2011 ACCF/AHA guideline for coronary artery bypass graft surgery: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

The Journal of thoracic and cardiovascular surgery (Impact Factor: 3.99). 01/2012; 143(1):4-34. DOI: 10.1016/j.jtcvs.2011.10.015
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    ABSTRACT: Cardiovascular diseases are the main cause of 40% of deaths in Iran annually. Many patients undergoing coronary artery bypass graft surgery have previous cardiovascular risk factors which could be prevented. The present study aimed to assess the prevalence of cardiovascular risk factors in the patients undergoing coronary artery bypass graft surgery. In this cross-sectional (descriptive - analytical) study, a data collecting form was used. A total of 246 patients were selected from six hospitals of Shiraz using random stratification. Descriptive statistics were presented through figures and tables and t-test was used to analyze the continuous variables. All the statistical analyses were performed using the SPSS statistical software (version 15.0). Besides, P < 0.05 was considered as statistically significant. Among the study patients, only 11.67% had no risk factors and 88.33% had one or more risk factors. The most common risk factors observed in the patients were hypertension, obesity and overweight, hyperlipidemia, and diabetes mellitus. The results showed a significant difference between males and females regarding the prevalence of hypertension (P = 0.001), diabetes (P = 0.028), hypercholesterolemia (P = 0.020), and cigarette smoking (P = 0.001). In addition, the patients' mean levels of cholesterol, LDL, triglyceride, and fasting blood sugar were higher than the acceptable level, while that of HDL was lower than the accepted level. These patients are recommended to be trained regarding lifestyle changes. Also, prevention strategies can play an important role in reducing patient morbidity and mortality.
    12/2014; 8(4):139-42.
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    ABSTRACT: Purpose of review Recently, hybrid coronary artery revascularization (HCAR), combining the benefits of both percutaneous coronary intervention and coronary artery bypass graft surgery (CABG) while minimizing their respective shortcomings, has been developed. This review is aimed to explore and discuss recent clinical outcomes and patient selection, and comment on surgical approaches for HCAR. Recent findings Current forms of HCAR include off-pump mini-sternotomy or on-pump full sternotomy CABG [left internal mammary artery (LIMA)-to-left anterior descending artery(LAD) CABG followed by drug-eluting stents (DES) to non-LAD territories], robotic-assisted off-pump HCAR (robotic LIMA-to-LAD CABG and DES to non-LAD territories), and off-pump mini-thoracotomy single-vessel small thoracotomy (LIMA-to-LAD CABG), all of which have reported acceptable early to mid-term patency rates and freedom from major cardiac and cerebrovascular adverse events. As long-term effectiveness compared with conventional CABG remains to be demonstrated, especially in patients with diabetes and patients with higher SYNTAX scores, appropriate discussion between the 'Heart Team' and patient is needed prior to HCAR. Summary HCAR presents an attractive alternative option for treating patients with multivessel coronary artery disease because it maximizes the clear survival benefits of LIMA-LAD grafting, improves quality assurance with completion angiography, and allows quicker patient recovery; furthermore, patients avoid the negative systemic inflammatory effects of cardiopulmonary bypass and delayed healing after sternotomy.
    Current Opinion in Cardiology 08/2014; 29(6). DOI:10.1097/HCO.0000000000000112 · 2.59 Impact Factor

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May 29, 2014