery Bypass Graft

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Total 62 results found since Jan 2013.

Individually Optimized Hemodynamic Therapy Reduces Complications and Length of Stay in the Intensive Care Unit: A Prospective, Randomized Controlled Trial
Background: The authors hypothesized that goal-directed hemodynamic therapy, based on the combination of functional and volumetric hemodynamic parameters, improves outcome in patients with cardiac surgery. Therefore, a therapy guided by stroke volume variation, individually optimized global end-diastolic volume index, cardiac index, and mean arterial pressure was compared with an algorithm based on mean arterial pressure and central venous pressure. Methods: This prospective, controlled, parallel-arm, open-label trial randomized 100 coronary artery bypass grafting and/or aortic valve replacement patients to a study group (...
Source: Anesthesiology - September 17, 2013 Category: Anesthesiology Tags: Perioperative Medicine Source Type: research

High Thoracic Epidural Analgesia as an Adjunct to General Anesthesia is Associated With Better Outcome in Low-to-Moderate Risk Cardiac Surgery Patients
Conclusion: This large, uniquely matched single-center cohort was generated, and, subject to the listed limitations the authors concluded that supplemental HTEA to general anesthesia had a better outcome in low-risk cardiac surgery patients, with a significantly lower 6-month mortality rate compared with the control group. However, regression analysis revealed that HTEA only had an independently positive effect on the frequency of postoperative dialysis.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 31, 2013 Category: Anesthesiology Authors: Michael Stenger, Anja Fabrin, Henrik Schmidt, Jacob Greisen, Poul Erik Mortensen, Carl-Johan Jakobsen Tags: Original Article Source Type: research

Perioperative Management of Combined Carotid and Coronary Artery Bypass Grafting Procedures
The objective of this review is to provide a high level overview on current thinking for treatment of patients with combined carotid and coronary artery disease given that these patients are at higher risk of adverse cardiac events, stroke, and death. This review discusses (1) the current literature addressing perioperative stroke risk in the setting of coronary artery bypass graft, (2) the literature regarding different surgical approaches when both carotid and coronary revascularization are being considered, and (3) the data available to guide optimal management of this complex patient population to minimize complication...
Source: Anesthesiology Clinics - July 7, 2014 Category: Anesthesiology Authors: Daryl A. Oakes, Kenneth D. Eichenbaum Source Type: research

Basic Data From 176 Studies on the Immediate Outcome After Aortic Valve Replacement With or Without Coronary Artery Bypass Surgery
Objective: The aim of this study was to summarize the immediate outcome after aortic valve replacement (AVR) with or without coronary artery bypass grafting (CABG).Design: Systematic review and meta-analysis.Setting: University hospitals.Participants: Participants were 683,286 patients who underwent AVR with or without CABG. Patients undergoing other major cardiac procedures were excluded from this analysis.Interventions: AVR with or without CABG.Measurements and Main Results: Operative mortality after AVR with or without concomitant CABG was 4.3%, stroke 2.1%, pacemaker implantation 5.9%, and dialysis 2.2%. After isolated...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 2, 2013 Category: Anesthesiology Authors: Fausto Biancari, Marta Martin, Giulia Bordin, Elia Vettore, Giulia Vinco, Vesa Anttila, Juhani Airaksinen, Francesco Vasques Tags: Original Articles Source Type: research

Perioperative Management of Combined Carotid and Coronary Artery Bypass Grafting Procedures
The objective of this review is to provide a high level overview on current thinking for treatment of patients with combined carotid and coronary artery disease given that these patients are at higher risk of adverse cardiac events, stroke, and death. This review discusses (1) the current literature addressing perioperative stroke risk in the setting of coronary artery bypass graft, (2) the literature regarding different surgical approaches when both carotid and coronary revascularization are being considered, and (3) the data available to guide optimal management of this complex patient population to minimize complication...
Source: Anesthesiology Clinics - October 12, 2014 Category: Anesthesiology Source Type: research

Is there any benefit in combined neuraxial-general anesthesia for myocardial revascularization?
Conclusions The use of neuraxial anesthesia in cardiac surgery remains controversial. The greatest benefit found by this review was the possibility of reducing postoperative arrhythmias, but this result was contradictory among the identified findings. The results of findings regarding mortality, myocardial infarction, stroke and in-hospital length of stay did not show greater efficacy of neuraxial anesthesia.
Source: Brazilian Journal of Anesthesiology - March 8, 2015 Category: Anesthesiology Source Type: research

Is there any benefit in associating neuraxial anesthesia to general anesthesia for coronary artery bypass graft surgery?
Conclusions The use of neuraxial anesthesia in cardiac surgery remains controversial. The greatest benefit found by this review was the possibility of reducing postoperative arrhythmias, but this result was contradictory among the identified findings. The results of findings regarding mortality, myocardial infarction, stroke and in-hospital length of stay did not show greater efficacy of neuraxial anesthesia.
Source: Brazilian Journal of Anesthesiology - April 21, 2016 Category: Anesthesiology Source Type: research

