MedWorm: Coronary Artery Bypass Graft

Proteomic Analysis of Plasma from Patients Undergoing Coronary Artery Bypass Grafting Reveals a Protease/Antiprotease Imbalance in Favor of the Serpin α1-Antichymotrypsin

Journal of Proteome Research — Sat, 20 Mar 2010 10:06:45 +0100

Journal of Proteome Research, Volume 0, Issue 0, Articles ASAP (As Soon As Publishable). (Source: Journal of Proteome Research)

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Risk factors for acute renal failure after heart surgery

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

CONCLUSION: Renal dysfunction was the most frequent postoperative organ dysfunction in patients undergone CABG and/or valve surgery and age, congestive heart failure, COPD, endocarditis, myocardial infarction < 30 days, valve surgery, cardiopulmonary bypass time >120 min, and peripheral arterial vascular disease were the risk factors independently associated with acute renal failure (ARF). (Source: Revista Brasileira de Cirurgia Cardiovascular)

Does the coronary disease increase the hospital mortality in patients with aortic stenosis undergoing valve replacement?

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

CONCLUSIONS: In patients undergoing implant isolated from aortic valve prosthesis, the presence of atherosclerotic coronary artery disease associated critical in at least two arteries, influenced the hospital mortality. In patients undergoing surgical treatment combined the number of coronary arteries with critical atherosclerotic disease and extent of coronary artery bypass grafting (complete or incomplete), did not affect the hospital mortality, but the realization of more than three anastomoses in the distal myocardial revascularization interfered. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Relationship on walk test and pulmonary function tests with the length of hospitalization in cardiac surgery patients

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

CONCLUSION: These results suggest that patients with increased postoperative capacity to walk have a shorter time of hospitalization and it also suggest that the distance in the 6MWT can better represent the functional capacity of these patients than pulmonary function alone. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Off-pump correction of coronary fistula: the single suture technique approach

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

We describe the use of this technique during an off-pump correction of a coronary artery fistula associated with right coronary dilatation. The suggested technique is quicker and less complex than on-pump surgery. Furthermore, it can be a useful tool for congenital fistula correction in select cases, stimulating the practice of less invasive heart surgery in these patients. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Jatene's operation without Lecompte maneuver in child with Taussig-Bing heart

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

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Minimally invasive video-assisted atrial septal defect correction and myocardial revascularization

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

To MCT / CNPq / MEC / CAPES Program of Editing and Publication of Brazilian Scientific Journals

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

Comparable patency achieved with radial artery and saphenous vein grafts

MedWire News - Cardiology — Fri, 19 Mar 2010 14:06:51 +0100

Study findings indicate that radial artery vein grafts provide comparable patency to saphenous vein grafts at 1 year after coronary artery bypass graft surgery. (Source: MedWire News - Cardiology)

Alternative Interpretation of Mitochondrial Metabolic Changes in Atrial Tissue of Type II Diabetic Human Heart

Journal of the American College of Cardiology — Fri, 19 Mar 2010 14:00:33 +0100

Anderson et al. () presented an elegant study in which they assessed the rates of substrate oxidation and reactive oxygen species production of atrial tissue from diabetic patients with normal ejection fraction undergoing coronary artery bypass graft. The authors observed reduced mitochondrial respiratory capacity with palmitoyl-L-carnitine and glutamate as substrate, but not with pyruvate and succinate, as well as augmented reactive oxygen species production in the diabetic group when compared with nondiabetic patients. They then suggested that the existence of myocardial insulin resistance may explain the observed defects in oxidative capacity. However, 3 major concerns have not been addressed in the manuscript, which render the conclusions questionable. (Source: Journal of the American ...

Timing of Revascularization after Acute Myocardial Infarction [ORIGINAL ARTICLE]

Asian Cardiovascular and Thoracic Annals — Fri, 19 Mar 2010 09:53:54 +0100

The optimal timing of surgical revascularization after acute myocardial infarction remains controversial. Higher mortality after emergency coronary artery bypass has been documented. We retrospectively reviewed 278 patients who underwent coronary artery bypass between 2005 and 2007. The time from onset of myocardial infarction to surgical revascularization was the basis for dividing patients into 3 groups: surgery was performed within 24 h in group 1, at 24–72 h in group 2, and after 14 days in group 3. There was a definite relationship between the timing of revascularization and the outcome of surgery. Group 1 had a mortality rate of 11.7%, group 2 had 7% mortality, and group 3 had 2.5% mortality. Group 1 had the highest incidence of postoperative complications. Surgical revasculari...

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Autologous Ring vs. Flexible Prosthetic Ring for Ischemic Mitral Regurgitation [ORIGINAL ARTICLE]

Asian Cardiovascular and Thoracic Annals — Fri, 19 Mar 2010 09:53:54 +0100

Ring annuloplasty is the most common strategy for correction of ischemic mitral regurgitation. When a commercial prosthesis is unavailable or too expensive, an autogenous annuloplasty ring can be handmade by the surgeon. The aim of this study was to compare short-term results of mitral valve repair with autologous annuloplasty rings and the SJM Tailor flexible prosthesis. Between March 2004 and April 2006, 100 patients undergoing coronary artery bypass grafting and mitral ring annuloplasty for ischemic regurgitation were randomly assigned to either type of prosthesis. Transesophageal and transthoracic echocardiography showed no significant differences between these techniques in terms of immediate success of the repair and its durability at 3, 6, and 9 months postoperatively. Autogenous ri...

Coronary Artery Graft Dilatation Aided by Multidetector Computed Tomography [CASE STUDIES]

Asian Cardiovascular and Thoracic Annals — Fri, 19 Mar 2010 09:53:54 +0100

We describe a successful case of percutaneous coronary intervention for occluded coronary artery bypass grafts with the aid of multidetector computed tomography. (Source: Asian Cardiovascular and Thoracic Annals)

PLATO: Ticagrelor lowers total and CV mortality vs clopidogrel in CABG patients

MedWire News - Cardiology — Fri, 19 Mar 2010 00:00:00 +0100

Ticagrelor was associated with significantly lower total and cardiovascular mortality when compared with clopidogrel in acute coronary syndrome patients undergoing coronary artery bypass graft surgery, without any difference in the risk of bleeding related to surgery, latest PLATO subanalysis findings show. (Source: MedWire News - Cardiology)

ACC: No Benefit from Ventricular Reconstruction (CME/CE)

MedPage Today Cardiovascular — Thu, 18 Mar 2010 20:02:23 +0100

ATLANTA (MedPage Today) -- Surgical ventricular reconstruction during a coronary artery bypass graft (CABG) does not appear to benefit any subgroup of patients, a secondary analysis of a randomized trial showed. (Source: MedPage Today Cardiovascular)

ACC: Long-Term Outcomes Similar for Stents and CABG (CME/CE)

MedPage Today Cardiovascular — Thu, 18 Mar 2010 18:21:10 +0100

ATLANTA (MedPage Today) -- For patients with unprotected left main coronary artery disease, stenting and bypass grafting result in similar rates of death, Q-wave myocardial infarction, and stroke in the long term, researchers found. (Source: MedPage Today Cardiovascular)

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ACC: Radial Artery Matches Saphenous Vein for CABG (CME/CE)

MedPage Today Cardiovascular — Thu, 18 Mar 2010 16:44:49 +0100

ATLANTA (MedPage Today) -- Coronary artery bypass grafts taken from the radial artery may provide short-term patency that is just as good as that of the more standard saphenous vein grafts, researchers found in a randomized trial. (Source: MedPage Today Cardiovascular)

Clopidogrel Provides Significantly Greater Inhibition of Platelet Activity Than Aspirin When Combined With Atorvastatin After Coronary Artery Bypass Grafting: A Prospective Randomized Study

Clinical and Applied Thrombosis/Hemostasis — Thu, 18 Mar 2010 11:48:35 +0100

Conclusions: Our results demonstrate that the combination of C + A is more effective than that of ASA + A in inhibiting ADP-mediated platelet aggregation and expression of major platelet receptors after CABG. (Source: Clinical and Applied Thrombosis/Hemostasis)

PLATO CABG Analysis Confuses Cardiologists

Medscape Today Headlines — Wed, 17 Mar 2010 17:36:40 +0100

Cardiologists here at the ACC meeting were confused by a new analysis of PLATO, this time in ACS patients who subsequently underwent CABG surgery. Heartwire (Source: Medscape Today Headlines)

For Left Main Coronary Blockages, Hybrid Revascularization Effective

Health News from Medical News Today — Wed, 17 Mar 2010 07:00:00 +0100

The left main coronary artery provides most of the blood to the heart, and current guidelines call for patients with blockages in this artery to undergo bypass surgery. Hybrid revascularization is a combination of coronary artery bypass surgery and percutaneous coronary intervention (PCI). Emory physicians have been performing these procedures "off-pump" in a minimally invasive fashion, without breaking open the chest. This technique is also known as "endo-ACAB" (endoscopic atraumatic coronary artery bypass)... (Source: Health News from Medical News Today)

For Left Main Coronary Blockages, Hybrid Revascularization Effective

Cardiovascular / Cardiology News From Medical News Today — Wed, 17 Mar 2010 07:00:00 +0100

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Patency for Radial-Artery No Better Than Saphenous-Vein Grafts at One Year

Medscape Today Headlines — Tue, 16 Mar 2010 22:25:50 +0100

The study results may surprise some surgeons, who have tended to think that the radial artery might perform more like the LIMA, which has demonstrated superiority to the saphenous vein for CABG procedures. But 12 months is not enough. Heartwire (Source: Medscape Today Headlines)

Finally Final? New STICH Analysis Finds No Subset That Benefits From Ventricular Reconstruction

Medscape Today Headlines — Tue, 16 Mar 2010 21:20:50 +0100

STICH investigators examine whether baseline end-diastolic volume index and total volume reduction mark which CABG patients benefit from surgical ventricular reduction. Heartwire (Source: Medscape Today Headlines)

