Objective: Corticosteroids decrease side effects after noncardiac elective surgery. A randomized, double blinded, placebo-controlled study was plan to test the hypothesis that standard doses of dexamethasone (6X2) would decrease the incidence of atrial fibrillation (AF) following cardiac surgery.Methods: A total of 185 patients undergoing coronary revascularization surgery were enrolled in this clinical study. The anesthetic management was standardized in all patients. Dexamethasone (6 mg/ml) or saline (1 ml) was administered after the induction of anesthesia and a second dose of the same study drug was given on the morning after surgery. The incidence of AF was determined by analyzing the first 72 hours of continuously recorded electrocardiogram records after cardiac surgery, to determine the incidence and severity of postoperative side effects.Results: 19Abbaszadeh M, et al. -Perioperative intravenous corticosteroids reduce incidence of atrial fibrillation following cardiac surgery: a randomized study Bras Cir Cardiovasc 2012;27(1):18-23 Rev

Objective: Although the overall complication rate has been decreased significantly in recent years, stroke is a severe complication after coronary bypass operations. The purpose of this study is to evaluate the influence of carotid artery disease on the results of patients under CABG operation.Methods: In a retrospective cohort study, 1,978 patients under CABG operation were studied in Shariati Hospital between April 2002 and March 2006. The patients who had only valve replacement or non-CABG procedure were excluded from this study. As part of preoperative evaluation, carotid duplex ultrasonography scans were performed. In order to estimate the degree of carotid arteries stenosis, ultrasound imaging measurement and velocity criteria were considered. The patients were classified into three groups: those with no significant stenosis of the internal carotid artery (ICA) (moderate) group A, those with significant stenosis (sever) group B and those with the occluded ICA (critical) group C. Finally, all data were analyzed by SPSS software. Statistical analyses were performed using the following testes; chisquare, Fisher exact and Student's t tests.Results: The distribution of the 1,978 patients undergoing CABG operation were as follows: group A = 1,938, group B = 30, and group C = 10. The results of the evaluations show that perioperative stroke rates were 1.2% (24 patients) in group A, 0.4% (eight patients) in group B and 0.3% (six patients) in group C (P<0.0001). Furthermore, perioperative mortality rates for groups A, B and C were 0.1% (two patients), 0.3% (five patients) and 0.4% (seven patients), respectively (P<0.0001).Conclusion: The stroke and mortality in patients undergoing CABG are increased when ICA occlusion is present. Rev Bras Cir Cardiovasc 2011;26(2):258-63 Descriptors

Fatores de risco que afetam as complicações da dissecação da veia safena na revascularização cirúrgica do miocárdioThe risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery Abstract Objective: Problem of wound healing is commonly observed after coronary artery bypass graft procedures. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complication after coronary revascularization procedures.Methods: After institutional ethical committee review and approval, a retrospective review was undertaken of 4029 bypass procedures with saphenous vein graft performed over a period of six years is conducted. Thirteen risk factors for those who developed major leg wound complications were analyzed and compared with the entire cohort of patients, undergoing similar bypass procedures during the same period.Results: Lower extremity wound complications occurred in 68 patients (1.7%), 43 of them required additional surgical interventions. There were 17 wound debridements, nine skin grafts, one angioplasty, 11 fasciotomies, three vascular procedures, and two free tissue transfers. Of 13 variables evaluated by multivariate analysis, female gender, BMI, use of internal thoracic artery graft, peripheral vascular disease, the use of postoperative intraaortic balloon pump and preexisting hyperlipidemia were identified as significant independent predictors of major leg wound complications (p<0.05).Conclusions: Rev Bras Cir Cardiovasc 2008; 23(3): 317-322