The results of coronary artery surgery In women and men under the age of 45

Background: This study aims to investigate possible risk factors with the morbidity and mortality rates in women and men under the age of 45 undergoing coronary artery bypass graft (CABG) surgery

Effect of vitamin D deficiency on the development of postoperative atrial fibrillation in coronary artery bypass patients

Introduction: Various factors may be responsible for the development of postoperative atrial fibrillation (POAF) in coronary artery bypass graft (CABG) patients. In our study, we demonstrated the effect of vitamin D deficiency on the development of POAF. Methods: In this prospective case control study, patients undergoing elective, isolated CABG were considered. A total of 15 patients (16.6%) who developed POAF during the first five days after surgery made up the POAF group. Seventy-five patients that had a sinus rhythm in the same period were the non-POAF group. The two groups were compared statistically in terms of laboratory, clinical, echocardiographic, operative, and postoperative parameters. Results: All patients were in sinus rhythm at discharge. The baseline characteristics of the study groups were comparable. The POAF group had a lower vitamin D level than the non-POAF group (9.0 ± 5.0 and 15.0 ± 8.4 ng/mL, respectively; P = 0.007). In the POAF group, the patients’ left atrium diameter and incidence of hypertension (HT) were higher than those of the non-POAF group. Conclusion: Incidence of POAF was significantly higher in patients with vitamin D deficiency or insufficiency than the patients with vitamin D level in normal range. Therefore vitamin D deficiency or insufficiency may be a predictor of POAF in patients with CABG

Effects of pulmonary perfusion during cardiopulmonary bypass on lung functions after cardiac operation

Background Pulmonary artery perfusion during cardiopulmonary bypass (CPB) is a known but rarely used technique in adult cardiac surgery. In this study, we aimed to investigate biochemical and histopathological effects of pulmonary artery perfusion during CPB on lung functions. Methods Between May 2014 and August 2014, all patients (n = 24) who gave informed consent for participating this study with inclusion criteria were included. Patients undergoing isolated coronary artery bypass grafting were sequentially randomized to conventional CPB (control group, n = 12) and conventional CPB with selective pulmonary artery perfusion (study group, n = 12). Lung functions were monitored using PF ratio, alveolar-arterial oxygen gradient, and lactate levels. A small sample tissue from the left lung was excised for histopathologic examination. Immunocytochemistry analysis was performed using anti-rabbit polyclonal vascular endothelial growth factor (VEGF), rabbit polyclonal inducible nitric oxide synthase (i-NOS), and BCL-2 antibodies. Results Postoperative course of the patients were uneventful without any clinical outcome differences in terms of cardiopulmonary complications, ventilation time and hospital stay. Pulmonary perfusion group had significantly better oxygenation values after extubation and at postoperative 24-hour. Electron microscopy examinations revealed better preservation of the alveolar wall integrity with pulmonary perfusion. The intensity of VEGF, i-NOS, and BCL-2 antibody expressions in bronchial epithelial cells were more prominent in the pulmonary perfusion group. Conclusions Pulmonary artery perfusion during aortic cross-clamping provides better oxygenation and preservation of the wall alveolar integrity after coronary artery bypass grafting surgery. This technique can be used as a protective strategy to minimize CPB-induced lung injury in adult cardiac surgery

Seksen Yaş ve Üzeri Hastalarda Koroner Arter Bypass Cerrahisine Ek Olarak Uygulanan Prosedürler Operasyonun Riskini Arttırır mı?

Aim: In association with increasing life expectancy, the number of elderly individuals undergoing coronary bypass grafting (CABG) and additional cardiac surgical procedures are increasing. In this study, we evaluated the effects of additional cardiac procedures and preoperative risk factors for postoperative mortality and morbidity in patients 80 years of age and older. Methods: The records of 29 patients aged 80 years and older (82.86±2.91) who had undergone coronary bypass surgery in the department of cardiac surgery between September 2009 and June 2012, were retrospectively reviewed. The subjects were divided into two groups: group 1 included the patients who had undergone CABG, group 2 consisted of those who had undergone CABG and additional cardiac procedures. Results: The mean age of the patients [14 male (48.3%) 15 female (51.7%)] was 82.86±2.91 years. The left internal thoracic artery was harvested for all patients. The mean number of graft per patient was 3.07±0.95. Carotid endarterectomy was performed in 3 patients before CABG. CABG and aortic valve replacement were performed in 1 patient. CABG, mitral valve replacement ant tricuspid plasty were performed in another patient. Furthermore, in one patient, abdominal aortic graft replacement due to ruptured abdominal aortic aneurysm and CABG was performed at the same session. The mean EuroSCORE was 5.06±5.16. Postoperative 30 days mortality was 6.8%, and the mean length of stay in hospital was 10.45±8.18 days. Conclusion: Coronary bypass surgery is an acceptable treatment method in patients 80 years of age and older. Although additional cardiac procedures may increase sugical risks, they can be successfully performed. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 14-8