PLATO CABG analysis confuses cardiologists

theHeart.org — Tue, 16 Mar 2010 21:15:08 +0100

Cardiologists here at the ACC meeting were confused by a new analysis of PLATO, this time in ACS patients who subsequently underwent CABG surgery. Those in the ticagrelor group were 50% less likely... For complete story visit theheart.org. (Source: theHeart.org)

Patency for radial-artery no better than saphenous-vein grafts at one year

theHeart.org — Tue, 16 Mar 2010 20:15:13 +0100

The study results may surprise some surgeons, who have tended to think that the radial artery might perform more like the LIMA, which has demonstrated superiority to the saphenous vein for CABG... For complete story visit theheart.org. (Source: theHeart.org)

Newer Blood Thinner Beats Plavix for Bypass Patients

MedlinePlus Health News — Tue, 16 Mar 2010 20:00:00 +0100

More people taking Plavix before surgery died soon after than those using Brilinta, study finds Source: HealthDay Related MedlinePlus Pages: Blood Thinners, Coronary Artery Bypass Surgery (Source: MedlinePlus Health News)

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Finally final? New STICH analysis finds no subset that benefits from ventricular reconstruction

theHeart.org — Tue, 16 Mar 2010 18:45:30 +0100

STICH investigators examine whether baseline end-diastolic volume index and total volume reduction mark which CABG patients benefit from surgical ventricular reduction. For complete story visit theheart.org. (Source: theHeart.org)

ACC: CABG Data Suggest Ticagrelor Benefit (CME/CE)

MedPage Today Geriatrics — Tue, 16 Mar 2010 15:13:06 +0100

ATLANTA (MedPage Today) -- Acute coronary syndrome patients randomized to an investigational antiplatelet noted for its quick-on, quick-off activity had a lower mortality rate following coronary artery bypass surgery than control patients, researchers here reported. (Source: MedPage Today Geriatrics)

ACC: Ticagrelor Is Promising Alternative to Clopidogrel

Modern Medicine — Tue, 16 Mar 2010 00:00:00 +0100

The use of ticagrelor instead of clopidogrel in patients with acute coronary syndrome who undergo coronary artery bypass graft surgery is associated with a lower likelihood of fatal outcomes, according to research presented at the Annual Scientific Session of the American College of Cardiology, held from March 14 to 16 in Atlanta. (Source: Modern Medicine)

PCI vs CABG in Complicated Diabetic Patients.

Circulation Journal — Tue, 16 Mar 2010 00:00:00 +0100

Authors: Kim KS PMID: 20234105 [PubMed - as supplied by publisher] (Source: Circulation Journal)

New PLATO Sub-Analysis of CABG Patients Presented at ACC

World Pharma News — Tue, 16 Mar 2010 00:00:00 +0100

AstraZeneca announced results of a new analysis of the PLATO study which showed there were fewer deaths in patients with acute coronary syndromes (ACS) who took the investigational oral antiplatelet BRILINTA (ticagrelor) within seven days prior to having heart bypass surgery (coronary artery bypass graft, CABG) compared to those who took clopidogrel. (Source: World Pharma News)

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Prior Coronary Artery Bypass Graft Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Journal of the American College of Cardiology: Cardiovascular Interventions — Mon, 15 Mar 2010 20:59:21 +0100

Conclusions Prior CABG patients with STEMI are less likely to undergo acute reperfusion, have worse angiographic outcomes following primary PCI, and higher 90-day mortality. These findings are especially applicable when the IRA was a bypass graft. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)

MAQUET Cardiovascular Announces Results From Large Coronary Artery Bypass Graft Surgery Study Showing Favorable Results for Endoscopic Vessel Harvesting Technology

HSMN NewsFeed — Mon, 15 Mar 2010 19:42:46 +0100

Use of Minimally Invasive VASOVIEW System Decreases Risk of Leg Wound Infection While Providing Clinical Outcomes Comparable to Traditional Vein Harvesting Procedure WAYNE, N.J., March 15 (HSMN NewsFeed) -- MAQUET Cardiovascular LLC, a leading provide... Devices, Cardiology, SurgeryMAQUET Cardiovascular, Endoscopic Vessel Harvesting, CABG (Source: HSMN NewsFeed)

Safety And Efficacy Of Drug-Eluting Stents Vs. Bypass Surgery To Be Determined By EXCEL Trial

Health News from Medical News Today — Mon, 15 Mar 2010 07:00:00 +0100

The announcement of a new clinical trial, EXCEL (Evaluation of Xience Prime versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization), that will compare drug-eluting stents to coronary artery bypass graft surgery in patients with left main coronary artery disease, was made today at "Optimizing PCI Outcomes: Evolving Paradigms," a symposium presented by the Cardiovascular Research Foundation... (Source: Health News from Medical News Today)

Safety And Efficacy Of Drug-Eluting Stents Vs. Bypass Surgery To Be Determined By EXCEL Trial

Cardiovascular / Cardiology News From Medical News Today — Mon, 15 Mar 2010 07:00:00 +0100

The announcement of a new clinical trial, EXCEL (Evaluation of Xience Prime versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization), that will compare drug-eluting stents to coronary artery bypass graft surgery in patients with left main coronary artery disease, was made today at "Optimizing PCI Outcomes: Evolving Paradigms," a symposium presente... (Source: Cardiovascular / Cardiology News From Medical News Today)

Hybrid revascularization effective for left main coronary blockages

EurekAlert! - Medicine and Health — Mon, 15 Mar 2010 04:00:00 +0100

(Emory University) Hybrid revascularization is a combination of coronary artery bypass surgery and percutaneous coronary intervention.Researchers will report on outcomes from 21 Emory patients with blockages in the left main coronary artery treated using hybrid revascularization. (Source: EurekAlert! - Medicine and Health)

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Long-term prognosis in ethnic Chinese patients with unprotected left main coronary artery disease

Clinical Research in Cardiology — Sun, 14 Mar 2010 12:25:11 +0100

Conclusion For Chinese patients with unprotected left main coronary artery disease, a significant higher risk of cardiovascular death was noted in the medical therapy group. Overall the long-term cardiovascular survival was similar in LMCA patients treated with either PCI or CABG, but CABG provided better survival outcome in high-risk subgroup patients. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00392-010-0139-5Authors Hui-Chun Huang, National Taiwan University Hospital, National Taiwan University College of Medicine Division of Cardiology, Department of Internal Medicine, Graduate Institute of Clinical Medicine No. 7 Chung-Shan South Road Taipei 100 TaiwanHsien-Li Kao, National Taiwan University Hospital, National Taiwan University College of M...

Excel Trial Will Determine Safety and Efficacy of Drug-Eluting Stents vs. Bypass Surgery in Patients with Left Main Coronary Artery Disease

News from Angioplasty.Org — Sun, 14 Mar 2010 00:30:00 +0100

EXCEL trial will determine safety and efficacy of drug-eluting stents vs. bypass surgery

EurekAlert! - Medicine and Health — Sat, 13 Mar 2010 05:00:00 +0100

(Cardiovascular Research Foundation) The announcement of a new clinical trial, EXCEL (Evaluation of Xience Prime versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization), that will compare drug-eluting stents to coronary artery bypass graft surgery in patients with left main coronary artery disease, was made today at "Optimizing PCI Outcomes: Evolving Paradigms," a symposium presented by the Cardiovascular Research Foundation. (Source: EurekAlert! - Medicine and Health)

EXCEL trial will determine safety and efficacy of drug-eluting stents vs. bypass surgery

ScienceDaily Headlines — Sat, 13 Mar 2010 05:00:00 +0100

A new clinical trial, EXCEL (Evaluation of Xience Prime versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization), is being launched in order to compare drug-eluting stents to coronary artery bypass graft surgery in patients with left main coronary artery disease. (Source: ScienceDaily Headlines)

Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine

Clinics — Fri, 12 Mar 2010 14:39:55 +0100

OBJECTIVE: The aim of this prospective, randomized study was to evaluate the hemodynamic and analgesic effects of ketamine by comparing it with propofol starting at the induction of anesthesia until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery. INTRODUCTION: Anesthetic induction and maintenance may induce myocardial ischemia in patients with coronary artery disease. A primary goal in the anesthesia of patients undergoing coronary artery bypass grafting surgery is both the attenuation of sympathetic responses to noxious stimuli and the prevention of hypotension. METHODS: Thirty patients undergoing coronary artery bypass grafting surgery were randomized to receive either ketamine 2 mg.kg-1 (Group K) or propofol 0.5 mg.kg-1 (Group P) during induction of...

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[Transient subclavian artery spasm observed during percutaneous coronary intervention for acute myocardial infarction.]

Turk Kardiyoloji Dernegi arsivi — Fri, 12 Mar 2010 11:50:04 +0100

Authors: Karakurt O, Kılıç H, Akdemir R A 68-year-old man with a history of two coronary artery bypass operations was admitted with acute inferior myocardial infarction (AMI) and cardiogenic shock. The electrocardiogram showed ST-segment elevation in leads D2, D3, and aVF. Coronary angiography demonstrated a 75% thrombotic stenosis in the right coronary artery (RCA), 90-99% stenosis in the intermediate coronary artery, and plaques in the circumflex artery. While assessing the patency of bypass grafts, a 99% stenosis was noted in the distal subclavian artery. The culprit artery was deemed to be the RCA, and after direct stenting, TIMI III flow was achieved. Ten days later, stent implantation was performed for the intermediate coronary artery, at which time distal subcla...

The Use of Coronary Revascularisation Procedures in Urban Australian Aboriginals and a Matched General Population: Coronary Procedures in Aboriginals

Heart, Lung & Circulation — Thu, 11 Mar 2010 13:57:54 +0100

Conclusions: Coronary revascularisation procedures for IHD were used with equal frequency in Aboriginal people and matched non-Aboriginals. Aboriginal people were more likely to have CABG than PCI. Revascularisation rate and type in ACS admissions were the same. (Source: Heart, Lung & Circulation)

Revascularization for coronary artery disease in diabetes mellitus: Angioplasty, stents and coronary artery bypass grafting

Reviews in Endocrine & Metabolic Disorders — Thu, 11 Mar 2010 08:06:56 +0100

Abstract Patients with diabetes mellitus (DM) are prone to a diffuse and rapidly progressive form of atherosclerosis, which increases their likelihood of requiring revascularization. However, the unique pathophysiology of atherosclerosis in patients with DM modifies the response to arterial injury, with profound clinical consequences for patients undergoing percutaneous coronary intervention (PCI). Multiple studies have shown that DM is a strong risk factor for restenosis following successful balloon angioplasty or coronary stenting, with greater need for repeat revascularization and inferior clinical outcomes. Early data suggest that drug eluting stents reduce restenosis rates and the need for repeat revascularization irrespective of the diabetic state and with no signifi...

