The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Apr 2009
Bilateral internal thoracic artery on the left side: a propensity score-matched study of impact of the third conduit on the right side.
This study was undertaken to evaluate long-term results of bilateral internal thoracic artery grafting with saphenous vein or another arterial conduit as the third conduit. ⋯ In patients with triple-vessel disease undergoing first isolated coronary artery bypass grafting, supplementary venous grafts seem to provide more stability than gastroepiploic artery, which may even impair long-term outcome.
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J. Thorac. Cardiovasc. Surg. · Apr 2009
Increased mortality and perioperative complications in patients with previous elective percutaneous coronary interventions undergoing coronary artery bypass surgery.
The relationship between previous percutaneous coronary intervention and perioperative outcome after coronary artery bypass grafting remains undetermined. The aim of the study was to investigate whether previous elective percutaneous coronary intervention influences the outcome of elective coronary artery bypass grafting. ⋯ Patients with a history of elective percutaneous coronary intervention before referral to coronary artery bypass grafting have a worse perioperative outcome in terms of mortality, major adverse cardiac events, and perioperative complications compared with patients without a history of percutaneous coronary intervention. This fact should be considered in risk stratification for patients who are scheduled for elective coronary artery bypass grafting.
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J. Thorac. Cardiovasc. Surg. · Apr 2009
The role of cerebral hyperperfusion in postoperative neurologic dysfunction after left ventricular assist device implantation for end-stage heart failure.
Cerebral hyperperfusion is a life-threatening syndrome that can occur in patients with chronically hypoperfused cerebral vasculature whose normal cerebral circulation was re-established after carotid endarterectomy or angioplasty. We sought to determine whether the abrupt restoration of perfusion to the brain after left ventricular assist device (LVAD) implantation produced similar syndromes. ⋯ Our findings showed that normal flow might overwhelm cerebral autoregulation in patients with severe heart failure, suggesting that cerebral hyperperfusion is possible in recipients of mechanical circulatory support with neurologic dysfunction.
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J. Thorac. Cardiovasc. Surg. · Apr 2009
Does preoperative atrial fibrillation increase the risk for mortality and morbidity after coronary artery bypass grafting?
Preoperative atrial fibrillation has been associated with less favorable outcomes in patients undergoing coronary artery bypass grafting. However, it was never investigated in a large cohort of patients using a national database. This study aims to (1) identify the effect of atrial fibrillation on operative mortality and morbidity in patients undergoing isolated coronary artery bypass grafting and (2) identify the potential effect of atrial fibrillation on patients with decreased left ventricular ejection fraction (
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J. Thorac. Cardiovasc. Surg. · Apr 2009
Study of the factors related to atrial fibrillation after coronary artery bypass grafting: a search for a marker to predict the occurrence of atrial fibrillation before surgical intervention.
Atrial fibrillation after cardiac surgery is a frequent complication. In this study we studied various factors in addition to trying to identify a marker that would predict the potential for atrial fibrillation before surgical intervention to prevent its occurrence. ⋯ The fibrosis of tissue associated with age is believed to be closely related to the occurrence of atrial fibrillation after coronary artery bypass grafting. This study suggests that the preoperative values of atrial natriuretic peptide, angiotensin II, the sialylated carbohydrate antigen KL-6, hyaluronic acid, and pyridinoline cross-linked telopeptide of type I collagen in the blood are useful as a new index for the occurrence of atrial fibrillation after coronary artery bypass grafting.