Abstract:Objective -This study was conducted to determine whether HbA1c is a predictor of short term mortality and morbidity after coronary artery bypass graft operation. Methods -The coronary artery bypass graft operation was performed on the patients between January 2009 and January 2013. Each patient's medical record was retrospectively reviewed. The patients who were included in the study were evaluated in groups of 60. One group was comprised of nondiabetic patients, whose HbA1c level is below 6% (the control group 0), the other included diabetic patients with the HbA1c level is between 6-6.9% (the group 1) and the last group, group 2, included those patients with HbA1c level is equal or greater than 7%. Pre, peri and post operation data was compared. The deaths that occured in the first 30 days were evaluated as mortality and complications as morbitity. Results -While mortality was not observed in the control group, one incident was observed in group 1 and 5 in group 2, which corresponds to 1.7% and 8.3% respectively. The mortality ratio in the group with patients whose HbA1c was greater or equal to 7% found statistically significant compared to the control group (P=0.02). The following parameters were observed in group 2 and were found statistically significant: the need for dialisis (25%, P<0.01), atrial fibrillation (33%, P=0.01), revision due to bleeding (10%, P=0.18), cerebrovascular event (16,7%, P=0.01), duration of mechanic ventilation (19.5±21.6, P=0.06), duration of hospital stay (approximately 9.91±5.35 days, P=0.01), infection in scar (53%, P<0.01), mediastenit (11%, P=0.01) and urinary tract infection (10%, P=0.01) Conclusion -We concluded that in those diabetic patients that elective coronart artery bypass graft is applied, highly reactive HbA1c levels (HbA1c ≥7), may indicate morbitity in the early stages of post operation.

ObjectiveThis study aimed to show the effects of intra-operative diltiazem infusion on flow in arterial and venous grafts in coronary artery bypass graft surgery.MethodsHundred fourty patients with a total of 361 grafts [205 (57%) arterial and 156 (43%) venous] underwent isolated coronary surgery. All the grafts were measured by intraoperative transit time flow meter intra-operatively. Group A (n=70) consisted of patients who received diltiazem infusion (dose of 2.5 microgram/kg/min), and Group B (n=70) didn't receive diltiazem infusion.ResultsMean graft flow values of left internal mammary artery were 53 ml/min in Group A and 40 ml/min in Group B (P<0.001). Pulsatility index (PI) values of left internal mammary artery for Group A and Group B were 2.6 and 3.0 respectively (P<0.001). No statistically significant difference was found between venous graft parameters.ConclusionWe recommend an effect of diltiazem infusion in increasing graft flows in coronary artery bypass graft operations.

LV aneurysm can be repaired with acceptable surgical risk. Surgical treatment of LV aneurysm is associated with an improvement in long-term survival and symptoms.

Background: High preoperative BNP levels can be a marker of higher risk for coronary artery bypass grafting. We investigated the predictive value of serum NT-proBNP levels undergoing coronary artery bypass grafting for the need for inotropic support. Methods: In this prospective study, preoperative serum NT-proBNP levels were obtained in 51 patients [80.4% (n=42) were males and 19.6% (n=9) were females] undergoing isolated coronary artery bypass grafting. The study patients were divided into three groups depending on NT-proBNP levels as low NT-proBNP (<100 pg/ml, Group-1, 29.4%, n=15) group, moderately high NT-proBNP (NT-proBNP <500 pg/mL and >100 pg/mL, Group-2, 29.4%, n=15) group, and high NT-proBNP (>500 pg/mL, Group-3, 41.2%, n=21) group.Results: At postoperative day 0, the mean adrenalin, dopamine, dobutamine, and noradrenalin consumptions were 0.1±0.7 microgram/kg/min, 0.08±0.56 microgram/kg/min, 2.1±3.01 microgram/ kilogram/min, and 1.35±3.45 microgram/kg/min, respectively. There were no statistically significant differences between the groups in terms of the use of adrenalin (p=0.50, p>0.05), dopamine (p=0.31 p>0.05), dobutamine (p=0.59 p>0.05), and noradrenalin (p=0.24 p>0.05) at postoperative day 0. The doses of inotropic agents used at postoperative days 1 and 2 did not show significant differences between the groups for the three inotropic agents.Conclusion: Preoperative serum NT-proBNP levels in patients undergoing coronary artery bypass grafting are not associated with the need for inotropic support in the postoperative period.Cardiovasc. j. 2017; 9(2): 90-96

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