Long-term Follow-up After Coronary Artery Bypass Grafting Reoperation

Shapira, Itzhak; Isakov, Aharon; Heller, Israel; Topilsky, M; Pines, Amos

doi:10.1378/chest.115.6.1593

Cited by 25 publications

(16 citation statements)

References 24 publications

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“…1 As many as 10% to 20% of patients who have had CABG surgery will need a reoperation. 2 This group of patients in particular can lack native arteries and veins that can be used as replacements. The need for vascular grafts that can be used as AV shunts is increasing.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Straining Combined with Fibrin Gel Cell Seeding Improves Strength of Tissue-Engineered Small-Diameter Vascular Grafts

Stekelenburg

Rutten

Snoeckx

et al. 2009

Tissue Engineering Part A

133

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Vascular tissue engineering represents a promising approach for the development of living small-diameter vascular grafts that can be used for replacement therapy. The culture of strong human tissue-engineered (TE) vascular grafts has required long culture times, up to several months, whether or not combined with gene therapy. This article describes the culture of strong, genetically unmodified, human TE vascular grafts in 4 weeks Small-diameter vascular grafts were engineered using a fast-degrading polyglycolic acid scaffold coated with poly-4-hydroxybutyrate combined with fibrin gel and seeded with myofibroblasts isolated from discarded saphenous veins from patients undergoing coronary bypass surgery. The TE grafts were subjected to dynamic strain conditions. After 28 d of in vitro culture, the grafts demonstrated burst pressures of 903 +/- 123 mmHg. Comparison with native vessels (intact human left internal mammary arteries (LIMAs) and saphenous veins) showed no significant differences in the amount of DNA, whereas the TE vessels contained approximately 50% of the native collagen content. In the physiological pressure range, up to 300 mmHg, the mechanical properties of the TE vessels were comparable to the LIMA. In this study, we showed that dynamic conditioning combined with fibrin gel cell seeding enhances the mechanical properties of small-diameter TE grafts. These grafts might provide a promising alternative to currently used vascular replacements.

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Section: Introductionmentioning

confidence: 99%

Dynamic Straining Combined with Fibrin Gel Cell Seeding Improves Strength of Tissue-Engineered Small-Diameter Vascular Grafts

Stekelenburg

Rutten

Snoeckx

et al. 2009

Tissue Engineering Part A

133

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show abstract

“…It has been documented that 10-year mortality rate for coronary artery bypass ranges from 15% to 30%, depending on age, sex, previous left ventricular dysfunction and graft type (Johnson et al, 1989;Yusuf et al, 1994;Cameron et al, 1996;Shapira et al, 1999). The development of intimal hyperplasia (IH) at the distal anastomosis is responsible for a significant proportion of late failure of small diameter artery bypass surgeries.…”

Section: Introductionmentioning

confidence: 99%

An S-type bypass can improve the hemodynamics in the bypassed arteries and suppress intimal hyperplasia along the host artery floor

Fan

Jiang

et al. 2008

Journal of Biomechanics

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“…Cerrahi hemşirenin bu tutumu, hastanın yeniden ameliyat olmasına engel olabilecek etkili sonuçlar oluşturacaktır. [29,30] …”

Section: Yeniden Ameliyat Olacak Hastada Risk Faktörleriunclassified

“…Laparoskopik ameliyatlar sonrası yinelenen ameliyatlarda hastaların %89'unun ameliyat sonrası memnuniyet oranının yüksek olduğu belirtilmektedir. [29] Yeniden ameliyat sonrası planlanan kaliteli ve uygun bakım hastanın memnuniyet düzeyinin ve konforunun artmasına katkı verecektir. [25,30] Son yıllarda artan teknolojik olanakların varlığı, morbidite ve mortalite oranının azalmasında önemli bir etmendir.…”

Section: Ameliyat öNcesi Hemşirelik Bakımıunclassified

Reoperation and Nursing Care

Aydιn¹,

Çilingir²

2017

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ÖZYeniden ameliyat olma (reoperasyon), ameliyata neden olan durumun tekrarlanması ya da komplikasyon nedeniyle hastanın yeniden ameliyata alınmasıdır. Ameliyat olan hastalar, ameliyat sonrası dönemde birçok sorunla karşılaşabilmektedir. Bu dönemde yaşanan sorunlar, hastayı olumsuz etkilemekte ve bazı durumlarda hastanın yeniden ameliyat edilmesi gerekmektedir. Bununla birlikte, ikinci kez ameliyat olan hastaların mortalite ve gelişebilecek komplikasyon oranları da artmaktadır. Hastanın ikinci kez ameliyat olmasına karar verilmesi sağlık çalışanı yönünden oldukça güç bir durumdur. Bireysel etmenler göz önünde bulundurularak kar-zarar ilişkisinin gözden geçirilmesi karar vermede etkili olmaktadır. Yeniden ameliyat olma riski taşıyan hastaların bulunduğu kliniklerde çalışan cerrahi hemşiresinin, uygulanacak girişimleri erken tespit edilebilmesi için klinik deneyim kazanmış olması gerekmektedir. Bu nedenle, cerrahi hemşiresi hastanın ameliyat öncesi dönemde öyküsünü doğru sorgulamalı, bireysel etmenleri değerlendirmeli, etkili hemşirelik bakımı uygulayarak yaşanan sorunların azaltılmasında ve komplikasyon yönetiminde etkin olmalıdır. Ayrıca ikinci kez ameliyat olan bireyin ameliyat sonrası taburculuğunun planlanmasında, cerrahi hemşiresinin riskleri bilmesi ve önlem alınacak durumları bireye iletmesi kaliteli iyileşmenin gerçekleşmesine katkı sağlayacaktır.Anahtar kelimeler: Hasta bakımı; perioperatif hemşirelik; reoperasyon. ABSTRACTReoperation refers to a patient re-undertaking an operation due to the reoccurrence of the condition or to correct the complications of a previous operation. Patients who have an operation may face many problems during the post-surgery period. Problems seen during this period may affect patients negatively and require reoperation in some cases. However, the rate of mortality and possible complications increases among those having an operation for the second time. It is a very difficult situation for the healthcare worker to make the decision for a second operation. In addition to individual factors, reviewing profit and loss balance may be influential upon this decision. It is necessary that surgical nurses working at clinics where patients with reoperation risk stay should have clinical experience so that they can determine the interventions early. Therefore, surgical nurses should thoroughly ask patients about history in pre-surgery period, assess individual factors, and be effective in reducing problems and in complication management by administering effective nursing care. This will contribute to the successful planning of post-operation discharge of the patients. Surgical nurses must know the risks and communicate which measures are to be taken in order to achieve a high-quality recovery.

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Long-term Follow-up After Coronary Artery Bypass Grafting Reoperation

Cited by 25 publications

References 24 publications

Dynamic Straining Combined with Fibrin Gel Cell Seeding Improves Strength of Tissue-Engineered Small-Diameter Vascular Grafts

Dynamic Straining Combined with Fibrin Gel Cell Seeding Improves Strength of Tissue-Engineered Small-Diameter Vascular Grafts

An S-type bypass can improve the hemodynamics in the bypassed arteries and suppress intimal hyperplasia along the host artery floor

Reoperation and Nursing Care

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