Changes in activated partial thromboplastin time and international normalised ratio after on-pump and off-pump surgical revascularization of the heart

Čeke, Lejla Selimović; Imamović, Semir; Ljuca, Farid; Jerkić, Z; Imamović, Goran; Hadžimešić, Munevera; Pojskić, Aida; Kovčić, Jasmina

doi:10.17305/bjbms.2014.2266

Cited by 6 publications

(2 citation statements)

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“…The leading cause of death worldwide, especially in developed countries, is coronary artery disease (CAD) [1][2][3][4]. The etiology of CAD is atherosclerosis, which obstructs coronary arteries that supply oxygen and nutrition to the heart muscle [5].…”

Section: Introductionmentioning

confidence: 99%

Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery

Milutinović

Zorc-Pleskovič

2020

Bosn J of Basic Med Sci

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The patency of the vein graft in coronary artery bypass grafting could be dependent on the conventional open (vsO) or endoscopic (vsE) harvesting and on the hypoxic damage of endothelial cells. We aimed to evaluate both surgical techniques according to endothelial loss that occurs in the time between harvesting and implantation. Twenty-six saphenous veins were divided into vsO (n = 16) and vsE (n = 10) group. Three samples were taken from each vein. The first sample was taken after removal, the second before implantation of the distal part, and the third before the implantation of the proximal part, and they were stained with HE, Movat, and immunohistochemically with CD31. A significant loss of endothelial cells within both groups was found at the time of implantation of the distal and the proximal part of the vein graft compared to the endothelial cells at the time of harvesting. There were no significant differences in the endothelial loss between vsE and vsO groups at the time of harvesting and at the time before the implantation of the distal part. A higher number of endothelial cells was found in vsE group compared to vsO group at the time just before the implantation of the proximal part. The comparison of the implanted portions of vsE and vsO grafts to mammary arteries revealed a significant loss of endothelial cells only in vsO graft. We conclude that, at the time of implantation, the endothelial layer of the vein graft harvested endoscopically is more preserved than of the vein graft harvested openly.

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Section: Introductionmentioning

confidence: 99%

Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery

Milutinović

Zorc-Pleskovič

2020

Bosn J of Basic Med Sci

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“…Coronary artery disease (CAD) is characterized by inflammation within the atherosclerotic coronary vessel wall [1][2][3]. For decades, the tunica intima and, partly, the tunica media were the focus of research, and perivascular adipose tissue (PVAT) that surrounds coronary arteries (CAs) was considered to be passive and only supportive tissue.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory cells in perivascular adipose tissue and the integrity of the tunica media in atherosclerotic coronary arteries

Zorc-Pleskovič

Zorc²,

Šuput

et al. 2019

Bosn J of Basic Med Sci

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Obstructive coronary artery disease (CAD) is characterized by inflammation within the atherosclerotic coronary arteries. Infiltration of inflammatory cells into muscular media can lead to remodeling and weakening of the arterial wall. We examined the relationship between inflammatory infiltration in perivascular adipose tissue (PVAT), state of the external elastic membrane, and the intensity of inflammatory infiltration in the tunica media of coronary arteries obtained by endarterectomy from symptomatic patients with diffuse CAD. We analyzed endarterectomy sequesters from 22 coronary arteries that contained the intima, media, a part of the adventitia, and PVAT in at least one part of the sequester. The coronary arteries were divided into two groups according to the presence or absence of inflammatory infiltration in PVAT. Staining with hematoxylin-eosin and by the Movat's method showed atherosclerotic changes in the intima and media. Immunohistochemistry (anti-leukocyte common antigen [LCA] antibody) was used for the detection of leukocytes. We found a significant positive correlation between inflammatory infiltration in PVAT and preservation of the external elastic membrane of coronary arteries. Furthermore, we found a significant negative correlation between inflammatory infiltration in PVAT and the intensity of inflammatory infiltration in the media. It seems that the integrity of the external elastic membrane and the proinflammatory properties of PVAT restrain inflammatory cells within PVAT. Both effects may prevent the migration of inflammatory cells into the media and delay the development of CAD.

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Use of Idarucizumab to reverse the anticoagulant effect of dabigatran in cardiac transplant surgery. A multicentric experience in Spain

Crespo-Leiro

López‐Vilella

Granados

et al. 2019

Clinical Transplantation

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BackgroundAnticoagulation in heart transplant (HT) recipients increases the risk of hemorrhagic complications, so correct reversal of anticoagulation is needed. Dabigatran, a direct thrombin inhibitor, is increasingly used for anticoagulation in patients with non‐valvular atrial fibrillation (NVAF) whose effect can be reversed by idarucizumab.AimTo present a nationwide experience using idarucizumab for the urgent reversal of dabigatran before HT.MethodsMulticenter observational study in 12 Spanish centers to analyze the clinical outcomes after using idarucizumab before HT surgery.ResultsFifty‐three patients were included (81.1% male). 7.5% required re‐operation in the immediate postoperative period to control bleeding and 66% transfusion of blood products. Median length of stay in the intensive care unit was 6 days and total hospital stay 24 days. 30‐day survival was 92.4%. There were four deaths in the first month, all in the first 5 days post‐HT. Only in one patient (transplanted due to a congenital heart disease, after sternotomy) who had surgical problems and right ventricular failure post‐HT death was associated with bleeding.ConclusionsThese results may support the use of dabigatran as an alternative to vitamin K antagonists in patients listed for HT requiring anticoagulation due to NVAF. More studies are needed to reaffirm these observations.

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Changes in activated partial thromboplastin time and international normalised ratio after on-pump and off-pump surgical revascularization of the heart

Cited by 6 publications

References 0 publications

Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery

Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery

Inflammatory cells in perivascular adipose tissue and the integrity of the tunica media in atherosclerotic coronary arteries

Use of Idarucizumab to reverse the anticoagulant effect of dabigatran in cardiac transplant surgery. A multicentric experience in Spain

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