Association of Carotid Arterial Circumferential Strain With Left Ventricular Function and Hemodynamic Compromise During Off-Pump Coronary Artery Bypass Surgery

Song, Young Goo; Shim, Ju Hyun; Song, Jong Wook; Shim, Chi Young; Kim, Eui Kyung; Kwak, Young Lan

doi:10.1253/circj.cj-14-0378

Cited by 7 publications

(7 citation statements)

References 33 publications

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“…24 In addition to carotid stenosis and a past history of stroke, we previously reported that perioperative delayed stroke was associated with postoperative AF, LOS, and MI. 25 Heart positioning is a concern during OPCAB. We have adopted the use of IABP in patients with severe carotid stenosis to prevent hemodynamic cerebral infarction during heart positioning.…”

Section: Multivariate Cox Hazard Modelmentioning

confidence: 99%

Does Age at Operation Influence the Short- and Long-Term Outcomes of Off-Pump Coronary Artery Bypass Grafting?

Ohira

Doi

Numata

et al. 2015

Circ J

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Section: Multivariate Cox Hazard Modelmentioning

confidence: 99%

Does Age at Operation Influence the Short- and Long-Term Outcomes of Off-Pump Coronary Artery Bypass Grafting?

Ohira

Doi

Numata

et al. 2015

Circ J

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“…On the other hand, inevitable hemodynamic derangements and reduction in cardiac output during distal anastomosis may elicit organ damage, especially when endothelial dysfunction is present. Moreover, compliance of the vascular system assessed at the carotid artery has been shown to be closely related to the degree of hemodynamic compromise during grafting in OPCAB, possibly owing to vascular-ventricular coupling 31 . Therefore, preoperative vascular status as assessed by using carotid IMT would have clinical relevance in predicting a composite of cardiovascular morbidity endpoints after OPCAB, which has not been validated before.…”

Section: Discussionmentioning

confidence: 99%

“…We also observed a significantly higher vasopressor requirement in the increased IMT group than in the normal IMT group during the operation in order to maintain the preset target MAP. This might also be attributed to reduced vascular compliance 31 and increased blood pressure variability 35 , 36 , which are characteristic features of patients with increased carotid IMT. Increased blood pressure variability was reported to markedly contribute to the increased risk of cardiovascular events in nonsurgical patients with increased carotid IMT, supporting the close relationship between the vasopressor requirement and carotid IMT.…”

Section: Discussionmentioning

confidence: 99%

Prognostic role of carotid intima-media thickness in off-pump coronary artery bypass surgery

Ham

Song

Shim

et al. 2018

Sci Rep

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Carotid intima-media thickness (IMT) is a well-known predictor of adverse outcomes in the ischemic heart disease patients; however, evidence is lacking in patients undergoing off-pump coronary artery bypass surgery (OPCAB). Data from 407 patients who underwent OPCAB between April 2013 and August 2016 were retrospectively reviewed. A composite of cardiovascular morbidity endpoints was defined as the presence of stroke, acute myocardial infarction, new cardiac arrhythmia (newly developed atrial fibrillation, atrial flutter, or atrioventricular block), cardiovascular death, or cerebrovascular death within 30 days after surgery. Increased carotid IMT was defined as ≥0.9 mm on one or both sides. The incidence of a composite of cardiovascular morbidity endpoints was 24.0% in the normal IMT group (n = 221) and 34.4% in the increased IMT group (n = 186) (p = 0.021). Multivariable analysis revealed increased IMT (odds ratio 1.719, 95% confidence interval 1.108 to 2.666, p = 0.016) and preoperative renal replacement therapy (odds ratio 4.264, 95% confidence interval 1.679 to 10.829, p = 0.002) as independent predictors of a composite of cardiovascular morbidity endpoints. In patients undergoing OPCAB, preoperative assessment of carotid IMT may help predicting the development of a postoperative composite of cardiovascular morbidity endpoints.

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“…Off‐pump coronary artery bypass (OPCAB) surgery is an attractive alternative to cCABG in patients with impaired left ventricular function. The benefits of OPCAB are based on the fact that it can help avoid cardiopulmonary bypass and aortic manipulation, which were endorsed by observations showing that the procedure avoided the negative effects of cardiopulmonary bypass on markers of inflammation, coagulation, micro‐embolization, thermoregulation, acid‐based balance, and regional perfusion 7–9 . Positive short‐ and medium‐term outcomes of reducing morbidity and mortality have been observed in previous studies 10,11 .…”

Section: Introductionmentioning

confidence: 96%

Feasibility of off‐pump coronary artery grafting for patients with impaired left ventricular ejection fraction: A retrospective cohort study from a single institutional database

et al. 2021

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Objective Despite substantial advances in surgical practice, the management of patients with impaired left ventricular ejection fraction (LVEF) remains challenging. Furthermore, evidence on the outcomes of off‐pump coronary artery bypass (OPCAB) surgery in this population is inconsistent. We conducted the present study to compare the short‐ and long‐term outcomes of OPCAB in patients with different ejection fractions. Methods This retrospective cohort study used data from the Hua‐Shan Cardiac Surgery and included consecutive patients aged ≥ 18 years who underwent OPCAB procedures during 2016–2019. The patients included in the study were followed up until death or the end of data collection. Patients with different ejection fractions were matched 1:2 using propensity score matching. Factors associated with short‐term outcomes were determined using logistic regression, and Kaplan–Meier survival analyses for the differences in all‐cause death were generated. Results The two propensity score matched groups consisted of 40 left ventricular dysfunction (LVD) and 80 normal left ventricular function (NLVF) patients. No significant intergroup differences were observed in the postoperative outcomes for the occurrence of left heart failure (22.5% in LVD vs. 5.0% in NLVF, p = .009). Age (odds ratio = 1.11, 95% confidence interval = 1.04–1.18) but not the preoperative LVEF was shown to be a strong predictor of short‐term events in logistic regression analyses. Kaplan–Meier curves displayed similar freedom from all‐cause death (p = .119) or cardio‐death (p = .092) between groups. Conclusion The immediate postoperative outcomes and long‐term outcomes were similar between the groups, indicating that OPCAB is a safe and effective choice for patients with LVD.

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Association of Carotid Arterial Circumferential Strain With Left Ventricular Function and Hemodynamic Compromise During Off-Pump Coronary Artery Bypass Surgery

Cited by 7 publications

References 33 publications

Does Age at Operation Influence the Short- and Long-Term Outcomes of Off-Pump Coronary Artery Bypass Grafting?

Does Age at Operation Influence the Short- and Long-Term Outcomes of Off-Pump Coronary Artery Bypass Grafting?

Prognostic role of carotid intima-media thickness in off-pump coronary artery bypass surgery

Feasibility of off‐pump coronary artery grafting for patients with impaired left ventricular ejection fraction: A retrospective cohort study from a single institutional database

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