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 GuidelinesWriting Committee MembersJ Thorac Cardiovasc Surg201214343410.1016/j.jtcvs.2011.10.01522172748

The Journal of thoracic and cardiovascular surgery (Impact Factor: 4.17). 01/2012; 143(1):4-34. DOI: 10.1016/j.jtcvs.2011.10.015
Source: PubMed
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Available from: Manesh R Patel, Dec 16, 2013
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    • "Yet broad conclusions on the survival benefit of BITA remain limited by lack of data from randomized, prospective studies. Accordingly, current ACC/AHA Guidelines list BITA grafting as a Class IIA recommendation, with Level of Evidence B, which signifies the recommendation is “based on evidence from a single randomized trial or nonrandomized studies” [12]. A systematic review in 2001 by Taggart et al. identified only 9 cohort studies and no randomized trials [13]. "
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    ABSTRACT: Substantial evidence exists to support a long-term survival benefit with bilateral internal thoracic artery (BITA) revascularization in coronary artery bypass grafting. However, this technique remains grossly underutilized worldwide and especially in the United States. In this review, we discuss evidence for the advantages of BITA grafting as well as the associated the risk of sternal wound complications. We then review a growing body of literature that suggests 'skeletonization' of the internal thoracic artery during harvest confers a protective benefit against sternal wound infection in patients receiving BITA.
    Full-text · Article · Nov 2013 · Journal of Clinical and Experimental Cardiology
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    • "There are no defi ned criteria of eligibility for OPCABG (Hillis et al. 2011). In the institution where this research took place, over 95% of annual CABG surgeries are performed using an off-pump method. "
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    ABSTRACT: Objectives. Postoperative cognitive dysfunction (POCD) is an important neuropsychiatric complication of coronary artery bypass grafting (CABG). It is most likely caused by microembolic brain damage and affects domains of attention, memory, executive functions and dexterity. In order to achieve better neuroprotection, surgeons introduced some advantageous operating procedures. Noteworthy among them is a state-of-the-art off-pump CABG aorta no-touch technique ("no touch" OPCABG). The aim of this study was to investigate the short-term effect of "no touch" OPCABG on patients' attention and executive functions. Methods. In this prospective, observational, single-surgeon trial, 74 patients scheduled for elective CABG were studied. Thirty-five patients underwent "no-touch" OPCABG and were compared to 39 patients who underwent "traditional" OPCABG. Subjects underwent neurological and neuropsychological evaluation at the time of admission (7 ± 2 days preoperatively) and discharge (7 days postoperatively). Results. Patients who underwent "traditional" OPCABG showed a significant decline in postoperative performance on 4 neuropsychological tests, while patients treated with "no touch" OPCABG showed a significant decline on 1 test. Twenty patients from "traditional" OPCABG group and ten patients from "no touch" OPCABG group were diagnosed with POCD. Conclusions. Use of "no touch" OPCABG was associated with better attention and executive functions 1 week after surgery compared with "traditional" OPCABG.
    Full-text · Article · Aug 2013 · The World Journal of Biological Psychiatry
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    • "Concurrent PCI and hypothermia are safe, with good outcomes reported for comatose cardiac arrest patients who undergo PCI (1). Emergency CABG after failed PCI is required in <1% of cases, and the subjects most likely to require it are those with evolving STEMI, cardiogenic shock, 3-vessel coronary artery disease, or the presence of a type C coronary arterial lesion (defined as >2 cm in length, an excessively tortuous proximal segment, an extremely angulated segment, a total occlusion >3 months in duration, or a degenerated SVG that appears to be friable) (10). However, when PCI fails, the safety of hypothermia after emergent CABG has not been demonstrated in post-cardiac arrest patients. "
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    ABSTRACT: We report the case of 60-yr-old female in which therapeutic hypothermia (TH) was successfully induced maintaining the target temperature of 34℃ for 12 hr despite a risk of hypothermia-induced coagulation abnormalities following an emergent coronary artery bypass grafting (CABG) due to failed percutaneous coronary intervention, who suffered a cardiac arrest. Emergent CABG may be a relative contraindication for TH in post-cardiac arrest patients because hypothermia may increase the risk of infection and bleeding. However, the possibility of an improved neurologic outcome outweighs the risk of bleeding, although major surgery may be a relative contraindication for TH.
    Full-text · Article · Aug 2013 · Journal of Korean medical science
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