The SYNTAX study

Clinical Research in Cardiology Supplements — Wed, 10 Mar 2010 15:43:48 +0100

Abstract The SYNTAX study randomized patients (pts) with three-vessel or left main coronary artery disease (CAD) into pts who underwent bypass grafting (CABG) or percutaneous coronary intervention (PCI). The primary endpoint of the study was a major adverse cardiac or cerebrovascular event (death from any cause, stroke, myocardial infarction, repeated revascularization)(MACCE). Rates of MACCE at 12 months were significantly higher in the PCI group (17.8%) than in the CAGB group (12.4%, p < 0.002). This was caused by an increased rate of repeated revascularizations in PCI pts (13.5%) compared to CABG pts (5.9%, p < 0.001). The rates of death and myocardial infarction were similar between the two groups. Stroke was significantly more likely to occur with C...

Intrathoracic fire during preparation of the left internal thoracic artery for coronary artery bypass grafting

Journal of Cardiothoracic Surgery — Wed, 10 Mar 2010 00:00:00 +0100

We report a case in which an intrathoracic fire developed following an air leak combined with high pressure oxygen ventilation in a patient with severe chronic obstructive pulmonary disease. The patient presented to our institution with diffuse coronary artery disease and angina pectoris. He was treated with coronary artery bypass graft surgery, including left internal thoracic artery harvesting. Additionally to this rare presentation of an intrathoracic fire, a brief review of surgical fires is included to this paper. (Source: Journal of Cardiothoracic Surgery)

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Health-Related Quality of Life After Coronary Artery Bypass Grafting: A Review of Randomized Controlled Trials

Journal of Cardiac Surgery — Wed, 10 Mar 2010 00:00:00 +0100

Objective outcome measures (i.e., survival, mortality, morbidity, complication rate, symptom recurrence, and need for re-interventions) have long been used as benchmarks for successful cardiac surgery, including coronary artery bypass grafting (CABG). Along with these objectively measurable outcome indicators, acquired improvement by cardiac surgery in subjectively experienced health-related quality of life (HRQoL) has gained importance during the last decade in cardiac surgical research. If an increasing proportion of adult patients referred for CABG are elderly, octogenarians or even nonagenarians, the acquired HRQoL benefit from bypass surgery should be considered to be at least as important an outcome measure as potentially marginal improvement in life expectancy or longevity alone. To...

Myocardial Transfection of Hypoxia Inducible Factor-1alpha Via an Adenoviral Vector During Coronary Artery Bypass Grafting:

Circulation Journal — Wed, 10 Mar 2010 00:00:00 +0100

Conclusions: These data support the feasibility and preliminary safety of adenoviral transfection with Ad2HIF in regions of viable myocardium. Additional studies will be required to determine the efficacy and safety of Ad2HIF. PMID: 20215699 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Yellow nail syndrome following thoracic surgery: A new association?

Journal of Postgraduate Medicine — Tue, 09 Mar 2010 16:15:37 +0100

Banta D P, Dandamudi N, Parekh H J, Anholm J DJournal of Postgraduate Medicine 2009 55(4):270-271An 80-year-old man presented with the characteristic triad of yellow nail syndrome (chronic respiratory disorders, primary lymphedema and yellow nails) in association with coronary artery bypass graft surgery. Treatment with mechanical pleurodesis and vitamin E resulted in near complete resolution of the yellow nails, pleural effusions, and lower extremity edema. The etiology of the yellow nail syndrome has been described as an anatomical or functional lymphatic abnormality. Several conditions have previously been described as associated with this disease. This is the first report of the association of this syndrome with thoracic surgery. (Source: Journal of Postgraduate Medicine)

'Biological bypass' for heart disease

Medicineworld.org: New Article Alert — Tue, 09 Mar 2010 14:04:37 +0100

A new method of growing arteries could lead to a "biological bypass"or a non-invasive way to treat coronary artery disease, Yale School of Medicine scientists report with their colleagues in the recent issue of Journal of Clinical Investigation. Coronary arteries can become blocked with plaque, leading to a decrease in the supply of blood and oxygen to the heart. Over time this blockage can lead to debilitating chest pain or heart attack. Severe blockages in multiple major vessels may require coronary artery bypass graft surgery, a major invasive surgery........ (Source: Medicineworld.org: New Article Alert)

Transit-time flow predicts outcomes in coronary artery bypass graft patients

MedWire News - Cardiology — Tue, 09 Mar 2010 13:58:10 +0100

Researchers report that a high pulsatility index on intraoperative measurement of transit-time flow of arterial grafts is associated with poor outcomes in patients undergoing coronary artery bypass graft surgery. (Source: MedWire News - Cardiology)

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New Method To Grow Arteries Could Lead To 'Biological Bypass' For Heart Disease

Health News from Medical News Today — Tue, 09 Mar 2010 13:00:00 +0100

A new method of growing arteries could lead to a "biological bypass" - or a non-invasive way to treat coronary artery disease, Yale School of Medicine researchers report with their colleagues in the April issue of Journal of Clinical Investigation. Coronary arteries can become blocked with plaque, leading to a decrease in the supply of blood and oxygen to the heart. Over time this blockage can lead to debilitating chest pain or heart attack. Severe blockages in multiple major vessels may require coronary artery bypass graft surgery, a major invasive surgery... (Source: Health News from Medical News Today)

Effectiveness and Safety of Drug-Eluting Stents in Vein Grafts: A Meta-Analysis

Medscape Today Headlines — Mon, 08 Mar 2010 12:04:23 +0100

Drug-eluting stent (DES) use in occluded vein grafts is not standard practice but is used off-label. Is the existing data sufficient to indicate DES over bare metal stents post CABG? American Heart Journal (Source: Medscape Today Headlines)

Pre-Surgery C-Reactive Protein Linked to Long-Term Mortality

Modern Medicine — Mon, 08 Mar 2010 00:00:00 +0100

Surgical patients undergoing primary, non-emergent coronary artery bypass graft-only surgery with elevated preoperative levels of C-reactive protein are at heightened risk for longer hospital stays and long-term mortality, according to a study in the March issue of Anesthesiology. (Source: Modern Medicine)

Catastrophic Right Ventricular Rupture Prevented by Coincident Coronary Artery Bypass Grafting: The Pivotal Role of Cardiac Magnetic Resonance Imaging.

Texas Heart Institute Journal — Sat, 06 Mar 2010 23:20:04 +0100

Authors: Farber NJ, Biederman RW WEB SITE FEATURE. PMID: 20200646 [PubMed - as supplied by publisher] (Source: Texas Heart Institute Journal)

Revascularization options in patients with chronic kidney disease.

Texas Heart Institute Journal — Sat, 06 Mar 2010 23:20:04 +0100

Authors: Ashrith G, Elayda MA, Wilson JM Cardiovascular disease is the leading cause of death in patients who have chronic kidney disease or end-stage renal disease and are undergoing hemodialysis. Chronic kidney disease is a recognized risk factor for premature atherosclerosis. Unfortunately, most major randomized clinical trials that form the basis for evidence-based use of revascularization procedures exclude patients who have renal insufficiency. Retrospective, observational studies suggest that patients with end-stage renal disease and severe coronary occlusive disease have a lower risk of death if they undergo coronary revascularization rather than medical therapy alone. Due to a lack of prospective studies, however, the relative merits of percutaneous versus surgical revasculari...

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Trends During 1993-2004 in the Availability and Use of Revascularization After Acute Myocardial Infarction in Markets Affected by Certificate of Need Regulations

Medical Care Research and Review — Thu, 04 Mar 2010 23:55:16 +0100

This study examines trends in the diffusion of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) during 1993-2004 for patients with acute myocardial infarction in markets with and without Certificate of Need (CON) regulations for open-heart surgery or cardiac catheterization and in markets that repealed CON for either of these procedures. In contrast to prior studies, this study accounts for regional hospital markets that cross state boundaries—often with different CON activities in each state. The overall use of CABG increased modestly throughout the 1990s and subsequently decreased, corresponding to a dramatic increase in PCI. There was a greater rise in the number of CABG programs in markets with significant reduction in CON regulations during 1993-2...

Correlation Between the European System for Cardiac Operative Risk Evaluation and Sexual Function After Coronary Artery Bypass Graft Surgery

The Journal of Sexual Medicine — Thu, 04 Mar 2010 00:00:00 +0100

Conclusions. There is an inverse correlation between the components of EuroSCORE and the IIEF-5 score. Patients with higher EuroSCORE had lower IIEF-5 scores and vice versa.The EuroSCORE is a useful, quick, and inexpensive tool that allows prediction of ED in those patients with coronary artery disease patients who are undergoing CABG. Mohamed OA, Hamed HA, Roaiah MF, Helmy T, Mahran A, and Bennett CJ. Correlation between the European System for Cardiac Operative Risk Evaluation and sexual function after coronary artery bypass graft surgery. J Sex Med **;**:**[ndash]**. (Source: The Journal of Sexual Medicine)

Demographic and Clinical Determinants of Moderate to Vigorous Physical Activity During Home-Based Cardiac Rehabilitation: THE HOME-BASED DETERMINANTS OF EXERCISE (HOME) STUDY.

