The incidence of atherosclerosis is increasing rapidly all over the world. Inflammatory processes
have outstanding role in coronary artery disease (CAD) etiology and other atherosclerosis
manifestations. Recently attentions have been increased about gut microbiota in many fields of
medicine especially in inflammatory diseases like atherosclerosis. Ineffectiveness in gut barrier
functions and subsequent metabolic endotoxemia (caused by rise in plasma lipopolysaccharide
levels) is associated with low-grade chronic inflammation i.e. a recognized feature of
atherosclerosis. Furthermore, the role of trimethylamine-N-oxide (TMAO), a gut bacterial
metabolite has been suggested in atherosclerosis development. On the other hand, the effectiveness
of gut microbiota modulation that results in TMAO reduction has been investigated. Moreover,
considerable evidence supports a role for the endocannabinoid system (ECS) in atherosclerosis
pathology which affects gut microbiota, but their effects on atherosclerosis are controversial.
Therefore, we presented some evidence about the relationship between gut microbiota and ECS
in atherosclerosis. We also presented evidences that gut microbiota modulation by pre/probiotics
can have significant influence on the ECS.
Background:The objective of this study was to assess the results of the pulmonary artery (PA) banding in patients with congenital heart defects (CHD) and pulmonary hypertension (PH) in the current era.Methods:We analyzed data from 305 patients who underwent PA banding between April 2005 and April 2010 at our centre. All patients were approached through a left thoracotomy. Twenty percent of patients underwent PA banding based on Trusler's rule (Group 1), 55% of them underwent PA banding based on PA pressure measurement (Group 2), and the rest of them (25%) based on surgeon experience (Group 3). The follow-up period was 39 ± 20 month and 75% of patients (230 cases) had definitive repair at mean interval 23 ± 10 months.Results:The rate of anatomically and functionally effectiveness of PA banding in all groups was high (97% and 92%, respectively). There were no significant differences in anatomically and functionally efficacy rate between all groups (P=0.77, P=0.728, respectively). There was PA bifurcation stenosis in six cases (2%), and pulmonary valve injury in one case (0.3%). The mortality rate in PA banding was 2% and in definitive repair was 3%.Conclusions:We believe that PA banding still plays a role in management of patients with CHD, particularly for infants with medical problems such as sepsis, low body weight, intracranial hemorrhage and associated non cardiac anomalies. PA banding can be done safely with low morbidity and mortality.
Introduction: Coronary artery bypass surgery (CABG) is associated with ischemia-reperfusion injury and tissue damage. CoQ10 as an antioxidant has an important role and may have cardio-protective effects after myocardial dysfunction and CABG. We aimed to evaluate whether CoQ10 has a myocardial cardio protective impact on cardiac biomarkers after CABG.
Methods: In this double-blind study, 80 patients with coronary artery disease (CAD) who underwent CABG surgery were divided into intervention and control groups and received Q10 supplement or placebo, respectively. The surgical characteristics of the patients in the two groups were similar. The intervention group received 150 mg of Q10 supplement per day for 7 days before the surgery. The control group received placebo capsule. After operation the inter- and intra-group blood levels of CK-MB and troponin, before and after supplementation and 12 hours after the CABG, and postoperative outcomes such as intensive care unit (ICU) stay and hospital stay were compared.
Results: In this study, 40 subjects were located in each group. The participation rate was 97.5% and men and women accounted for 52.5% and 47.5% respectively. The mean age of the subjects was 58.17 ± 8.55. The two groups were not significantly different in terms of basic variables. Within-group comparison showed a significant increase in the level of troponin enzymes over time (P < 0.001) and CK-MB (P < 0.001). However, between-group comparison showed no significant difference between the two groups in terms of CK-MB (P = 0.384) and troponin (P = 0.115). In the end, no interaction was observed between the intervention and time on CK-MB (P = 0.095) and troponin (P = 0.198) variables.
Conclusion: Q10 supplementation 7 days before surgery was not effective in reducing CK-MB and troponin after CABG.
