Introduction
Classic coronary artery bypass grafting (CABG) surgery involves diastolic
cardiac arrest under cardiopulmonary bypass, while off-pump CABG (OPCABG)
has become widespread in recent years.
Methods
174 patients who underwent OPCABG were included in the study. Patients were
divided into two groups. Group I (n=90) received ivabradine and Group M
(n=84) received metoprolol before surgery until postoperative day 10.
Intraoperative arrhythmias and hypotension were recorded. Postoperative
atrial fibrillation (AF) and arrhythmia, mortality and morbidity rates were
assessed based on the 30-day postoperative follow-up.
Results
There were no significant differences in the intraoperative amount of
inotropic support and red blood cell transfusion between groups (P=0.87 and
P=0.31). However, the rates of intraoperative arrhythmias and hypotension
were not significantly higher in Group M (P=0.317 and P=0.47). Ventricular
tachycardia/ventricular fibrillation (VT/VF) was observed in 2 patients in
both groups. Postoperative AF occurred in 7 patients (7.7%) in Group I and
in 10 patients (11.9%) in Group M. Although there was a trend towards a
higher prevalence of AF in Group M patients, this did not reach statistical
significance. In addition, mortality and morbidity rates were comparable
between groups.
Objective: The incidence of atrial fibrillation (AF) in patients with ST segment elevation myocardial infarction (STEMI) varies between 7% and 21%, and most of these studies were in the thrombolytic era. However, the frequency of new-onset AF during the primary percutaneous coronary intervention (PCI) period is still unclear. We aimed to investigate the frequency of new-onset AF and its effects on long-term clinical events in patients undergoing primary PCI. Methods: A total of 1,603 patients who were diagnosed with STEMI and underwent primary PCI were included in the study. All the patients were monitored for at least 48 hours after the procedure. The primary endpoint of the study was defined as new-onset AF during hospitalization. Results: The median follow-up period of our study was 44 months. New-onset AF developed in 85 (6.1%) patients. CHADs-VASc > 2, KILLIP > 2, and left atrial diameter were found to be independent predictors for the development of new-onset AF. In the AF (+) group, the all-cause and in-hospital mortality rates were found to be significantly higher. New-onset AF development in patients with STEMI was detected as an independent predictor of in-hospital mortality.
Conclusion:In the era of primary percutaneous transluminal coronary angioplasty, new-onset AF rates were found to be lower than the literature data. In addition, new-onset AF was found to be a predictor of in-hospital mortality, and deaths occurred mostly in the early period. Therefore, close follow-up of these patients in the early period and re-evaluation in terms of AF burden when the patient becomes stable are important.
Early colonization of A. actinomycetemcomitans in oral cavities could be assessed as a risk marker for periodontal disease. Periodontal pathogens may enter bloodstream through bacteremia; thus, the presence of periodontal pathogens in the oral cavity of children should be assessed as a risk marker for cardiac diseases in older ages.
BackgroundWe aimed at assessing the efficacy of the patch plasty technique without endarterectomy in patients with diffuse coronary artery. Long anastomosis of the left internal mammary artery graft (LIMA) to the left anterior descending (LAD) artery was performed and examined using transthoracic Doppler echocardiography to detect coronary flow reserve (CFR) and epicardial stenosis.MethodsForty-one patients (6 women; mean age, 58 ± 9 years) who underwent coronary artery bypass surgery using the patch plasty technique without endarterectomy were included in the study. Presence of CFR was examined in each patient by transthoracic Doppler echocardiography.ResultsOne of the patients (2.4%) died on the first postoperative day. The remaining patients were divided into 2 groups: those with normal CFR (CFR ≥ 2) (n = 35, 88%) and those with low CFR (CFR < 2) (n = 5, 12.0%). The length of patch plasty (3.6 ± 0.82 cm) in the low CFR group was significantly longer than that in the normal CFR group (2.69 ± 0.75 cm). Coronary angiography was performed for the 3 patients with CFR < 2: Two patients showed normal grafts and anastomoses, but the third patient’s distal LAD-LIMA anastomosis was almost 90% occluded.ConclusionWe elucidated the reliability of the patch plasty without endarterectomy method and transthoracic Doppler echocardiography for detecting the severity of coronary artery disease.
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