Journal of Cardiopulmonary Rehabilitation and Prevention — Thu, 04 Mar 2010 00:00:00 +0100

CONCLUSIONS: The MVPA levels of patients attending home-based CR tend to vary depending on gender, whether or not metabolic syndrome was present, and prior MVPA levels, suggesting the need to potentially target these particular groups in future behavioral interventions aimed at increasing MVPA. PMID: 20216322 [PubMed - as supplied by publisher] (Source: Journal of Cardiopulmonary Rehabilitation and Prevention)

On-Pump versus Off-Pump CABG

New England Journal of Medicine — Wed, 03 Mar 2010 00:00:00 +0100

To the Editor: In the Veterans Affairs Randomized On/Off Bypass (ROOBY) trial, Shroyer et al. (Nov. 5 issue)1 assigned 2203 ... (Source: New England Journal of Medicine)

The -251A>T polymorphism of interleukin-8 is associated with longer mechanical ventilation and hospital staying after coronary surgery.

Cytokine — Wed, 03 Mar 2010 00:00:00 +0100

Conclusions: OPCAB results in post-operative inflammatory responses. Genetic backgrounds alter the extent of inflammatory response and might relate to clinical outcome of OPCAB. PMID: 20206550 [PubMed - as supplied by publisher] (Source: Cytokine)

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Successful recovery using surgical intervention to treat ischemic cardiomyopathy and cardiogenic shock.

Annals of Thoracic and Cardiovascular Surgery — Tue, 02 Mar 2010 19:36:17 +0100

We report here a successful case of recovery from cardiogenic shock resulting from ischemic cardiomyopathy, treated by using a left ventricular assist device (LVAD). The LVAD was successfully explanted at the time of simultaneous coronary artery bypass grafting and left ventricular restoration after recovery from end-organ dysfunction by LVAD support. (Ann Thorac Cardiovasc Surg 2010; 16: 52-54). PMID: 20190712 [PubMed - in process] (Source: Annals of Thoracic and Cardiovascular Surgery)

Intravenous levosimendan-norepinephrine combination during off-pump coronary artery bypass grafting in a hemodialysis patient with severe myocardial dysfunction

Journal of Cardiothoracic Surgery — Tue, 02 Mar 2010 00:00:00 +0100

This the case of a 63 year-old man with end-stage renal disease (on chronic hemodialysis), unstable angina and significantly impaired myocardial contractility with low left ventricular ejection fraction, who underwent off-pump one vessel coronary bypass surgery. Combined continuous levosimendan and norepinephrine infusion (at 0.07 mug/kg/min and 0.05 mug/kg/min respectively) started immediately after anesthesia induction and continued for 24 hours. The levosimendan / norepinephrine combination helped maintain an appropriate hemodynamic profile, thereby contributing to uneventful completion of surgery and postoperative hemodynamic stability. Although levosimendan is considered contraindicated in ESRD patients, this case report suggests that combined perioperative levosimendan / norepinephri...

Chronic stable coronary artery disease: drugs vs. revascularization

European Heart Journal — Mon, 01 Mar 2010 08:05:56 +0100

Coronary artery disease remains the leading cause of mortality in most industrialized countries, although age-standardized mortality related to coronary artery disease (CAD) has decreased by more than 40% during the last two decades. Coronary atherosclerosis may cause angina pectoris, myocardial infarction, heart failure, arrhythmia, and sudden death. Medical management of atherosclerosis and its manifestation aims at retardation of progression of plaque formation, prevention of plaque rupture, and subsequent events and treatment of symptoms, when these occur as well as treatment of the sequelae of the disease. Revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) is performed as treatment of flow-limiting coronary stenosis to reduce ...

Review: Drugs versus revascularisation in chronic stable coronary artery disease

NeLM - News — Mon, 01 Mar 2010 00:00:00 +0100

Source: European Heart Journal Area: News This review in the European Heart Journal on drug treatment and revascularisation for patients with stable coronary artery disease (CAD) looks at the following: . Prevalence, incidence, and prognosis of angina pectoris . Pathophysiology of stable coronary artery disease . Medical treatment of coronary artery disease and angina pectori . Revascularisation in stable coronary artery disease . The debate The authors conclude that all patients with atherosclerosis benefit from life long drug therapy in addition to a healthy lifestyle. Revascularisation exerts favourable effects on symptoms, quality of life, exercise capacity, and survival, particularly in those with extensive CAD and documented mode...

The ability of pleth variability index to predict the hemodynamic effects of positive end-expiratory pressure in mechanically ventilated patients under general anesthesia.

Anesthesia and Analgesia — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSIONS: PVI may be useful in automatically and noninvasively detecting the hemodynamic effects of PEEP when V(T) is >8 mL/kg in ventilated and sedated patients with acceptable sensitivity and specificity. PMID: 20185658 [PubMed - in process] (Source: Anesthesia and Analgesia)

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Pharmacological agents: antifibrinolytics and desmopressin

Best Practice and Research. Clinical Anaesthesiology — Mon, 01 Mar 2010 00:00:00 +0100

This article provides an overview of the scientific evidence regarding the efficacy and safety of antifibrinolytic agents and desmopressin to reduce surgical blood loss. The synthetic derivatives of lysine are the only antifibrinolytics available in clinical practice since the withdrawal of aprotinin. There is evidence that the prophylactic use of lysine analogues is efficacious in reducing perioperative blood loss in cardiac and major orthopaedic surgery. The impact on exposure to blood transfusion is, however, variable. There is no evidence at present that they improve the overall outcome. Lysine analogues appear to be well tolerated in coronary artery bypass surgery, but less is known regarding their risk–benefit profile in special patient groups. Further studies are needed to elucida...

Timing of nonemergent coronary artery bypass grafting and mortality after non-ST elevation acute coronary syndrome

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Time from admission to CABG was not associated with an increased risk of short-term mortality. However, there was a trend toward increased mortality with early CABG, and this study does not exclude the presence of a modest risk association between timing of CABG and short-term mortality. (Source: American Heart Journal)

CABG Star Rating Coming to the Web Soon

Family Practice News — Mon, 01 Mar 2010 00:00:00 +0100

FORT LAUDERDALE, FLA. — Later this year, coronary bypass patients will start steering their surgeon choices by the stars. A one- to three-star rating system for cardiac surgeons developed by the Society for Thoracic Surgeons will appear on a Consumer Reports Web site, probably beginning in June. (Source: Family Practice News)

CRT: In-hospital death rates decline for PCI, CABG

Cardiovascular Business News — Sat, 27 Feb 2010 02:44:46 +0100

Washington, D.C.—The age-adjusted in-hospital mortality rate from both PCI and CABG has declined to its lowest level in 2004, according to two separate studies presented at the Cardiovascular Research Technologies (CRT) meeting last week. (Source: Cardiovascular Business News)

Low cardiopulmonary bypass perfusion temperatures are associated with acute kidney injury following coronary artery bypass surgery [Original articles]

European Journal of Cardio-Thoracic Surgery — Fri, 26 Feb 2010 22:01:57 +0100

Conclusions: Lower CPB perfusion temperatures are significantly associated with AKI following CABG. In addition to the known age-related decline in renal function, it appears that hypothermia may contribute to renal injury during cardiac surgery. (Source: European Journal of Cardio-Thoracic Surgery)

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Incidence and prediction of permanent neurological deficits after cardiac surgery -- are the existing models of prediction truly global? [Original articles]

European Journal of Cardio-Thoracic Surgery — Fri, 26 Feb 2010 22:01:57 +0100

Conclusion: PND after cardiac operation is associated with a high mortality and poor prognosis. The incidence of PND varies depending on the procedure. Predictive models of neurological injury post-cardiac surgery should be more centre-specific. (Source: European Journal of Cardio-Thoracic Surgery)

Surgical myocardial revascularization of patients with ischemic cardiomyopathy and severe left ventricular disfunction

Clinics — Fri, 26 Feb 2010 14:34:09 +0100

OBJECTIVE: To determine long-term survival, identify preoperative factors predictive of a favorable outcome, and assess functional improvement after coronary artery bypass grafting in patients with advanced left ventricular dysfunction. METHODS: Between 1995 and 2001, 244 patients who underwent coronary artery bypass grafting and had a preoperative left ventricular ejection fraction less than or equal to 35% were included. left ventricular ejection fraction was determined by uniplanar or biplanar ventriculography during left heart catheterization. Indication for surgery was predominance of tissue viability. Functional improvement was evaluated through echocardiography and gated scintigraphy at exercise/ rest. Survival was determined by Kaplan-Meier analysis. RESULTS: Mean left ventricular ...

Origins of the coronary arteries and their significance

Clinics — Fri, 26 Feb 2010 14:34:09 +0100

DISCUSSION: The preferential location of the ostia was within the sinus and above the cusps, but below the sinutubular ridge. On occasion, normal variants like multiple ostia, vertical or circumferential shift in the position, and slit-like ostia may create confusion in interpreting the images and pose a difficulty during procedures like angiography, angioplasty, and coronary artery bypass grafting. (Source: Clinics)

Percutaneous Coronary Intervention or Coronary Artery Bypass Surgery for Cardiogenic Shock and Multivessel Coronary Artery Disease?

Medscape Today Headlines — Fri, 26 Feb 2010 12:04:24 +0100

Post STEMI revascularization strategies are examined to find the optimal path for those with multi-vessel disease and cardiogenic shock American Heart Journal (Source: Medscape Today Headlines)

Anesthetic management of a patient undergoing liver transplantation who had previous coronary artery bypass grafting using an in situ right gastroepiploic artery

Journal of Anesthesia — Fri, 26 Feb 2010 09:42:42 +0100

We describe successful anesthetic management during living-donor liver transplantation in a 63-year-old man with previous coronary artery bypass grafting (CABG) that employed an in situ right gastroepiploic artery (RGEA). Anesthesia was maintained with 1.5% isoflurane in air/oxygen and fentanyl. A five-lead electrocardiogram, transesophageal echocardiogram, and pacing pulmonary artery catheter evaluated cardiac function. A pacing wire was inserted through the catheter to prepare for intraoperative severe bradyarrhythmia. Olprinone and nicorandil were continuously infused to prevent decrease in coronary arterial blood flow and the collapse of cardiac function. Avoiding disruption of circulation to coronary arteries through injury or spasm of the RGEA graft and preparing for cardiac in...

