No abstract

Introduction: Coronary artery bypass grafting forms the bulk of a cardiac surgeon′s workload. An extensive amount of research has been undertaken to improve the outcomes of this procedure. This literature review aimed to summarize key areas that influence coronary artery bypass grafting in modern day practice. Methods: A comprehensive electronic search was done using PubMed, Ovid, SCOPUS, Embase and google scholar from inception to July 2020. Articles were included if they discussed factors affecting outcomes in coronary bypass grafting (CABG). Case reports, expert opinion, and editorials were excluded. Results: There are many factors that influence and predict outcomes following coronary artery bypass surgery. Age, diabetes, and isolated systolic hypertension were preoperative factors with strong correlation to mortality and morbidity rates post CABG. In addition to these, the degree of renal failure and heart failure correlated with poorer operative results. The use of the left internal mammary artery has transformed outcomes and has proven advantage over venous conduit use. Newer minimal invasive techniques have the potential to further optimize outcomes. Conclusion: The numerous and complex factors which impair outcomes following CABG need to be further researched and addressed using larger trials and possible optimization of multidisciplinary team approach to further improve long term outcomes.

Objective To investigate whether axillary artery cannulation has supremacy over innominate artery cannulation in thoracic aortic surgery. Methods A comprehensive search was undertaken among the four major databases (PubMed, Excerpta Medica dataBASE [EMBASE], Scopus, and Ovid) to identify all randomized and nonrandomized controlled trials comparing axillary to innominate artery cannulation in thoracic aortic surgery. Databases were evaluated and assessed up to March 2017. Results Only three studies fulfilled the criteria for this meta-analysis, including 534 patients. Cardiopulmonary bypass time was significantly shorter in the innominate group ( P =0.004). However, the innominate group had significantly higher risk of prolonged intubation > 48 hours ( P =0.04) than the axillary group. Further analysis revealed no significant difference between the innominate and axillary groups for deep hypothermic circulatory arrest time ( P =0.06). The relative risks for temporary and permanent neurological deficits as well as in-hospital mortality were not significantly different for both groups ( P =0.90, P =0.49, and P =0.55, respectively). Length of hospital stay was similar for both groups. Conclusion There is no superiority of axillary over innominate artery cannulation in thoracic aortic surgery in terms of perioperative outcomes; however, as the studies were limited, larger scale comparative studies are required to provide a solid evidence base for choosing optimal arterial cannulation site.

No abstract

Total arterial revascularization during coronary artery bypass surgery has proven its superiority over vein graft conduits in both long-term patency and lower conduit associated complications, especially in the young population. Yet, the use of long saphenous vein as a reliable conduit is still in practice, especially in cohorts where a systemic vascular disease exists and there is risk of involvement of internal thoracic and radial arteries in such pathology. With modern day practice and the increasing evidence of arterial conduit supremacy over the vein grafting, the fate of such vein conduit utilization comes into question. With modern day practice and the increasing evidence of arterial conduit supremacy over the vein grafting, the fate of such vein conduit utilization comes into question. This brief review focuses on current evidence behind total arterial revascularization and use of long saphenous vein as a reliable conduit for coronary revascularization.

No abstract

Objective: To increase our understanding of the psychological attachment styles in order to develop a preventative strategy that could potentially improve patients' perioperative outcomes.Methods: A comprehensive literature search was performed utilizing major electronic databases. The search was done from inception to January 2019. All of the relevant papers have been extracted and critically appraised in this review. Results: Understanding the psychological aspects of patients is crucial for a satisfactory postoperative outcome. Depression and anxiety have been shown to increase both mortality and morbidity after coronary artery bypass graft surgery, independently of medical factors, although the behavioural and biological mechanisms are poorly understood. Psychosocial assessment is an important part of the pre-transplant evaluation process. The majority of individuals undergoing a transplant have significant psychosocial problems and can either be deferred or denied the transplant until these psychosocial issues are approached and managed. Psychological distress has been shown to affect longterm prognosis of cardiac patients and as a result, it should be addressed during follow-up of cardiac arrest survivors due to cardiac cause. Several studies have considered different approaches and analyses of different psychological attachments, and the understanding of such parameters perioperatively could possibly minimise perioperatively complications. Conclusion: Since psychological distress affects long-term prognosis of cardiac surgery patients, it should be addressed during follow-up of cardiac arrest survivors due to cardiac cause.

Materials and Methods Slices Loading and Tumor LocalizationDTI volume was download from slicer software in sample data (Figure 1). Figure 1: The tumor (red arrow) in DTI a) And FA b) Slices.