The heart surgery forum
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The heart surgery forum · Jan 2003
Primary OPCAB as a strategy for acute coronary syndrome and acute myocardial infarction.
Conventional coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass (CPB) carries higher mortality and morbidity for patients undergoing surgery during acute coronary syndrome (ACS). The aim of this retrospective study was to evaluate potential benefits of avoiding CPB by instead performing off-pump CAB (OPCAB) during surgery on patients in ACS. ⋯ OPCAB is a valuable treatment strategy in ACS patients; however, it carries significant mortality and morbidity. Careful preselection and timing of intervention are required in order for patients to fully benefit from the OPCAB strategy.
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The heart surgery forum · Jan 2003
A feasibility study of the safety and efficacy of a combined clopidogrel and aspirin regimen following off-pump coronary artery bypass grafting.
Effective antiplatelet therapy may decrease the risk of complications following off-pump coronary artery bypass surgery (CABG). We prospectively evaluated the safety and early efficacy of a combined regimen of clopidogrel and aspirin starting immediately after off-pump CABG. ⋯ Early administration of a combined regimen of clopidogrel and aspirin following off-pump CABG is safe and is associated with a relatively low incidence of major adverse cardiac events, bleeding, PE, and DVT. Consequently, its routine administration after off-pump CABG is recommended.
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The heart surgery forum · Jan 2003
A miniature right heart support system improves cardiac output and stroke volume during beating heart posterior/lateral coronary artery bypass grafting.
Certain heart manipulations carried out to access anastomotic sites during beating heart coronary artery bypass (OPCAB) compromise hemodynamics, and these risks can affect end-organ perfusion and limit patient selection. Evidence suggests that right heart support (RHS) augments left ventricular preload and provides hemodynamic stability. This study evaluated hemodynamic measures in OPCAB with RHS with respect to individual target vessels and general target distribution groups. ⋯ Augmenting left ventricular preload with RHS improves hemodynamic measures during OPCAB for all target vessel positions and provides critical support in a large number of anastomoses.
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The heart surgery forum · Jan 2003
Case ReportsPatent foramen ovale causing refractory hypoxemia after off-pump coronary artery bypass: a case report.
Patent foramen ovale (PFO) is not uncommon in the adult population undergoing cardiac surgery. Although usually innocent, PFO can cause severe hypoxemia, which can be reversed only by surgical or interventional interruption of the interatrial right-to-left shunt. Such a case is presented, and the diagnosis and pathophysiology are discussed.
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This study was designed to evaluate the feasibility of beating heart coronary bypass operations on the anterior vessels of the heart through very limited sternotomy (VLS). ⋯ Coronary bypass grafting on the LAD, the RCA, and their tributaries can be safely performed through VLS. Early and midterm results are comparable with those of classic methods of myocardial revascularization. Conversion to full sternotomy is quite easy and safe, should the necessity arise.