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Cardiac troponin I levels after cardiac surgery as predictor for in-hospital mortality [ESCVS article - Cardiac general]

Interactive CardioVascular and Thoracic Surgery — Fri, 26 Feb 2010 01:18:44 +0100

Conclusion: Postoperative cTnI level, measured within the first hour after cardiac surgery, can identify a subgroup of patients with increased risk for hospital mortality. These patients may benefit from better monitoring, eventually with specific diagnostic and therapeutic interventions. (Source: Interactive CardioVascular and Thoracic Surgery)

Five years follow-up after Y-graft arterial revascularization: on pump versus off pump; prospective clinical trial [ESCVS article - Coronary]

Interactive CardioVascular and Thoracic Surgery — Fri, 26 Feb 2010 01:18:44 +0100

Conclusions: The use of a free RIMA as Y-graft from the LIMA performed off pump eradicates aortic manipulations and provides complete revascularization to high-risk patients with mortality similar to the one of a lower risk population operated on pump. The morbidity and cost was lower in the off-pump group. This advocates for the widespread usage of the technique in high-risk patients. (Source: Interactive CardioVascular and Thoracic Surgery)

Continuous coronary perfusion in redo aortic valve replacement following prior coronary surgery; an old trick for new dogs? [Brief communication - Cardiopulmonary bypass]

Interactive CardioVascular and Thoracic Surgery — Fri, 26 Feb 2010 01:18:44 +0100

The optimal myocardial protection method for aortic valve replacement in the setting of prior coronary artery bypass surgery remains a subject of debate. Protection is particularly challenging when a patent pedicled internal thoracic artery graft supplies a proximally obstructed left anterior descending artery. Herein, we describe a modification of an old technique; continuous coronary perfusion, which can be used in selected, anatomically suitable cases. (Source: Interactive CardioVascular and Thoracic Surgery)

Clinical performance and biocompatibility of hyaluronan-based heparin-bonded extracorporeal circuits in different risk cohorts [Institutional report - Cardiopulmonary bypass]

Interactive CardioVascular and Thoracic Surgery — Fri, 26 Feb 2010 01:18:43 +0100

This prospective randomized study compares novel hyaluronan-based heparin-bonded circuits vs. uncoated controls across EuroSCORE patient risk strata including biomaterial evaluation. Over a two-year period, 90 patients undergoing coronary artery bypass grafting were prospectively randomized to one of the two perfusion protocols: Group 1 was treated with hyaluronan-based heparin-bonded preconnected circuits (Vision HFO-GBSTM, Gish, CA, USA) and Group 2 with identical uncoated controls. Each group was composed of three subgroups (n=15) with respect to preoperative evaluation of low (EuroSCORE 0–2), medium (3–5) and high (6+) risk patients. Blood samples were collected after induction (T1) and heparinization (T2), 15 min after cardiopulmonary bypass start (T3), before cessation of...

Short- and medium-term survival following coronary artery bypass surgery in British Indo-Asian and white Caucasian individuals: impact of diabetes mellitus [Institutional report - Coronary]

Interactive CardioVascular and Thoracic Surgery — Fri, 26 Feb 2010 01:18:43 +0100

Previous studies have suggested that South Asian (SA) ethnicity is a predictor of poorer outcome after coronary artery bypass grafting (CABG). Our aim was to identify potential reasons for the higher postoperative mortality in SA patients and investigate all these reasons. All individuals undergoing isolated CABG in a tertiary cardiac centre from April 2002 to September 2007. In total, there were 2897 subjects (2623 white subjects; 274 SA subjects) who were included in an observational study showing the effect of ethnicity on the medium-term survival following CABG. Survival at 30 days and survival up to five years (median 2.7 years) were measured. SA subjects undergoing CABG were younger (62±9 vs. 66±9 years, P<0.001), less obese [body mass index (BMI) 26&p...

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Drug-eluting stents, CABG ‘equivalent’ in diabetic multivessel disease

MedWire News - Diabetes — Fri, 26 Feb 2010 00:00:00 +0100

Drug-eluting stents and coronary artery bypass graft surgery are equivalent for preventing major vascular events in patients with diabetes mellitus and multivessel disease, analysis of registry data suggests. (Source: MedWire News - Diabetes)

Reply

Journal of the American College of Cardiology — Thu, 25 Feb 2010 13:51:51 +0100

The aim of our study was to evaluate the effect of pre-operative angiotensin-converting enzyme inhibitor (ACEI) treatment on early outcomes after coronary artery bypass grafting (CABG) () by reviewing our prospectively collected institutional database. We agree that ACEI users were higher-risk patients compared with non-ACEI users; however, we identified a propensity score–matched group to perform our analysis. After matching, baseline characteristics were well balanced, without any statistical difference. Propensity scoring is simply a method for reducing the effect of selection bias and potential confounding in observational studies when randomization to treatment groups is not possible, and this was highlighted as a limitation of our study. (Source: Journal of the American College of ...

Angiotensin-Converting Enzyme Inhibitor as a Marker, Not a Risk Factor, for Poor Prognosis

Journal of the American College of Cardiology — Thu, 25 Feb 2010 13:51:50 +0100

The recent paper by Miceli et al. () showed that, compared with those not receiving angiotensin-converting enzyme inhibitor (ACEI) therapy, patients receiving ACEI therapy had a significant short-term risk of in-hospital death, renal dysfunction, and atrial fibrillation when they underwent a coronary artery bypass grafting. Propensity score matching was applied to control confounding factors that differed between ACEI and non-ACEI patients in this observational cohort study. However, 2 epidemiological issues should be mentioned here. First, potential bias from uncontrolled confounding may arise when ACEI use itself is a marker for a condition with a poor prognosis that will trigger clinicians to use ACEI therapy. Consequently, ACEI therapy is found to be associated with an increased risk o...

Architecture of the thrombi removed from coronary artery bypass grafts in a patient with acute myocardial infarction

Journal of Thrombosis and Thrombolysis — Thu, 25 Feb 2010 06:55:38 +0100

Abstract Using scanning electron microscopy we analyzed thrombotic material removed from coronary bypass grafts in a 57-year-old woman with multilevel atherosclerosis presenting with acute myocardial infarction (AMI). A white thrombotic material removed from the marginal branch bypass that contained large amounts of activated platelets displaying pseudopodia clearly visible at a higher magnification with a relatively low amount of fibrin. The other thrombus obtained from the right posterior descendent branch (RPD) bypass showed a highly organized fibrin structure composed of thicker fibers with low amounts of cellular components. Our findings indicate that the thrombus structure is different in AMI patients in whom the infarct-related vessel is vein anastomosis compared to...

Lipoprotein-Associated Phospholipase A2 Activity and Incident Coronary Heart Disease among Men and Women with Type 2 Diabetes.

Diabetes — Thu, 25 Feb 2010 00:00:00 +0100

Conclusions: Levels of Lp-PLA(2) activity were significantly associated with incident CHD among men and women with type 2 diabetes, independent of traditional and inflammatory risk factors. This positive association was strongest for more severe clinical endpoints. PMID: 20185811 [PubMed - as supplied by publisher] (Source: Diabetes)

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Preoperative C-reactive Protein Predicts Long-term Mortality and Hospital Length of Stay after Primary, Nonemergent Coronary Artery Bypass Grafting

Anesthesiology — Wed, 24 Feb 2010 13:41:10 +0100

Conclusion: We demonstrate that preoperative CRP levels as low as 3 mg/l are associated with increased long-term mortality and extended hospital length of stay in relatively lower-acuity patients undergoing primary, nonemergent coronary artery bypass graft-only surgery. These important findings may allow for more objective risk stratification of patients who present for uncomplicated surgical coronary revascularization. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology)

Randomized Comparison of Percutaneous Coronary Intervention With Coronary Artery Bypass Grafting in Diabetic Patients

Medscape Today Headlines — Wed, 24 Feb 2010 12:04:45 +0100

Results are reviewed from the first randomized trial of coronary revascularization in diabetic patients, but the jury is still out. Journal of the American College of Cardiology (Source: Medscape Today Headlines)

Preoperative statin is associated with decreased operative mortality in high risk coronary artery bypass patients

Journal of Cardiothoracic Surgery — Wed, 24 Feb 2010 00:00:00 +0100

Conclusions: Between 2000 and 2004 less than 50% of patients at this institution were receiving statins before admission for isolated CABG. A retrospective analysis of this cohort provides evidence that preoperative statin use is associated with lower operative mortality in high-risk patients. (Source: Journal of Cardiothoracic Surgery)

Effect of Preoperative Statin Therapy on Patients Undergoing Isolated and Combined Valvular Heart Surgery [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:26 +0100

Conclusions Our large series failed to detect a protective effect of preoperative statin therapy on perioperative outcomes or long-term survival in patients undergoing isolated valve surgery. Valve patients undergoing concomitant coronary artery bypass grafting, however, appear to receive a long-term survival benefit from statins. (Source: The Annals of Thoracic Surgery)

Delayed Malignant Hyperthermia After Routine Coronary Artery Bypass [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:26 +0100

Malignant hyperthermia is a rare but well-described hypermetabolic disorder of skeletal muscle that can be potentially fatal if untreated. In our patient, malignant hyperthermia developed several minutes after discontinuation of the known triggering agent after an uncomplicated coronary revascularization. This case illustrates the dramatic presentation and successful management of a rare disease with a rare onset. (Source: The Annals of Thoracic Surgery)

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Coronary Artery Bypass Grafting in Cold-Induced Urticaria [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:26 +0100

We report the case of a 41-year-old woman with chronic cold-induced urticaria, who underwent a successful coronary bypass grafting, and describe perioperative management of this rare disorder. (Source: The Annals of Thoracic Surgery)

The Sinker Technique: A Simple, Effective Technique for Exposing Coronary Arteries in Off-Pump Surgery [HOW TO DO IT]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:26 +0100

