OFF-PUMP CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH CORONARY ARTERY DISEASE AND CONCOMITANT MITRAL VALVE REGURGITATION

Complex Issues of Cardiovascular Diseases, Journal Year: 2025, Volume and Issue: 13(4), P. 35 - 46

Published: Jan. 11, 2025

Highlights The review presents a retrospective analysis of data patients who underwent combined coronary artery bypass grafting and mitral valve repair/replacement. authors comparatively assessed outcomes off-pump (OPCABG) on-pump CABG (ONCABG) in with valvular pathology. Abstract Aim . To evaluate the benefits disease concomitant (MV) regurgitation. Methods study included 50 MV simultaneous correction Patients were divided into 2 groups: group 1 (n = 26) patiens (ONCABG), 24) OPCABG. Results In OPCABG there was shorter aortic cross-clamping time (85,5 [71,25; 105,25] vs 119 [99,25; 132,25] min, compared ONCABG group, p < 0,05), duration CPB (136,5 [119,25; 158,5] 168,5 [142,75; 186,25] overall operation (292,5 [252,5; 360] 340 [287,5; 385] respectively, 0,15). Moreover, this lower need for transfusion blood its components: freshly frozen plasma (2 [2; 3] 3 [3; 3], RBC mass [1; 2] 2], 0,4), number bed-days during hospital stay (20 [13,5; 26,25] 23,5 [17,5; 26] days, 0,05). Conclusions. Off-pump pathology is safe reproducible technique that provides time, duration. length are reduced as well.

Language: Английский

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National Trends in Racial and Ethnic Disparities in Mortality from Mechanical Complications of Cardiac Valves and Grafts (1999–2020)

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(2), P. 562 - 562

Published: Jan. 16, 2025

Background: The volume of cardiac valve and coronary artery revascularization procedures is rising in the United States. This cross-sectional study explores ethnic disparities mortality surgery attributed to mechanical failures implantable heart valves grafts. Methods: We used CDC Wide-Ranging Online Data for Epidemiologic Research Multiple Causes Death database identify patients whose single cause death was categorized by complications cardiovascular prosthetic devices, implants, grafts (ICD-10 code T82) between 1999 2020. Joinpoint software (version 5.2.0, National Cancer Institute) construct log-linear regression models estimate average annual percent changes age-adjusted (per 100,000). These patterns were compared stratified sex, age (0-44, 44-64, 65 years or older), US census regions White, Black, Hispanic, non-Hispanic, American Indian, Alaskan Native, Asian American, Pacific Islanders. Results: Age-adjusted due implants declined across ethnicities from 2.21 (95% CI 2.16-2.27) 0.88 0.85-0.91) Black populations (1.31 [95% 1.20-1.42]), both men (1.56 1.37-1.74]) women (1.02 0.90-1.15]) experienced higher 2020 all other ethnicities. disparity pronounced younger groups (age 0-64), wherein among (0.18 0.13-0.25]) more than doubled that White (0.08 0.06-0.10]). Conclusions: Over last two decades, has significantly. However, women, particularly patients, continue experience rates

Language: Английский

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Beating-Heart Coronary Artery Bypass grafting (BH-CABG) in patients with End-Stage Renal Disease (ESRD): comparison of the Society of Thoracic Surgeons (STS) predicted risk with actual outcomes

Journal of Cardiothoracic Surgery, Journal Year: 2025, Volume and Issue: 20(1)

