28SÁ, MPBO ET AL -Risk factors for mediastinitis after coronary artery bypass grafting surgery Bras Cir Cardiovasc 2011; 26.1: 27-35 Rev

Fatores de risco para síndrome de baixo débito cardíaco após cirurgia de revascularização miocárdicaRisk factors for low cardiac output syndrome after coronary artery bypass grafting surgery Abstract Objectives: Low cardiac output syndrome (LCOS) is a serious complication after cardiac surgery and is associated with significant morbidity and mortality. The aim of this study is to identify risk factors for LCOS in patients undergoing coronary artery bypass grafting (CABG) in the Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco -PROCAPE (Recife, PE, Brazil).Methods: A historical prospective study comprising 605 consecutive patients operated between May 2007 and December 2010. We evaluated 12 preoperative and 7 intraoperative variables. We applied univariate and multivariate logistic regression analysis.Results: The incidence of LCOS was 14.7% (n = 89), with a lethality rate of 52.8% (n = 47). In multivariate analysis by logistic regression, four variables remained as independent risk factors: age ≥ 60 years (OR 2.00, 95% CI 1.20 to 6.14, P = 0.009), on-pump CABG (OR 2.16, 95% CI 1.40 to 7.08, P = 0.006), emergency surgery (OR 4.71, 95% CI 1.34 to 26.55, P = 0.028), incomplete revascularization (OR 2.62, 95% CI 1.32 to 5.86, P = 0.003), and ejection fraction <50%.Conclusions: This study identified the following independent risk factors for LCOS after CABG: age ≥ 60 years of off-pump CABG, emergency surgery, incomplete CABG and ejection fraction <50%. Rev Bras Cir Cardiovasc 2012;27(2):217-23

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Background: Mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. Diabetes is a feared risk factor for mediastinitis and viewed with caution by cardiovascular surgeons.Objective SÁ, MPBO ET AL -Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patientsRev Bras Cir Cardiovasc 2011;26(2):183-9

CABG+MVR can be performed safely in patients with moderate-to-severe IMR. CABG+MVR resulted in lower rates of complications than CABG only. Both surgical approaches resulted in significant improvement of postoperative LVEF. However, there was greater improvement in the CABG+MVR group.