Exposure and stabilization of coronary arteries in the circumflex and right territory is essential for off-pump coronary artery bypass grafting. A new, easy technique of exposing and stabilizing coronary arteries using a sinker (weight) hung on a silicone elastomer suture for hemostasis from the arteriotomy is described. (Source: The Annals of Thoracic Surgery)

Increased Graft Occlusion or String Sign in Composite Arterial Grafting for Mildly Stenosed Target Vessels [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions The angiographic outcomes of composite grafts were closely related to the severity of stenosis of the target coronary artery. In target vessels with mild stenosis, composite grafting resulted in a higher incidence of graft occlusion or string sign than individual grafting did. (Source: The Annals of Thoracic Surgery)

Preoperative Cardiac Troponin I to Assess Midterm Risks of Coronary Bypass Grafting Operations in Patients With Recent Myocardial Infarction [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions Preoperative cTnI exceeding 0.15 ng/mL in patients with recent AMI undergoing CABG is associated with higher postoperative myocardial damage and is a strong determinant of postoperative morbidity and mortality within the 6-month period. (Source: The Annals of Thoracic Surgery)

Preoperative Atrial Fibrillation and Elevated C-Reactive Protein Levels as Predictors of Mediastinitis After Coronary Artery Bypass Grafting [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions Apart from previously described risk factors for the development of postoperative mediastinitis, we found preoperative atrial fibrillation and an elevated C-reactive protein level to be significant predictors of mediastinitis in patients undergoing CABG. (Source: The Annals of Thoracic Surgery)

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The Complement System Is Activated in a Biphasic Pattern After Coronary Artery Bypass Grafting [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions Complement activation after cardiac surgery is regulated in a complex biphasic way, with additional inhibitory mechanisms engaged from 8 hours postoperatively onward. (Source: The Annals of Thoracic Surgery)

Off-Pump Right Coronary Artery Bypass With Saphaneous Vein or In-Situ Right Internal Thoracic Artery [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions Both RITA and SV showed favorable graft patency for the RCA system in OPCABG. The SV graft showed better patency in patients with moderate stenosis of RCA compared with RITA in situ. A longer follow-up period is necessary to clarify our current results. (Source: The Annals of Thoracic Surgery)

Retrograde Arterial Perfusion, Not Incision Location, Significantly Increases the Risk of Stroke in Reoperative Mitral Valve Procedures [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions The incidence of stroke in reoperative MV operations is associated with perfusion strategies, not with the incisional approach. Reoperative sternotomy and minithoracotomy with central cannulation are both useful for reoperative MV procedures and are associated with low stroke rates. (Source: The Annals of Thoracic Surgery)

Chronic Atrial Fibrillation Is Associated With Reduced Survival After Aortic and Double Valve Replacement [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions Chronic AF negatively affects survival after AVR with or without CABG and DVR with a mechanical prosthesis. Prospective randomized evaluation of AF ablation is suggested for these patients. (Source: The Annals of Thoracic Surgery)

Effect of Concomitant Coronary Artery Disease on Procedural and Late Outcomes of Transcatheter Aortic Valve Implantation [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:25 +0100

Conclusions Coexisting coronary artery disease negatively impacts procedural outcomes and long-term survival in patients undergoing TAVI, and implies that risk assessment and anticipated outcomes might be inaccurate due to stratification as isolated aortic valve replacement rather than AVR+CABG. Comparison of procedural outcomes, based on operative approach without controlling for unequal distribution of CAD in the cohorts, are likely invalid. (Source: The Annals of Thoracic Surgery)

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Increased Graft Occlusion or String Sign in Composite Arterial Grafting for Mildly Stenosed Target Vessels.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:12:12 +0100

CONCLUSIONS: The angiographic outcomes of composite grafts were closely related to the severity of stenosis of the target coronary artery. In target vessels with mild stenosis, composite grafting resulted in a higher incidence of graft occlusion or string sign than individual grafting did. PMID: 20172108 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Preoperative Cardiac Troponin I to Assess Midterm Risks of Coronary Bypass Grafting Operations in Patients With Recent Myocardial Infarction.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:12:00 +0100

CONCLUSIONS: Preoperative cTnI exceeding 0.15 ng/mL in patients with recent AMI undergoing CABG is associated with higher postoperative myocardial damage and is a strong determinant of postoperative morbidity and mortality within the 6-month period. PMID: 20172112 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Preoperative Atrial Fibrillation and Elevated C-Reactive Protein Levels as Predictors of Mediastinitis After Coronary Artery Bypass Grafting.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:11:55 +0100

CONCLUSIONS: Apart from previously described risk factors for the development of postoperative mediastinitis, we found preoperative atrial fibrillation and an elevated C-reactive protein level to be significant predictors of mediastinitis in patients undergoing CABG. PMID: 20172114 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

The Complement System Is Activated in a Biphasic Pattern After Coronary Artery Bypass Grafting.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:11:52 +0100

CONCLUSIONS: Complement activation after cardiac surgery is regulated in a complex biphasic way, with additional inhibitory mechanisms engaged from 8 hours postoperatively onward. PMID: 20172115 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Off-Pump Right Coronary Artery Bypass With Saphaneous Vein or In-Situ Right Internal Thoracic Artery.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:11:49 +0100

CONCLUSIONS: Both RITA and SV showed favorable graft patency for the RCA system in OPCABG. The SV graft showed better patency in patients with moderate stenosis of RCA compared with RITA in situ. A longer follow-up period is necessary to clarify our current results. PMID: 20172116 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

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Retrograde Arterial Perfusion, Not Incision Location, Significantly Increases the Risk of Stroke in Reoperative Mitral Valve Procedures.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:11:46 +0100

CONCLUSIONS: The incidence of stroke in reoperative MV operations is associated with perfusion strategies, not with the incisional approach. Reoperative sternotomy and minithoracotomy with central cannulation are both useful for reoperative MV procedures and are associated with low stroke rates. PMID: 20172117 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Chronic Atrial Fibrillation Is Associated With Reduced Survival After Aortic and Double Valve Replacement.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:11:41 +0100

CONCLUSIONS: Chronic AF negatively affects survival after AVR with or without CABG and DVR with a mechanical prosthesis. Prospective randomized evaluation of AF ablation is suggested for these patients. PMID: 20172119 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Effect of Concomitant Coronary Artery Disease on Procedural and Late Outcomes of Transcatheter Aortic Valve Implantation.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:11:30 +0100

CONCLUSIONS: Coexisting coronary artery disease negatively impacts procedural outcomes and long-term survival in patients undergoing TAVI, and implies that risk assessment and anticipated outcomes might be inaccurate due to stratification as isolated aortic valve replacement rather than AVR+CABG. Comparison of procedural outcomes, based on operative approach without controlling for unequal distribution of CAD in the cohorts, are likely invalid. PMID: 20172123 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Effect of Preoperative Statin Therapy on Patients Undergoing Isolated and Combined Valvular Heart Surgery.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:11:21 +0100

CONCLUSIONS: Our large series failed to detect a protective effect of preoperative statin therapy on perioperative outcomes or long-term survival in patients undergoing isolated valve surgery. Valve patients undergoing concomitant coronary artery bypass grafting, however, appear to receive a long-term survival benefit from statins. PMID: 20172126 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Delayed Malignant Hyperthermia After Routine Coronary Artery Bypass.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:09:41 +0100

Authors: Firstenberg M, Abel E, Blais D, Andritsos M Malignant hyperthermia is a rare but well-described hypermetabolic disorder of skeletal muscle that can be potentially fatal if untreated. In our patient, malignant hyperthermia developed several minutes after discontinuation of the known triggering agent after an uncomplicated coronary revascularization. This case illustrates the dramatic presentation and successful management of a rare disease with a rare onset. PMID: 20172160 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

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Coronary Artery Bypass Grafting in Cold-Induced Urticaria.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:09:39 +0100

The Sinker Technique: A Simple, Effective Technique for Exposing Coronary Arteries in Off-Pump Surgery.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:08:28 +0100

Authors: Matsushita T, Masuda S, Inoue T, Yamamoto S Exposure and stabilization of coronary arteries in the circumflex and right territory is essential for off-pump coronary artery bypass grafting. A new, easy technique of exposing and stabilizing coronary arteries using a sinker (weight) hung on a silicone elastomer suture for hemostasis from the arteriotomy is described. PMID: 20172186 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Updating Risk Factors For Patients Undergoing Coronary Artery Bypass Graft Surgery

Health News from Medical News Today — Tue, 23 Feb 2010 11:00:00 +0100

A new study published in the March issue of Anesthesiology raises awareness for an additional risk category for patients undergoing routine coronary artery bypass surgery - low to moderate levels of inflammation. C-reactive protein (CRP) is a recognized marker of systemic inflammation, routinely measured in patients to assess their risk for heart attack. CRP has emerged as a predictor of adverse cardiac events in healthy, non-surgical patients along with the more universally recognized cardiac risk factors of high cholesterol, high blood pressure, diabetes, smoking and obesity... (Source: Health News from Medical News Today)

Updating Risk Factors For Patients Undergoing Coronary Artery Bypass Graft Surgery

Pain / Anesthetics News From Medical News Today — Tue, 23 Feb 2010 11:00:00 +0100

Clinical significance of ischemic electrocardiographic changes during stress myocardial perfusion imaging: sub-analysis of the J-ACCESS study

Annals of Nuclear Medicine — Tue, 23 Feb 2010 08:08:18 +0100

Conclusions Ischemic ECG changes during exercise stress are well associated with higher incidence of cardiac events in patients demonstrated reversible perfusion defect on MPI. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s12149-010-0346-1Authors Kazuya Takehana, Kansai Medical University Cardiovascular Division, Department of Medicine II 2-3-1 Shin-machi Hirakata Osaka 573-1191 JapanShigeyuki Nishimura, Saitama Medical School Hospital Division of Cardiology Saitama JapanHirofumi Maeba, Kansai Medical University Cardiovascular Division, Department of Medicine II 2-3-1 Shin-machi Hirakata Osaka 573-1191 JapanTakanao Ueyama, Kansai Medical University Cardiovascular Division, Department of Medicine II 2-3-1 Shin-machi Hirakata Osaka 573-1191 JapanTos...

