Carotid artery stenosis in asymptomatic patients undergoing coronary artery bypass grafting: who and when should be screened?

Özyalçın, Sertan; Diken, Adem İlkay; Yalçınkaya, Adnan; Türkmen, Ufuk

doi:10.33963/kp.15649

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…The reason for this may be the cost. However, since the coexistence of the two pathologies will increase mortality and morbidity, hence, many centers perform carotid artery screening before CABG (23). CAS was detected in a total of 17 (29%) patients with this screening, which was also performed in our clinic.…”

Section: Discussionmentioning

confidence: 90%

Can near infrared spectroscopy predict stroke in coronary artery by-pass graft?

KETENCİLER

Gemalmaz

Gültekin

2022

Anatolian Current Medical Journal

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Aim: Central nervous system may be affected after coronary artery by-pass graft (CABG) and carotid artery stenosis is an important risk factor. Near infrared spectroscopy (NIRS) is used to measure the regional cerebral oxygen concentration (rScO2). The aim of this study is to determine the relationship of rScO2 in patients with carotid artery lesion and to determine the relation of stroke with rScO2 changes. Material and Method: The patients who had cardiac bypass surgery were involved in the study. Demographic characteristics and presence of carotid artery stenosis, were collected from the files. Bilateral rSO2 measurements performed by 2 sensors. RScO2 values are detected in 5 minutes of cross-clamp (XCL5), XCL30, XCL60, XCL90, XCL120 and after the by-pass. Results: 57 patients were involved in the study (40 male and mean age 62.54±13.08). 17 (29%) patients had carotid stenosis. rScO2 levels are statistically significantly decreased in the patients with stenosis after post-clamp 30 minutes. Three patients had stroke after surgery (5.2%). Two of the patients had carotid stenosis while one patient did not have. Conclusion: RScO2 decreased in carotid artery stenosis irrespective of the degree of the stenosis after 30 minutes of cross-clamp. Cerebral perfusion follow-up is important during the CPB and NIRS is a method that can be used for this purpose.

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Section: Discussionmentioning

confidence: 90%

Can near infrared spectroscopy predict stroke in coronary artery by-pass graft?

KETENCİLER

Gemalmaz

Gültekin

2022

Anatolian Current Medical Journal

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“…Nearly 686000 CABG operations are performed annually in the United States and more than 40000 in Iran [4]. The majority of patients undergoing CABG are middleaged or old [5]. The CABG surgery can cause short-term complications that increase the risk of falls during hospitalization [6,7].…”

Section: Introductionmentioning

confidence: 99%

Risk of Falling after Coronary Artery Bypass Grafting Surgery And its Related Factors

Rajabi

Paryad

Khanghah

et al. 2022

J Holist Nurs Midwifery

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Introduction: A fall is a sudden descent on the ground or other lower levels. It is a serious safety threat for hospitalized patients. Coronary artery bypass graft (CABG) surgery as an open heart surgery has complications such as cardiac arrhythmias and delirium that can increase the risk of fall. Objective: This study aims to determine the risk of falls in patients after CABG surgery and investigate its associated factors. Matetials and Methods: This cross-sectional study was conducted on 302 patients undergoing CABG surgery in a specialized hospital in Rasht City, Iran, from November 2019 to July 2020. They were selected by a sequential sampling method. The data collection instrument included demographic information, disease-related factors, surgery-related factors (before, during, after), and the Morse fall scale (MFS) checklist. The study data were collected after the patient's surgery and transfer from the intensive care unit to the surgical ward. Descriptive statistics, as well as the Kolmogorov Smirnov, Wilcoxon, Mann-Whitney U, Kruskal-Wallis, and Spearman correlation, were used to analyze the collected data. A rank regression model was used to determine the factors related to the risk of falls in patients. Results: The mean ±SD age of participants was 59.35 ±8.37 years. About 70.53% of the patients were male, and 46.03% were overweight (Body Mass Index ranged 25-29.9 kg/m2). The majority of patients at the time of admission to the surgical ward and before surgery (92.72%) had no risk of falls. After surgery and transfer to the surgical ward, 82.12% had a low risk of falls. The mean risk of falling was higher in patients over 60 years (P <0.05). With decreasing hemoglobin values on the morning of surgery, the risk of postoperative fall increased (P = 0.046, r = -0.115). The sodium level on the morning of surgery had a significant negative correlation (P = 0.040, r = -0.118) with the risk of falling, but urea level on the morning of surgery had a significant positive correlation (P = 0.001, r = 0.212) with the risk of falling. Using regression model, the results showed that with increasing age (B = 0.23, 95%CI; 0.07-0.39, P = 0.003), history of high blood pressure (B= 3.5, 95%CI: -0.69-0.39, P = 0.003), decrease in hemoglobin (B = -5.47, 95%CI; -10.2- -0.6, P = 0.02), an increase in creatinine (B = 17.73, 95%CI; 8.17-27.29, P = 0.001) and urea (B = 6.09, 95%CI; 2.57-9.61, P = 0.001) before the surgery, the risk of fall after CABG surgery increases. Conclusion: Several factors can increase the risk of falls after CABG surgery. Considering that the risk of falls in patients undergoing CABG surgery in most medical centers is examined only at the beginning of admission, it is recommended to consider the possibility of postoperative falls based on the predicting variables.

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