Effects of Smaller Physical Size on Complex Arterial Grafting in Coronary Artery Operations

Nishida, Hiroshi; Nakajima, Masahiro; Ihashi, K; Sato, Motoki; Shiikawa, A; Endo, Masahiro; Koyanagi, Hitoshi

doi:10.1016/s0003-4975(96)00281-4

“…Perioperative myocardial infarction in coronary artery bypass graft (CABG) surgery has been the topic of several studies [1][2][3][4][5][6][7][8][9][10][11][12]. Despite this, many questions have remained unanswered concerning its aetiology, risk factors and clinical relevance.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for fatal myocardial infarction after coronary bypass graft surgery

Ranucci¹,

Frigiola

²

,

Menicanti

³

et al. 2001

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“…Perioperative myocardial infarction in coronary artery bypass graft (CABG) surgery has been the topic of several studies [1][2][3][4][5][6][7][8][9][10][11][12]. Despite this, many questions have remained unanswered concerning its aetiology, risk factors and clinical relevance.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for fatal myocardial infarction after coronary bypass graft surgery

Ranucci¹,

Frigiola

²

,

Menicanti

³

et al. 2001

European Journal of Anaesthesiology

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Background and objective The incidence and clinical impact of perioperative myocardial infarction during coronary artery bypass graft surgery vary greatly depending upon the diagnostic criteria applied. Fatal perioperative myocardial infarction has a less arguable diagnosis and clinical impact. The aim of this paper is to find out the risk factors for fatal myocardial infarction after coronary surgery. Methods Data from 1561 consecutive patients, who underwent coronary revascularization during a 10month period, have been retrospectively analysed. After an univariate analysis for pre-and intraoperative risk factors, a multivariate model (logistic regression analysis) was settled. Results Preoperative use of subcutaneous/intravenous heparin, a heparin sensitivity index <1.3 and need for a thromboendarterectomy of the left anterior descending coronary artery are independent risk factors for fatal myocardial infarction. The relative risk for fatal myocardial infarction was about 2 in the case of preoperative heparin use or heparin sensitivity index <1.3 and 5.5 in the case of thromboendarterectomy of the left anterior descending coronary artery. Conclusions In patients undergoing coronary artery bypass surgery, preoperative anticoagulation management with heparin may represent a risk factor for fatal myocardial infarction. Patterns of heparin resistance, whether or not due to heparin pretreatment, seem to be closely related to fatal myocardial infarction.

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