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State of the art of new P2Y12 antagonists

Internal and Emergency Medicine — Tue, 23 Feb 2010 08:04:05 +0100

Abstract The interaction of ADP with its platelet receptor P2Y12 plays a crucial role in platelet activation and thrombogenesis. This article reviews the pharmacology and clinical trials of specific antagonists of P2Y12. Clopidogrel is a thienopyridine with proven antithrombotic efficacy, but it has some important drawbacks: (a) it is a pro-drug that needs to be metabolized to its active metabolite; (b) it has a delayed onset and offset of action and (c) there is high inter-individual variability in pharmacological response. Prasugrel is also a thienopyridine, with faster onset of action and a more uniform inhibition of platelet function compared to clopidogrel, accounting for lower incidence of ischemic events in patients with acute coronary syndromes (ACS) undergoing per...

Sirolimus-eluting stent has comparable safety to CABG in multivessel disease

MedWire News - Cardiology — Tue, 23 Feb 2010 00:00:00 +0100

Coronary stenting with sirolimus-eluting stents in patients with multivessel disease has a long-term safety record similar to that of coronary artery bypass graft surgery and superior to that of stenting with bare-metal stents, suggests research. (Source: MedWire News - Cardiology)

Miniaturized versus conventional cardiopulmonary bypass in high-risk patients undergoing coronary artery bypass surgery.

Perfusion — Tue, 23 Feb 2010 00:00:00 +0100

CONCLUSIONS: Mini-CPB achieved somewhat better results than C-CPB in these high-risk patients undergoing isolated CABG. This study confirmed that cerebral protection could be the main benefit associated with the use of Mini-CPB. PMID: 20179173 [PubMed - as supplied by publisher] (Source: Perfusion)

Reply to the Editor

The Journal of Thoracic and Cardiovascular Surgery — Mon, 22 Feb 2010 17:08:11 +0100

We thank Drs D'Ancona and Pilato for their thoughtful comments. Patients with ischemic cardiomyopathy represent a diverse population who differ in the extent of myocardial ischemia, severity of the left ventricular dysfunction, and severity of functional ischemic mitral regurgitation. A thorough understanding of the extent of ischemic changes is essential for the appropriate planning of surgical therapy. Magnetic resonance imaging has emerged as a powerful diagnostic tool for the comprehensive evaluation of patients with ischemic cardiomyopathy. In our practice, magnetic resonance imaging is routinely used in patients with ischemic cardiomyopathy for the assessment of the severity and distribution of myocardial scarring, as well as the estimation of residual myocardial viability. Severity ...

Bleeding complications after off-pump coronary artery bypass surgery: Interpreting the contribution of hetastarch

The Journal of Thoracic and Cardiovascular Surgery — Mon, 22 Feb 2010 17:08:10 +0100

To the Editor: I read with interest the article by Hecht-Dolnik and colleagues examining the association between intraoperative administration of hetastarch and bleeding complications after off-pump coronary artery bypass graft surgery. The authors conclude that administration of 1 L of hetastarch in addition to albumin and crystalloid versus albumin and crystalloid alone resulted in increased risk of postoperative transfusion requirement and chest tube drainage. Given the existing body of evidence showing an association between greater quantitative blood loss with the use of high molecular weight (HMW) hetastarch compared with both lower molecular weight hetastarch and albumin, in both cardiac and noncardiac surgery, it is not clear what further information this study provides. Also, fea...

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Reply to the Editor

The Journal of Thoracic and Cardiovascular Surgery — Mon, 22 Feb 2010 17:08:10 +0100

We examined the relative safety in off-pump coronary artery bypass grafting (CABG) of two volume replacement fluids in widespread use at the time we conducted our study. Dr McKay argues that the questions we investigated are moot, that the fluids whose safety we investigated are not in widespread contemporary use, and that there were methodologic flaws in our study conduct. We will now address each of Dr McKay's arguments, showing that the choice between the volume replacement fluids we studied remains clinically relevant, that her methodologic concerns are overstated, and that our findings raise a series of further questions. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Regional wall motion abnormalities and scarring in severe functional ischemic mitral regurgitation: A pilot cardiovascular magnetic resonance imaging study

The Journal of Thoracic and Cardiovascular Surgery — Mon, 22 Feb 2010 17:08:10 +0100

To the Editor: We read with interest Flynn and colleagues' article concerning preoperative evaluation with cardiac magnetic resonance imaging (MRI) in patients undergoing coronary artery bypass grafting and mitral valve annuloplasty for ischemic mitral valve regurgitation (IMVR). (Source: The Journal of Thoracic and Cardiovascular Surgery)

A multicenter prospective randomized trial of a second-generation anastomotic device in coronary artery bypass surgery

The Journal of Thoracic and Cardiovascular Surgery — Mon, 22 Feb 2010 17:08:01 +0100

Conclusions: This prospective multicenter randomized controlled trial demonstrated good in-hospital and late clinical outcomes and excellent 1-year patency for vein grafts anastomosed both by the St Jude Medical second-generation aortic connector system and by hand. The patency of the connector grafts did not differ from that of the hand-sutured grafts. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Is conventional aortic arch surgery justifiable in octogenarians?

The Journal of Thoracic and Cardiovascular Surgery — Mon, 22 Feb 2010 17:07:59 +0100

Conclusions: The outcome of conventional aortic arch surgery in octogenarians is improving. The operations were performed with an acceptable operative risk even under emergency situations, including acute aortic dissection. The conventional surgical option for aortic arch diseases should not be abandoned only because of the high chronologic age of the patient. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Pre-operative clopidogrel use cautioned for cardiac patients

MedWire News - Thrombosis — Mon, 22 Feb 2010 16:17:25 +0100

Study findings highlight the risk for bleeding complications in patients who undergo coronary artery bypass graft surgery within a day of clopidogrel treatment. (Source: MedWire News - Thrombosis)

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JACC: Cypher stenting is comparable to CABG at five years

Cardiovascular Business News — Mon, 22 Feb 2010 14:06:14 +0100

At five years, Cordis’ Cypher sirolimus-eluting stents (SES) had a safety record comparable to CABG and superior to bare-metal stents (BMS), and a major adverse cardiac and cerebrovascular event (MACCE) rate that was higher than in patients treated with CABG and lower than in those treated with BMS, based on the results of the randomized ARTS II trial. (Source: Cardiovascular Business News)

5-Year Clinical Outcomes of the ARTS II (Arterial Revascularization Therapies Study II) of the Sirolimus-Eluting Stent in the Treatment of Patients With Multivessel De Novo Coronary Artery Lesions

Journal of the American College of Cardiology — Mon, 22 Feb 2010 00:00:00 +0100

Conclusions: At 5 years, SES had a safety record comparable to CABG and superior to BMS, and a MACCE rate that was higher than in patients treated with CABG, and lower than in those treated with BMS. Approximately one-third of the events seen with SES could be prevented through the elimination of early, late, and very late stent thrombosis. (Source: Journal of the American College of Cardiology)

Does treatment with n-3 polyunsaturated fatty acids prevent atrial fibrillation after open heart surgery?

Europace — Sat, 20 Feb 2010 14:44:32 +0100

Conclusion There is no evidence for a beneficial effect of treatment with n-3 PUFA on the occurrence of POAF in patients undergoing open heart surgery. (Source: Europace)

ARTS II: DES and CABG Have Similar Death, Stroke, and MI Out to Five Years

Medscape Medical News Headlines — Thu, 18 Feb 2010 16:22:47 +0100

In the ARTS II trial, the five-year composite safety end point of death, stroke, and MI are comparable for bypass surgery and intervention with a sirolimus-eluting stent, but major adverse events overall are lower with bypass. Heartwire (Source: Medscape Medical News Headlines)

Pulmonary embolism masqueraded as severe bronchospasm following coronary artery bypass surgery

Indian Journal of Thoracic and Cardiovascular Surgery — Thu, 18 Feb 2010 06:53:49 +0100

Abstract Late cardiac tamponade following coronary artery bypass surgery is an uncommon complication. It is associated with subtle signs and symptoms within days or weeks after cardiac surgery. Late cardiac tamponade usually presents with atypical clinical, haemodynamic, or echocardiographic manifestations. Combined Pulmonary Embolism (PE) and late cardiac tamponade occurring in a patient, is an extremely rare complication following coronary artery bypass surgery. In patients following cardiac surgery who experience repeated severe bronchospasm which does not respond to conventional modes of treatment, it would be prudent to rule out PE as a cause and manage accordingly. One should be vigilant and high index of suspicion is needed to diagnose and intervene early for better...

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Combined esophagogastric resection for cancer at esophagogastric junction and off pump CABG through left posterolateral thoracotomy

Indian Journal of Thoracic and Cardiovascular Surgery — Thu, 18 Feb 2010 06:53:47 +0100

We present such a patient who underwent simultaneous Off Pump Coronary Artery Bypass Grafting (OPCAB) and esophago-gastric resection successfully through a posterolateral thoracotomy and upper midline laparotomy. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s12055-009-0025-9Authors Plaban Mukherjee, Calcutta National Medical College Department of Cardiothoracic and Vascular Surgery Kolkata 700014 IndiaKallol Dasbaksi, Calcutta National Medical College Department of Cardiothoracic and Vascular Surgery Kolkata 700014 IndiaRamendra Narayan Hazra, Calcutta National Medical College Department of Cardiothoracic and Vascular Surgery Kolkata 700014 IndiaSrikanta Gangopadhyay, Calcutta National Medical College Department of Anesthesiology Kolkata 700014 IndiaMalay Mondal, Cal...

