Reduction of the Inflammatory Response in Patients Undergoing Minimally Invasive Coronary Artery Bypass Grafting

Gu, Yongquan; Mariani, Massimo A.; Oeveren, van Willem; Grandjean, JG; Boonstra, PW

doi:10.1016/s0003-4975(97)01127-2

Cited by 155 publications

(64 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have measured the plasma levels of elastase and complement C3a for neutrophils destroyed and observed platelet degranulaton by comparing on-pump CABG with off-pump CABG, with the level in the off-pump CABG group lower than that in the on-pump CABG group. 12,13 This therefore might shorten the duration of surgery, especially the duration of cardiopulmonary bypass, and might reduce the postoperative pulmonary complications. Advancing the surgeon skills and developing off-pump CABG were beneficial for patient recovery.…”

Section: Discussionmentioning

confidence: 99%

Study on the Risk Factors of Postoperative Hypoxemia in Patients Undergoing Coronary Artery Bypass Grafting

Ji¹,

Mei²,

Wang³

et al. 2008

Circ J

View full text Add to dashboard Cite

oronary artery bypass grafting (CABG) has been performed more extensively in China. With surgical improvement in technology, more and more elderly patients with coronary artery disease who have suffered with multiple organ dysfunction have had CABG been performed on them, and the postoperative hypoxemia seems to be on the increase. Some reports revealed that many factors and the interaction of these factors leads to postoperative hypoxemia following CABG. [1][2][3] In this study, the pre-, intra-, and post-operative materials in patients with coronary artery disease who had CABG performed on them from March 2004 to March 2008 were collected and analyzed retrospectively. The relative risk factors were tested through descriptive analysis and logistic regression, the independent high risk factors of postoperative hypoxemia were obtained, and the aim is to prevent and treat postoperative hypoxemia after CABG. Circulation Journal Vol.72, December 2008 Methods PatientsFrom March 2004 to March 2007, 576 patients (412 male and 164 female, mean age 68.36 years) suffering from coronary artery disease had CABG performed on them in our hospital. Among these cases, 422 suffered from stable angina, and 154 instable angina. Coronary artery angiography revealed that double vessel disease was observed in 54 cases, triple vessel disease in 522 cases, and 150 cases were concurrent with left main trunk disease; 50 cases were concurrent with left ventricular aneurysm. The 382 cases were performed with a beating heart CABG (including 66 cases with cardiopulmonary bypass) and 194 cases with an onpump CABG. The number of bypass graftings ranged from 2 to 5 (mean 2.96 per case). The Swan-Ganz transcatheter was used to monitor hymodynamic parameters intra-and postoperatively. A blood gas analyzer (i-STAT Corporation, East Windsor, NJ, USA) was used to measure the arterial partial pressure of oxygen (PaO2) and arterial oxygen saturation pre-, intra-and postoperatively. A Doppler-Ultrasound (VIVID 7) was used to measure the left ventricular ejection fraction (LVEF) and left ventricular endo-diastolic diameter (LVEDD) pre-and post-operatively. MethodsThe investigated materials were as follows: sex, age, smoking history and smoking index, preoperative acute cardiac infarction, preoperative hypertension, preoperative diabetes, preoperative chronic pulmonary diseases, pre- J 2008; 72: 1975 -1980 (Received April 14, 2008 revised manuscript received June 18, 2008; accepted July 15, 2008; released online October 17, 2008 518-8.543) are the 3 independent risk factors after decannulation following CABG. Conclusions Preoperative chronic pulmonary diseases, preoperative acute myocardial infarction, and preoperative diabetes are 3 independent risk factors of postoperative hypoxemia following CABG. (Circ J 2008; 72: 1975 -1980 Circ

show abstract

Section: Discussionmentioning

confidence: 99%

Study on the Risk Factors of Postoperative Hypoxemia in Patients Undergoing Coronary Artery Bypass Grafting

Ji¹,

Mei²,

Wang³

et al. 2008

Circ J

View full text Add to dashboard Cite

show abstract

“…Since practice evolves continuously, it is relevant to consider the differences between the techniques used in this study and newly developed techniques for coronary revascularization that may affect future practice, such as surgery without cardiopulmonary bypass and new, minimally invasive approaches. [29][30][31][32][33][34] Conversely, the 2.8 percent stent thrombosis rate per patient might have been prevented by platelet glycoprotein IIb/IIIa receptor blockade 35 or use of a heparin-coated stent. 6,36,37 Furthermore, in 30 percent of the patients with stents, some release of CK-MB was documented; the use of glycoprotein IIb/IIIa inhibitors might have reduced this rate of enzyme release by 50 percent.…”

Section: Discussionmentioning

confidence: 99%

Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease

Serruys

Unger

Sousa

2001

ACC Current Journal Review

208

266

View full text Add to dashboard Cite

“…For example, the rate of postoperative morbidity is reduced in patients undergoing cardiac operations without CPB, 12 and inflammatory reactions in patients undergoing bypass graft operations were reduced when CPB was not used. 13,14 Although avoidance of CPB should provide a more physiological milieu and reduce the perioperative stress response, with preservation of perioperative organ function, little has been published regarding the association of perioperative stress response and clinical outcomes after off-pump coronary artery bypass surgery (OPCAB). We therefore assessed the role of perioperative systemic inflammation and stress response on postoperative inflammatory complications (PIC) in patients undergoing OPCAB.…”

mentioning

confidence: 99%

Perioperative Indicators of Stress Response and Postoperative Inflammatory Complications in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery A Prospective Observational Study

Song

Lee

et al. 2008

Circ J

View full text Add to dashboard Cite

Background Little has been published regarding the association between perioperative stress response and clinical outcomes after off-pump coronary artery bypass surgery (OPCAB). The role of perioperative stress response in postoperative inflammatory complications (PIC) in patients undergoing OPCAB was assessed. Methods and ResultsThe study cohort consisted of 100 patients who underwent elective OPCAB over a 5-month period. Anesthetic management was standardized and blood samples were collected before surgery, immediately after surgery, and 1, 2, 3, and 7 days after surgery. Leukocyte, neutrophil, platelet, erythrocyte sedimentation rate, C-reactive protein, fibrinogen, cortisol, D-dimer, and fibrin degradation product were measured at each time point, and the association of each parameter with PIC was assessed. PIC included postoperative pulmonary complications, atrial fibrillation, and wound infections. PIC occurred in 30 patients at the median third postoperative day. Multivariate analysis showed preoperative cortisol (p=0.024) and cortisol on the first postoperative day (p=0.001) were significantly associated with PIC. Intraoperative cortisol release was correlated with intraoperative hemodynamic changes, including pulmonary artery pressure, central venous pressure, and cardiac index. Conclusions Patients with PIC after OPCAB have significantly increased preoperative cortisol and cortisol on the first postoperative day. Intraoperative cortisol release was significantly correlated with hemodynamic changes. The neurohormonal environment and inflammatory response during and after beating-heart surgery should be further explored. (Circ J 2008; 72: 1966 -1974

show abstract

Reduction of the Inflammatory Response in Patients Undergoing Minimally Invasive Coronary Artery Bypass Grafting

Cited by 155 publications

References 25 publications

Study on the Risk Factors of Postoperative Hypoxemia in Patients Undergoing Coronary Artery Bypass Grafting

Study on the Risk Factors of Postoperative Hypoxemia in Patients Undergoing Coronary Artery Bypass Grafting

Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease

Perioperative Indicators of Stress Response and Postoperative Inflammatory Complications in Patients Undergoing Off-Pump Coronary Artery Bypass Surgery A Prospective Observational Study

Contact Info

Product

Resources

About