Published: Jan. 27, 2025

End-Stage Renal Disease (ESRD) is an independent risk factor in outcomes for traditional coronary artery bypass grafting (TRAD-CAB) utilizing aortic cross-clamping and cardioplegic arrest. In order to determine if Beating-Heart CABG (BH-CABG) techniques offer benefit patients with ESRD, analysis of the Society Thoracic Surgeons (STS) predicted versus actual was performed. Between March 2017 - October 2023, all ESRD underwent BH-CABG by a single surgeon at institution. Patients were kept normothermic, ventilation maintained, intra-coronary shunts flow-probe graft assessment utilized during procedure. The STS calculator used compare results. There 55 patients– 37 men 18 women mean age 61.5 years (41–77 years). Co-medical conditions consisted following: HTN (100%), DM (85%), Pulmonary (49%), PVD (45%), CVD CVA (18%), COPD (9%). Fifty-one Pump-Assisted Direct Coronary Artery Bypass Grafting (PADCAB) four Off-Pump (OP-CAB). 16 Elective, 35 Urgent, 4 Emergent cases. Case presentation included: 24 NSTEMI, STEMI, 6 Unstable Angina, 7 CHF, 1 Cardiac Arrest, 13 positive exercise stress test (EST) renal transplant screening. EF 47% (range: 15–75%). number grafts 2.4 (1–4) CPB time 78 min (34–128 min) PAD-CAB group. Nine thirteen (69%) listed kidney transplant, one whom combined liver-kidney. hospital mortality (1.8%) compared 6.2%. stroke 3.3%. prolonged 20.2%. no return OR sternal wound infections. Prolonged Lengths Stay occurred 3 (5.5%) 16.9%. One-year 8 (14.5%). observed-to-expected < categories. appears demonstrate superior CABG. technique may advantages avoidance cardioplegia, maintenance normothermia ventilation, as well preservation blood flow construction grafting.

Language: Английский

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Bilateral Internal Mammary Artery in Off-pump Coronary Artery Grafting in Diabetic Patients

The American Journal of Cardiology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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First Series of Ascending Aorta Surgery in a Sub-Saharan African Country (Benin)

World Journal of Cardiovascular Surgery, Journal Year: 2025, Volume and Issue: 15(02), P. 33 - 41

Published: Jan. 1, 2025

Language: Английский

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Surgical outcomes of cardiac surgery in patients with antiphospholipid syndrome and systemic lupus erythematosus: A systematic review

Asian Cardiovascular and Thoracic Annals, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 21, 2025

Background Antiphospholipid syndrome and systemic lupus erythematosus are autoimmune inflammatory conditions involving multiple organs sharing various clinical aspects. Owing to the scarcity of data about surgical outcomes these disorders, we conducted a systematic review assess for patients with diagnoses undergoing heart surgery contextualize findings regarding high-risk cardiac surgeries. Methods A thorough search PubMed, Embase Scopus used Preferred Reporting Items Systematic Reviews Meta-Analyses standards find articles that involved who underwent had antiphospholipid erythematosus. Inclusion criteria concentrated on definitive diagnosis, while case reports studies lacking were excluded. Using Joanna Briggs Institute's methodologies, quality evaluation categorized according their risk bias. Results Fourteen 277 prevalence middle-aged females met inclusion out 6381 papers. The major preoperative comorbidity in cohort was history thromboembolic events (43%). Thromboembolic complications (6%) catastrophic (2%), even appropriate anticoagulation, notable early post-operative outcomes. Six percent people died within 30 days. Data from follow-up showed 14% death rate 23% frequency events. Conclusions With striking exception high syndrome, results analogous those procedures. Improving care this susceptible population requires an understanding hazards.

Language: Английский

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Multimodal monitoring of neutrophil activity during cardiac surgery

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: March 13, 2025

Cardiac surgery and the associated ischemia-reperfusion injury trigger an inflammatory response, which, in turn, can contribute to organ damage, prolonged hospitalization, mortality. Therefore, present study performed comprehensive monitoring of neutrophil-related inflammation patients who underwent aortic valve surgery, including extracorporeal circulation. Neutrophil-related inflammation, as well alterations cellular physiology, phenotype, function, were analyzed by flow cytometry, ELISA, microscopy. Neutrophil activation occurred intraoperatively preceded upregulation conventional markers such C-reactive protein interleukin-6. Perioperatively, neutrophils maintained a stable response platelet-activating factor (PAF) with regard CD11b CD66b expression but showed decreased CD10. Postoperatively, exhibited marked PAF-induced depolarization, while reactive oxygen species generation phagocytic activity remained largely stable. Surprisingly, platelet-neutrophil complex formation was severely impaired returned normal levels postoperatively. Further studies are needed elucidate implications these intraoperative postoperative changes neutrophil platelet respect potential immune dysfunction that temporarily increases susceptibility infectious or hemostatic complications.