Background:Patency of the revascularization conduit is an essential predictor of long-standing survival after coronary artery bypass grafting.Objectives:We have conducted this study to compare the mid-term patency rates of radial artery (RA), left internal thoracic artery (LITA) and also saphenous vein (SV) grafts in asymptomatic patients following coronary artery bypass graft surgery (CABG) undergoing total IV anesthesia.Patients and Methods:In this study, 30 three-vessel disease patients with 104 RA, LITA, and SV grafts used concomitantly for primary isolated non-emergent CABG surgery were assessed. The primary end point was CT angiographic graft patency rate. After 53.5 (24-97) months’ follow-up, graft patency was assessed using 128-slice CT coronary angiography. Logistic regression analysis was used to detect the independent predictors of graft failure.Results:A total of 104 grafts, including 30 LITA, 44 SV, and 30 RA grafts, were studied. Cumulative graft patency rates were 93.3% in LITA, 83.3% in RA, and 70.5% in SV grafts. Statistically significant difference was found between the LITA and the SV graft patency rates (P = 0.019), whereas the difference between the RA conduit patency and the LITA or SV graft patency rates did not have any statistical significance (P = 0.424 and P = 0.273, respectively). Independent predictors of RA grafts occlusion were native coronary stenosis < 70% and female gender.Conclusions:In our patients, the RA grafts had an acceptable patency rate in 2 to 5 years’ follow-up. Although the SV grafts had a relatively higher patency rate than RA grafts in our asymptomatic patients, the patency rates in RA and SV grafts were close to each other. The RA graft function was poor in the patients with a higher number of risk factors and in the females.
IntroductionThe superior cavopulmonary connection operation is one of the stages of the
palliative surgical management for patients with functionally single
ventricle. After surviving this stage, the patients are potential candidates
for the final palliative procedure: the Fontan operation.ObjectivesThis study aimed to analyze the outcomes of superior cavopulmonary connection
operations in our center and to identify factors affecting the survival and
the progression to Fontan stage.MethodsThe outcomes of 161 patients were retrospectively analyzed after undergoing
superior cavopulmonary connection operation in our center between 2005 and
2015.ResultsThe early mortality rate was 2.5%. Five (3.1%) patients underwent takedown of
the superior cavopulmonary connection. The rate of exclusion from the Fontan
stage was 8.3%. Statistical analysis revealed that elevated mean pulmonary
artery pressure preoperatively and the prior palliation with pulmonary
artery banding were risk factors for both early mortality and takedown;
however, the age, the morphology of the single ventricle and the type of
operation were not considered risk factors.ConclusionThe superior cavopulmonary connection operation can be performed with low
rate mortality and morbidity; however, the elevated mean pulmonary artery
pressure preoperatively and the prior pulmonary artery banding are
associated with poor outcomes.
Background:
Coronary artery bypass graft (CABG) is associated with oxidative stress and
tissue damage. Vitamin C, as an antioxidant agent, has an important role in attenuating the oxidative
stress damage and might have cardio-protective effects after CABG. We aimed to evaluate the probable
roles of vitamin C supplementation in cardiac biomarkers after CABG.
Methods::
In this randomized control trial, 122 patients undergoing CABG were randomly assigned
to the intervention (n=54) and control group (n=68) and received vitamin C (2 g intravenously) or
placebo, respectively. The surgical methods of the patients in the two groups were identical. The
primary efficacy endpoint of this trial is the difference in the levels of CK-MB, Troponin and Total
Antioxidant Capacity (TAC) were measured at study entry and 24 hrs after surgery between the two
groups.
Results::
The two groups were not significantly different in terms of basic variables. Within-group
comparison showed significant rises in the level of troponin (P < 0.001) and CK-MB (P < 0.001)
over time. However, between-group comparison showed no significant difference between the two
groups in terms of CK-MB (P=0.826) and troponin (P=0.821). As a whole, the correlation between
cardiac enzymes and surgical characteristic was not seen.
Conclusion::
The results showed that pretreatment with vitamin C could not reduce cardiac marker
following CABG. After the intervention, TAC did not differ between and within the intervention and
the control groups. Pretreatment with vitamin C as an antioxidant agent could not reduce ischemicreperfusion
resulting in CABG.
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