Do Additional Cardiac Surgical Procedures Increase the Surgical Risk in Patients 80 Years of age or Older Undergoing Coronary Bypass Gragting

Aim: In association with increasing life expectancy, the number of elderly individuals undergoing coronary bypass grafting (CABG) and additional cardiac surgical procedures are increasing. In this study, we evaluated the effects of additional cardiac procedures and preoperative risk factors for postoperative mortality and morbidity in patients 80 years of age and older

The effect of renal dose dopamine use on renal tubular function in diabetic patients undergoing coronary artery bypass graft surgery

Background: This study aims to evaluate clinical results of the prophylactic use of renal dose dopamine infusion in diabetic patients undergoing coronary artery bypass grafting (CABG). Methods: In this prospective randomized study, 40 consecutive diabetic patients who were scheduled for elective CABG were randomized into two equal groups: group 1 received dopamine infusion at renal dose (2.5-4.0 mg/kg/min) starting from induction of anesthesia for 48 hours; group 2 consisted of untreated controls. Standard sternotomy technique using aortic and right atrial cannulation was performed for cardiopulmonary bypass. Results: Daily urine output, fluid balance, serum creatinine, blood urea levels and creatinine clearance were measured at three and five days. In the control group, third and fifth postoperative day, creatinine clearance levels decreased about 24.8;plusmn;12.3 mL/min and 18.1;plusmn;10.1 mL/min, respectively. In the dopamine group, creatinine clearance levels in the third and fifth postoperative days increased by 7.7;plusmn;10.8 mL/min (p=0.005) and 10.7;plusmn;11.7 mL/min (p=0.001), respectively. Group 1 patients demonstrated less increase in serum creatinine level at three and five days than the controls (p;lt;0.001). Conclusion: Creatinine and creatinine clearance levels, suggestive of renal tubular function, were positively affected by renal dose dopamine infusion started at time of anesthesia induction. Our data may help us to re-normalize the renal functions in the postoperative period in diabetic patients, particularly.Amaç: Bu çalışmada koroner arter baypas greftleme (KABG) yapılan diyabet hastalarında renal doz dopamin infüzyonunun profilaktik kullanımının klinik sonuçları değerlendirildi.Ça­lış­ma­pla­nı:­Bu prospektif randomize çalışmada elektif KABG yapılması planlanan 40 ardışık diyabet hastası iki eşit gruba randomize edildi: grup 1'e anestezi indüksiyonundan itibaren 48 saat süreyle renal dozda (2.5-4.0 mg/kg/dk.) dopamin infüzyonu verildi; grup 2 ise tedavi edilmemiş kontrollerden oluşuyordu. Kardiyopulmoner baypas için aortik ve sağ atriyal kanülasyonu ile standart sternotomi tekniği uygulandı.Bul gu lar: Günlük idrar çıkışı, sıvı dengesi, serum kreatinin, kan üre düzeyleri ve kreatinin klirensi üç ve beşinci günlerde ölçüldü. Kontrol grubunda ameliyat sonrası üçüncü ve beşinci günlerde kreatinin klirens düzeyleri sırasıyla 24.8±12.3 mL/dk ve 18.1±10.1 mL/dk azaldı. Dopamin grubunda ameliyat sonrası üçüncü ve beşinci günlerde kreatinin klirens düzeyleri sırasıyla, 7.7±10.8 mL/dk. (p=0.005) ve 10.7±11.7 mL/dk. (p=0.001) arttı. Kontrol grubuna kıyasla, grup 1'deki hastaların serum kreatinin düzeyinde üçüncü ve beşinci günlerde daha az artış görüldü (p0.001).So nuç: Renal tübüler fonksiyonun göstergesi olan kreatinin ve kreatinin klirens düzeyleri, anestezi indüksiyonun başladığı zaman renal doz dopamin infüzyonu ile pozitif etkilendi. Verilerimiz, özellikle diyabet hastalarında ameliyat sonrası renal fonksiyonların yeniden normalleşmesine katkıda bulunabilir