International Perfusion Association

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IPA

Category: Coronary Artery Bypass

OPCABG 2024

On-Pump or Off-Pump Impact of Diabetic Patients Undergoing Coronary Artery Bypass Grafting: 5-Year Clinical Outcomes

This study evaluates the long-term outcomes of on-pump vs. off-pump coronary artery bypass grafting (CABG) in diabetic patients. A retrospective review of 1,269 patients found that off-pump CABG was associated with a lower 5-year all-cause death rate (4.23% vs. 5.95%) and reduced risks of postoperative stroke and atrial fibrillation. These results suggest potential advantages for diabetic patients undergoing off-pump CABG procedures.

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October 4, 2024
CABG Block

In-Hospital Graft Occlusion in Post-Coronary Artery Bypass Grafting Patients in the Early Postoperative Period: A Systematic Review and Meta-Analysis

This study evaluates the incidence and risk factors of early in-hospital graft occlusion in post-coronary artery bypass grafting (CABG) patients. The meta-analysis, including 22 studies with 35,798 patients, found a 5% occlusion rate. The rate varied based on symptom-driven or systematic graft patency assessments. Vein graft presence, female gender, and other factors like composite grafts may increase the risk of early occlusion.

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October 2, 2024
Surgery in Progress

New Approach to the Mitral Valve Through the Left Anterior Minithoracotomy for Combined Valve and Coronary Surgical Procedures

A new technique for accessing the mitral valve via the left anterior minithoracotomy has been developed for patients requiring both mitral valve surgery and coronary artery bypass grafting. From October 2020 to September 2022, 24 patients underwent this procedure, which involved specialized exposure maneuvers and conventional surgical techniques. The approach proved successful with no need for conversion to sternotomy, no major complications, and no mortality within 30 days post-procedure.

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June 8, 2024
Myocardial Injury

Hybrid Feature Selection in a Machine Learning Predictive Model for Perioperative Myocardial Injury in Noncoronary Cardiac Surgery with Cardiopulmonary Bypass

This study developed a predictive model for perioperative myocardial injury (PMI) using hybrid feature selection (FS) methods in patients undergoing noncoronary cardiac surgery with cardiopulmonary bypass (CPB). Conducted at Fuwai Hospital, China, the retrospective study included 1130 patients, with an overall PMI incidence of 20.3%. Various machine learning models were evaluated, with the Naïve Bayes model achieving the highest AUC. The study highlighted the importance of factors like prolonged CPB, aortic clamp time, and preoperative low platelet count in predicting PMI risk.

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May 12, 2024
Revasculatization

Hybrid Total Arterial Minimally Invasive Off-Pump Coronary Revascularization and Percutaneous Coronary Intervention Strategy for Multivessel Coronary Artery Disease: A Cohort Study with a Median 11-Year Follow-Up

This study examines hybrid coronary revascularization (HCR), a treatment combining minimally invasive coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for multivessel coronary artery disease (MV CAD). It involved 138 patients who underwent either MIDCAB or MICS-CABG, with a median follow-up of 11 years. Results showed a 36.7% incidence of major adverse cardiac and cerebral events (MACCE) and a higher mean survival rate for those completing hybrid treatment. The study supports HCR as a safe and effective option, highlighting the need for organized PCI steps post-surgery.

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May 11, 2024
Coronary Clock

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After On-Pump Coronary Artery Bypass Surgery

A study investigating the role of the systemic immune-inflammation index (SII) in predicting outcomes for patients undergoing on-pump coronary artery bypass graft (CABG) surgery found significant correlations. High preoperative SII values were linked to prolonged surgery and cardiopulmonary bypass times, extended ICU and hospital stays, and increased risks of severe complications such as atrial fibrillation, cardiac arrest, and mortality.

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April 23, 2024
Cardiac Rehab

Comprehensive Cardiac Rehabilitation Following Acute Myocardial Infarction Improves Clinical Outcomes Regardless of Exercise Capacity

This study evaluates the impact of comprehensive cardiac rehabilitation (CR) on patients with acute myocardial infarction (AMI) and varying exercise capacities. Involving 610 patients who underwent percutaneous coronary intervention, it found that those participating in CR showed a significantly lower incidence of major adverse cardiovascular events (MACE) over an average of 6.1 years compared to non-participants. This benefit was consistent across patients with both reduced and preserved exercise capacities, highlighting CR’s essential role in AMI recovery.

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April 22, 2024
CABG Hema

Antithrombotic Drug Removal with Hemoadsorption During Off-Pump Coronary Artery Bypass Grafting

This study evaluates the efficacy of using a hemoadsorption cartridge to remove antithrombotic drugs during off-pump coronary artery bypass grafting (OPCAB). Ten patients, predominantly male and with a mean age of 67.4 years, were treated with antithrombotics like ticagrelor and rivaroxaban. Hemoadsorption was integrated into the perioperative management using either a dialysis device or a standalone apheresis pump, showing a mean treatment time of 145 minutes. Results indicated low rates of bleeding, no deaths, or further interventions during a mean follow-up of 19.5 months, demonstrating that this method is feasible and safe.

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April 18, 2024

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