Cardiovascular revascularization medicine : including molecular interventions
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Cardiovasc Revasc Med · Jan 2009
Comparative StudyOff-pump coronary artery bypass grafting improves in-hospital mortality in patients with dialysis-dependent renal failure.
Patients with chronic dialysis-dependent end-stage renal disease are increasingly referred for coronary artery bypass grafting (CABG) and their early outcome is less favorable. Off-pump CABG (OPCAB) has achieved encouraging results in high-risk patients. Therefore, we designed this retrospective study to test the hypothesis that OPCAB reduced surgical risks in dialysis patients. ⋯ Our data suggest that OPCAB is a safe alternative to on-pump CABG in dialysis patients. Avoiding CPB resulted in less perioperative blood utilization, MI, and hospital mortality.
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Cardiovasc Revasc Med · Jan 2009
ReviewRisk and management of upper gastrointestinal bleeding associated with prolonged dual-antiplatelet therapy after percutaneous coronary intervention.
Prolonged dual-antiplatelet therapy with aspirin and clopidogrel is mandatory after drug-eluting stent implantation because of the potential increased risk of late stent thrombosis. The concern regarding prolonged antiplatelet therapy is the increased risk of bleeding. ⋯ Managing gastrointestinal bleeding in a patient who has undergone recent percutaneous coronary intervention requires balancing the risk of stent thrombosis against further catastrophic bleeding. Close combined management between gastroenterologist and cardiologist is advocated to optimize patient outcomes.