Language: Английский

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Association of Preoperative Functional Status With Short-Term Major Adverse Outcomes After Cardiac Surgery

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: March 14, 2025

Introduction Cardiac surgery plays a crucial role in treating wide range of cardiovascular conditions, offering life-saving interventions for patients with diseases such as coronary artery disease, heart valve disorders, and failure. However, these procedures are not without significant risks, including complications stroke, acute kidney injury, respiratory failure, infections. It is important to only recognize the potential associated but also identify high-risk early treatment process. With aging population increasing burden comorbidities, growing number likely present suboptimal functional status prior cardiac surgery. By incorporating into preoperative evaluations, healthcare providers can improve patient selection, enhance perioperative care, outcomes this population. Therefore, study aims investigate whether dependent an increased risk postoperative major adverse undergoing Methods We performed retrospective cohort analysis on adult based American College Surgeons National Surgical Quality Improvement Program (ACS NSQIP) 2011-2021 database. compared primary composite outcome consisting post-surgery between independent partially/totally patients. The was defined experiencing any following events: superficial incisional/deep incisional/organ space surgical site infection, death within 30 days post-operation, stroke/cerebral vascular accident (CVA), arrest requiring cardiopulmonary resuscitation (CPR), myocardial infarction, pulmonary embolism (PE), deep vein thrombosis (DVT)/thrombophlebitis, progressive renal insufficiency, ventilator use more than 48 hours unplanned intubation or reoperation, sepsis, septic shock, pneumonia. Confounding variables were age, gender, race, emergency case, baseline laboratory markers. used multivariable logistic regression obtain adjusted odds ratio (OR) 95% confidence intervals (CIs). Results Of 42,917 included study, 30.6% female 69.4% male, 46.5% group being 65-79 years old. prevalence 2.6%. Compared patients, those who had higher incidence (35.68% vs. 20.93%), yielding crude OR 2.09 (95% CI 1.85-2.37). association remained significant: 1.21 1.04-1.41) after adjustment body mass index (BMI), other comorbidities diabetes, hypertension, blood transfusion Conclusion Patients found have significantly greater surgery, even adjusting demographics, markers, characteristics. Further investigation needed explore development clinical application predictive tool that includes status, which could help facilitate timely prehabilitation programs capacity.

Language: Английский

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Antispasmodic Medications to Optimize Long-Term Radial Artery Graft Patency in CABG

Circulation Cardiovascular Interventions, Journal Year: 2025, Volume and Issue: unknown

Published: March 24, 2025

Language: Английский

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Minimal invasive extracorporeal circulation versus conventional cardiopulmonary bypass in cardiac surgery: a contemporary systematic review and meta-analysis

European Journal of Cardio-Thoracic Surgery, Journal Year: 2025, Volume and Issue: 67(4)

Published: March 25, 2025

The question whether minimal invasive extracorporeal circulation (MiECC) represents the optimal perfusion strategy in cardiac surgery remains unanswered. We sought to systematically review entire literature and thoroughly address impact of MiECC versus conventional CPB (cCPB) on adverse clinical outcomes after surgery. searched PubMed, Scopus Cochrane databases for appropriate articles as well conference proceedings from major congresses up August 31st, 2024. All randomized controlled trials (RCTs) that fulfilled pre-defined criteria were included analysis. primary outcome was mortality, while morbidity transfusion requirements secondary outcomes. risk bias assessed using Risk Bias 2 tool. studies meeting interest this systematic eligible synthesis. Of 738 records identified, 36 RCTs meta-analysis with a total 4,849 patients. associated significantly reduced mortality (OR 0.66; 95% CI: 0.53-0.81; p = 0.0002; I2=0%) postoperative myocardial infarction 0.42; 0.26-0.68; 0.002; cerebrovascular events 0.55; 0.37-0.80; 0.007; I2=0%). Moreover, RBC requirements, blood loss rate re-exploration bleeding together incidence atrial fibrillation. This resulted duration mechanical ventilation, ICU hospital stay. provides robust evidence beneficial effect reducing prompts wider adoption technology.

Language: Английский

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