Comparison of Levosimendan versus Dobutamine in Patients with Moderate to Severe Left Ventricular Dysfunction Undergoing Off-pump Coronary Artery Bypass Grafting: A Randomized Prospective Study.
CONCLUSIONS: Levosimendan was associated with statistically significant increase in indices of contractility (CI, LVSWI, and RVSWI) and decrease in PCWP during and after OPCAB. Levosimendan group had lower incidence of atrial fibrillation, shorter length of ICU, and hospital stay. PMID: 28393781 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - April 1, 2017 Category: Anesthesiology Authors: Kandasamy A, Simon HA, Murthy P, Annadurai M, Ali MM, Ramanathan G Tags: Ann Card Anaesth Source Type: research

Ischemic Optic Neuropathy in Cardiac Surgery Incidence and Risk Factors in the United States from the National Inpatient Sample 1998 to 2013
Conclusions The incidence of ischemic optic neuropathy in cardiac surgery did not change during the study period. Development of ischemic optic neuropathy after cardiac surgery is associated with carotid artery stenosis, stroke, and degenerative eye conditions.
Source: Anesthesiology - April 18, 2017 Category: Anesthesiology Source Type: research

Volatile anaesthetics versus propofol in the cardiac surgical setting of remote ischaemic preconditioning: a secondary analysis of a Cochrane Systematic Review.
CONCLUSIONS: Present data do not permit a final assessment regarding the role of volatile or intravenous anaesthetics as a possible confounding factor in RIPC trials. PMID: 29945432 [PubMed - as supplied by publisher]
Source: Minerva Anestesiologica - June 28, 2018 Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research

Anesthetic and Technical Considerations in Redo Coronary Artery Bypass Surgery Using Sternal-Sparing Approaches
REOPERATIVE CORONARY ARTERY bypass grafting (CABG) has decreased significantly in the previous 20 years, likely because of the increased availability of percutaneous coronary intervention (PCI). Reoperative surgery using the classic trans-sternal approach is more technically challenging than primary surgery and is associated with an increased risk of major complications and death. There is an increased risk of injury to patent bypass grafts, the great vessels, and right ventricle during sternal re-entry. Manipulation of the aorta or diseased bypass grafts can precipitate embolization and cause stroke or myocardial infarcti...
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 9, 2012 Category: Anesthesiology Authors: Mitsuko Takahashi, Amanda J. Rhee, Farzan Filsoufi, George Silvay, Ramachandra C. Reddy Tags: Case Reports Source Type: research

High Thoracic Epidural Analgesia and Cardiac Performance
We read with interest the recent paper of CJ Jakobsen et al regarding high thoracic epidural analgesia (HTEA) in cardiac surgery. They studied 60 low-risk patients between 65 and 80 years of age scheduled for elective coronary artery bypass graft surgery with or without HTEA. They thought HTEA improved perioperative cardiac performance both before and after cardiopulmonary bypass, shown by a higher stroke volume index and cardiac index without increases in heart rate or mean arterial pressure. But we do not think so.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 14, 2013 Category: Anesthesiology Authors: Yong Xin Liang, He Dong, Yun Bo Sun Tags: Letters to the Editor Source Type: research

Chronic Pressure-Overload Hypertrophy Attenuates Vortex Formation Time in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Systolic Function Undergoing Aortic Valve Replacement
Objective: Transmitral blood flow produces a vortex ring that enhances the hydraulic efficiency of early left ventricular (LV) filling. The effect of pressure-overload hypertrophy on the duration of LV vortex ring formation (vortex formation time [VFT]) is unknown. The current investigation tested the hypothesis that chronic LV pressure-overload hypertrophy produced by severe aortic stenosis (AS) reduces VFT in patients with preserved LV systolic function undergoing aortic valve replacement.Design: Observational study.Setting: Veterans Affairs Medical Center.Participants: After the Institutional Review Board's approval, 8 ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 3, 2013 Category: Anesthesiology Authors: Paul S. Pagel, Judith A. Hudetz Tags: Original Articles Source Type: research

Hemodynamic Pressure Waveform Analysis in Predicting Fluid Responsiveness
Objective: To assess the usefulness of central venous pressure (CVP), diastolic right ventricular pressure, and pulmonary capillary wedge pressure (PCWP) waveform analysis in predicting fluid responsiveness.Design: A prospective observational study.Setting: Tertiary care university hospital.Patients: Forty-four patients undergoing coronary artery bypass grafting.Interventions: Analysis of the a/v wave ratio of the PCWP, CVP, and right ventricular dP/dt to predict an increase in stroke volume>15% after the administration of 500mL of colloid.Measurements and Main Results: Forty-four patients were enrolled in this study and 7...
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 16, 2013 Category: Anesthesiology Authors: Sébastien Roy, Pierre Couture, Baqir Qizilbash, Francis Toupin, Sylvie Levesque, Michel Carrier, Jean Lambert, André Y. Denault Tags: Original Articles Source Type: research

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