Underutilization of Implantable Cardioverter Defibrillators Post Coronary Artery Bypass Grafting in Patients with Systolic Dysfunction

Pacing and Clinical Electrophysiology : PACE — Thu, 18 Feb 2010 00:00:00 +0100

Conclusion: One-fourth of patients with LVSD who undergo CABG do not have LVEF reassessed postoperatively which may lead to underutilization of ICDs. (PACE 2010; 1[ndash]7) (Source: Pacing and Clinical Electrophysiology : PACE)

Use of Drug-Eluting Stents in Multivessel Disease Examined

Modern Medicine — Thu, 18 Feb 2010 00:00:00 +0100

Off-label use of drug-eluting stents has a similar or better safety profile as coronary artery bypass graft and bare-metal stents in patients with multivessel disease after five years, with major adverse cardiac and cerebrovascular event rates higher than CABG but lower than bare-metal stenting, according to a study published online Feb. 17 in the Journal of the American College of Cardiology. (Source: Modern Medicine)

ARTS II: DES and CABG have similar death, stroke, and MI out to five years

theHeart.org — Wed, 17 Feb 2010 22:00:00 +0100

In the ARTS II trial, the five-year composite safety end point of death, stroke, and MI are comparable for bypass surgery and intervention with a sirolimus-eluting stent, but major adverse events... For complete story visit theheart.org. (Source: theHeart.org)

CABG, Drug-Eluting Stents Match Up Well (CME/CE)

MedPage Today Cardiovascular — Wed, 17 Feb 2010 21:00:00 +0100

Sirolimus-eluting coronary stents matched the safety and efficacy of bypass surgery and proved superior to bare-metal stents, according to a comparison of data from two trials of patients with multivessel coronary disease. (Source: MedPage Today Cardiovascular)

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Clinical Trial Summary: Arterial Revascularization Therapies Study II: Sirolimus-Eluting Stent in the Treatment of Patients With Multivessel De Novo Coronary Artery Lesions (ARTS II: 5-Year Results)

Cardiosource — Wed, 17 Feb 2010 17:00:00 +0100

The goal of the trial was to evaluate in a nonrandomized, open-label study, treatment with sirolimus-eluting stents (SES) compared with historical controls in the ARTS I trial of patients undergoing revascularization with coronary artery bypass graft surgery (CABG) or bare-metal stents (BMS) in pati. . . (Source: Cardiosource)

The Proportion of Patients with Cognitive Impairment after Coronary Artery Bypass Surgery: An 8-Month Follow-Up Study

Psychotherapy and Psychosomatics — Tue, 16 Feb 2010 23:00:00 +0100

Psychother Psychosom 1991;55:145150 (DOI:10.1159/000288422) (Source: Psychotherapy and Psychosomatics)

A Novel Modification of the Retrograde Approach for the Recanalization of Chronic Total Occlusion of the Coronary Arteries: Intravascular Ultrasound-Guided Reverse Controlled Antegrade and Retrograde Tracking

Journal of the American College of Cardiology: Cardiovascular Interventions — Mon, 15 Feb 2010 22:00:58 +0100

Conclusions This first series describes a high success rate of CTO recanalization with IVUS-guided reverse CART in selected patients performed by an experienced operator. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)

Racial and Ethnic Differences in the Use of High-Volume Hospitals and Surgeons [Original Article]

Archives of Surgery — Mon, 15 Feb 2010 20:50:40 +0100

Conclusions Minority patients in New York City are doubly disadvantaged in their surgical care; they are substantially less likely to use both high-volume hospitals and surgeons for procedures with an established volume-mortality association. Better information is needed about which providers minority patients have access to and how they select them. (Source: Archives of Surgery)

Rare variants of internal thoracic artery in patients with coronary artery disease

Indian Journal of Thoracic and Cardiovascular Surgery — Mon, 15 Feb 2010 17:46:56 +0100

We report two patients undergoing CABG for coronary artery disease presented with variants of internal thoracic artery: one patient has hypoplasia of ITAs bilaterally and another patient has hypoplasia of left ITA from the first part of sublcavian artery in association with a normal sized ipsilateral ITA with an aberrant origin from third part of subclavian artery. Content Type Journal ArticleCategory Case ReportsDOI 10.1007/s12055-009-0035-7Authors Lokeswara Rao Sajja, CARE Hospital, The Institute of Medical Sciences Division of Cardiothoracic Surgery Road No. 1, Banjara Hills Hyderabad IndiaGopichand Mannam, CARE Hospital, The Institute of Medical Sciences Division of Cardiothoracic Surgery Road No. 1, Banjara Hills Hyderabad India Journal Indian Journal of Thoracic and Ca...

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Effects of clopidogrel on perioperative blood loss in off pump elective coronary artery bypass surgery. A prospective single blinded observational study

Indian Journal of Thoracic and Cardiovascular Surgery — Mon, 15 Feb 2010 17:46:50 +0100

Conclusions There is no statistically significant difference in blood loss between three groups. In our study we could not find any significant association between perioperative blood loss and clopidogrel. Content Type Journal ArticleDOI 10.1007/s12055-009-0031-yAuthors Ranjith Baskar Karthekeyan, Sri Ramachandra Medical College and Research Institute Department of Cardiothoracic and Vascular Surgery Porur Chennai IndiaHarish Babu, Sri Ramachandra Medical College and Research Institute Department of Cardiothoracic and Vascular Surgery Porur Chennai IndiaMahesh Vakamudi, Sri Ramachandra Medical College and Research Institute Department of Cardiothoracic and Vascular Surgery Porur Chennai IndiaKarthikeyan Selvaraju, Sri Ramachandra Medical College and Research Institute ...

Gender Differences Seen in CABG Operative Mortality

Modern Medicine — Mon, 15 Feb 2010 00:00:00 +0100

Women who undergo coronary artery bypass graft surgery have significantly higher operative mortality than men having the same surgery, according to a study in the Feb. 1 issue of the American Journal of Cardiology. (Source: Modern Medicine)

Short-term supervised inpatient physiotherapy exercise protocol improves cardiac autonomic function after coronary artery bypass graft surgery - a randomised controlled trial.

Disability and Rehabilitation — Mon, 15 Feb 2010 00:00:00 +0100

Conclusions. A short-term supervised physiotherapy exercise protocol during inpatient CR improves CAR at the time of discharge. Thus, exercise-based inpatient CR might be an effective non-pharmacological tool to improve autonomic cardiac tone in patient's post-CABG. PMID: 20156053 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

CABG Star Rating Coming to a Web Site Soon

Internal Medicine News — Mon, 15 Feb 2010 00:00:00 +0100

FORT LAUDERDALE, FLA. — Later this year, coronary bypass patients will start steering their surgeon choices by the stars. A one-to-three star rating system for cardiac surgeons developed by the Society for Thoracic Surgeons will appear on a Consumer Reports Web site, probably beginning in June. (Source: Internal Medicine News)

Giant aneurysm of the right coronary artery and fistula to the coronary sinus

General Thoracic and Cardiovascular Surgery — Sat, 13 Feb 2010 06:53:12 +0100

We describe the case of a 67-year-old man with a rare combination of a giant coronary artery aneurysm with a fistula draining into the coronary sinus. The patient presented with a sensation of retrosternal pressure. He was examined by coronary angiography, which revealed a large aneurysm of the right coronary artery (RCA) with a fistula. This fistula originated from the distal RCA shortly beyond the crux and drained into the coronary sinus. The aneurysm was in the proximal portion of the RCA, measuring 4 cm in diameter and 7 cm in length. Surgical repair by closure of the fistula under direct vision, suture closure and plication of the aneurysm, and coronary artery bypass was performed. Postoperative echocardiography and computed tomography confirmed closure of the fistula. The patie...

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Effect of opium use on short-term outcome in patients undergoing coronary artery bypass surgery

General Thoracic and Cardiovascular Surgery — Sat, 13 Feb 2010 06:53:08 +0100

Conclusion Continued use of opium is a significant predictor of rehospitalization with a cardiac cause within 6 months of CABG surgery. This may be partly due to the low compliance of these patients with treatment recommendations. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11748-009-0529-7Authors Nasser Safaii, Tabriz University of Medical Sciences Cardiovascular Research Center Daneshgah Street Tabriz 5166615573 IranBabak Kazemi, Tabriz University of Medical Sciences Cardiovascular Research Center Daneshgah Street Tabriz 5166615573 Iran Journal General Thoracic and Cardiovascular SurgeryOnline ISSN 1863-6713Print ISSN 1863-6705 Journal Volume Volume 58 Journal Issue Volume 58, Number 2 / February, 2010 (Source: General Thoracic an...

Prospective Electrocardiogram-Gated Axial 64-Detector Computed Tomographic Angiography vs Retrospective Gated Helical Technique to Assess Coronary Artery Bypass Graft Anastomosis:

Circulation Journal — Sat, 13 Feb 2010 00:00:00 +0100

Conclusions: Following bypass surgery, 64-detector CT angiography using prospective ECG gating is superior to retrospective gating in limiting the radiation dose and maintaining the image quality of distal anastomoses. PMID: 20154407 [PubMed - as supplied by publisher] (Source: Circulation Journal)

A 3-Year Clinical Outcome After Percutaneous Coronary Intervention Using Sirolimus-Eluting Stent and Off-Pump Coronary Artery Bypass Grafting for the Treatment of Diabetic Patients With Multivessel Disease.

Circulation Journal — Sat, 13 Feb 2010 00:00:00 +0100

Conclusions: At the 3-year clinical follow-up, the prevalence of MACCE in diabetic patients with MVD was comparable between the SES and the OPCAB groups. PMID: 20154406 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Coronary Artery Bypass Graft Versus Drug-Eluting Stent for High-Risk Proximal Left Anterior Descending Stenosis

Current Treatment Options in Cardiovascular Medicine — Fri, 12 Feb 2010 07:32:52 +0100

Opinion statement Determining how to treat a patient with symptomatic isolated proximal left anterior descending coronary artery disease may present a challenge. Previous randomized trials comparing percutaneous coronary intervention (PCI) with bare metal stents with minimally invasive direct coronary artery bypass surgery demonstrated significantly higher reintervention rates for stenting, with similar mortality and reinfarction rates. However, current evidence suggests that the use of drug-eluting stents may reduce the need for repeat revascularization. Also, in recent studies there were fewer periprocedural complications in patients undergoing PCI, with similar death and reinfarction rates. Moreover, the quality of life for patients who have received drug-eluting stents...