Stroke in octogenarians undergoing coronary artery surgery with and without cardiopulmonary bypass

Early outcomes of coronary artery bypass with and without cardiopulmonary bypass in octogenarians

“…The most significant finding was a decreased incidence of postoperative neurological dysfunction in our off-pump cohort. This finding is in agreement with most recent reports of OPCAB versus CCAB surgery in this age group (8,(19)(20)(21). Adverse neurological events, including CVAs, transient ischemic episodes and other neurobehavioural dysfunction have been associated with cerebral hypoperfusion, edema and emboli generation in both OPCAB and CCAB patients (23).…”

“…Avoiding the aortic cannulation and cross-clamping associated with CPB may also benefit these patients because they may have a higher prevalence of aortic atheromatous disease. Published series examining the use of CPB in the elderly have reported significantly better outcomes in the OPCAB group, namely, decreased mortality (18,19), stroke (19,20), blood product transfusion (19,21), and postoperative intensive care unit (ICU) and hospital LOS (21). Here we present an analysis of our experience with this group of patients, in a combined series, from two busy cardiac surgery units in southwestern Ontario: the London Health Sciences Centre (London, Ontario) and the Trillium Health Centre (Mississauga, Ontario).…”

Myocardial revascularization in renal transplant patients

“…Although our data do not allow an effective conclusion about the effects of extracorporeal circulation in the transplanted kidney in the in-hospital and late periods, the current literature has stressed that surgery without extracorporeal circulation has its major benefit in patients with clinical morbidity in the preoperative period [28][29][30] . The in-hospital mortality rate in renal transplant patients has been reported as approximately 10% in the largest case series.…”

A comparison of off-pump and cardiopulmonary bypass for the development of postoperative atrial fibrillation

“…Özellikle 70 yaş ve üzeri hastalarda, çok düşük ejeksiyon fraksiyonu olanlarda, tekrar ameliyatlarda, serebrovasküler hastalık, karaciğer hastalığı, kanama diatezleri, ileri derecede kalsifik aortu olan hasta gruplarında ya da kan ve kan ürünleri kullanılamayan hastalarda KPB kullanılarak yapılan ameliyatlara göre üstünlük sağladığı çeşitli çalışmalarda bildirilmiştir. [6][7][8] Birçok çalışmanın sonuçlarına göre koroner cerrahi sonrası hastalarda AF ortaya çıkması ameliyat sonrası dönemde morbidite açısından önemli bir etken olup, herhangi bir etyolojik faktörle AF ortaya çıkması arasında kesin bir ilişki ve tam bir birlik sağlanamamıştır. [9,10] Bu çalışmaların birçoğunda sol ventrikül performansı, ileri yaş, HT, geçirilmiş Mİ, ameliyata bağlı iskemi süresi, tamamlanmamış revaskülarizasyon, önceden geçirilmiş kardiyak cerrahi, koroner lezyonların derecesi ve yaygınlığı, atriyal korumanın yetersizliğinin AF sıklığını artırdığı bildirilmiştir.…”