Management of patients after coronary artery bypass grafting surgery: a guide for primary care practitioners

Waard, Dominique de; Fagan, Andrew; Minnaar, Christo; Horne, David

doi:10.1503/cmaj.191108

Cited by 18 publications

(9 citation statements)

References 50 publications

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“…13 Another study by de Ward et al noted a lack of primary care follow-up at 30 days after a CABG procedure was associated with a 5-fold increased risk of poor cardiac function at one year, which may be attributed to suboptimal monitoring of complications, rehabilitation progress, or optimization of medications. 14 We did not find an increased trend in follow-up data among CABG and valve procedures, which must be considered a critical area for improvement. There was, however, a trend toward higher follow-up rates in congenital cardiac procedures with a higher RACHS-1 score.…”

Section: Discussionmentioning

confidence: 54%

Factors Associated With Lack of Long-Term Follow-Up Data After Global Cardiac Surgery Missions

Lannon,

Nuchovich,

Louis

et al. 2024

World J Pediatr Congenit Heart Surg

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Background: Humanitarian medical missions attempt to lessen the burden of limited access to cardiac surgery in low- and middle-income countries. While organizations express difficulties obtaining follow-up information, there is currently little evidence to support the various assumptions for lack of data. This study examines the factors influencing long-term patient follow-ups on repeated short-term cardiac surgery missions across nine countries. Methods: A retrospective analysis of CardioStart International's database (RedCap) was conducted to investigate demographic, socioeconomic, and surgical factors associated with follow-ups. Results: A total of 550 pediatric (50%) and adult (50%) cardiac surgery patients displayed a follow-up rate of 14.7%, with no significant difference between populations ( P = 1). Mean follow-up time was 1.5 years postoperative. Countries were highly variable, with Dominican Republic and Vietnam showing follow-up rates of 30.4% and 43.2%, respectively, while Brazil, Nepal, and Tanzania had no follow-ups ( P < 0.0001). The 11 surrogate factors for socioeconomic status, including home amenities and technology access, were predominantly insignificant, with the exception of phone access showing an unexpectedly decreased follow-up rate (11.6%, P = 0.006). Surgical intervention was a significant factor ( P = 0.009). No adult cardiac surgery trends were noted; however, congenital cases demonstrated increased follow-ups in patients with higher Risk Adjusted Congenital Heart Surgery scores, with ventricular septal defects (32.5%) exceeding atrial septal defects (7.3%). Conclusions: Follow-ups correlate with mission factors, including location and types of intervention, more so than previously assumed socioeconomic and technological factors. Thus, certain missions may require more allocation of resources and adapted organizational policies to overcome site-specific barriers to follow-up.

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Section: Discussionmentioning

confidence: 54%

Factors Associated With Lack of Long-Term Follow-Up Data After Global Cardiac Surgery Missions

Lannon,

Nuchovich,

Louis

et al. 2024

World J Pediatr Congenit Heart Surg

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“…There are many potential complications in patients receiving CABG surgery [11] Among them, gastrointestinal complications are particularly critical due to their high mortality rate [7]. Acute pancreatitis after cardiac surgery has been reported in previou literature (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…There are many potential complications in patients receiving CABG surgery [11]. Among them, gastrointestinal complications are particularly critical due to their high mortality rate [7].…”

Section: Discussionmentioning

confidence: 99%

Giant Pancreatic Pseudocyst after Coronary Artery Bypass Graft in a Hemodialysis Patient: A Case Report

Chan,

Hsieh,

et al. 2023

Clinics and Practice

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End-stage renal disease (ESRD) patients have a high prevalence of coronary artery disease, and coronary artery bypass graft (CABG) is one of the essential treatments. ESRD patients undergoing CABG surgery have an increased risk of postoperative complications, including acute pancreatitis. Here, we present the unique case of an exceptionally large pancreatic pseudocyst caused by pancreatitis in an ESRD patient after CABG surgery. A 45-year-old male with ESRD under maintenance hemodialysis received CABG surgery for significant coronary artery disease. Two weeks later, he experienced worsening abdominal pain and a palpable mass was noticed in the epigastric region. Computer tomography revealed an unusually large pseudocyst measuring 21 × 17 cm in the retroperitoneum due to necrotizing pancreatitis. The patient underwent percutaneous cystic drainage, and the symptoms were significantly improved without surgical intervention. Factors such as prolonged cardiopulmonary bypass time, postoperative hypotension, and intradialytic hypotension appeared to have contributed to the development of severe pancreatitis in this case. This report highlights the rarity of a giant pancreatic pseudocyst in an ESRD patient after CABG surgery and emphasizes the importance of vigilant postoperative care.

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“…A comprehensive cardiac rehabilitation program (CR) includes six main aspects: 1) initial patient assessment, 2) nutritional counseling and weight management, 3) ongoing management of coronary risk factors, 4) psychological management, 5) physical activity counseling, and 6) exercise training ( de Waard et al, 2021 ). In the cardiac rehabilitation clinic, exercise training programs were conducted three days a week over 8 weeks training groups performed exercise training on the treadmill (HP Cosmos, Germany) under the supervision of a physician, nurses, and the exercise physiologist.…”

Section: Methodsmentioning

confidence: 99%

Impact of high intensity interval and moderate continuous training on plasma ratios of ProBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 after coronary artery bypass grafting surgery

Karizak

Kashef²,

Gaeini³

et al. 2023

Front. Physiol.

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Background: ProBNP1-108/BNP1-32, and NT-pro-BNP1-76/BNP1-32 ratios are significant indices for predicting complications after coronary artery bypass grafting (CABG) surgery. However, the effect of aerobic training types on these biomarkers has not been fully understood. So, the current study aimed to determine the impact of aerobic interval and continuous training programs on plasma ratios of ProBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 after coronary artery bypass grafting surgery.Method: 36 patients were selected purposive (27 men and 9 women with mean of age 60.32 ± 5.81 years, height 164.64 ± 9.25 cm, weight 73.86 ± 14.23 kg, fat 32.30 ± 4.28, SBP 142.67 ± 6.49, DBP 84.5 ± 5.16 mmHg in seated position at rest situation and functional capacity of 7.08 ± 2.49 METs) and then divided randomly into three groups: control (C) group (without training program) moderate continuous training (MCT) and high intensity interval training (HIIT) (exercise training program was performed 3 days/week for 8 weeks) with intensities 65%–80% and 80%–95% of reserve heart rate in order. Blood samples were taken 48 h before the first session and 48 h after the last training session to measure the plasma levels of ProBNP1–108, corin enzyme, BNP1-32, and NT-pro-BNP1-76 using the enzyme-linked immunosorbent assay (ELISA) technique. Wilcoxin and kruskal wallis tests were used for analyzing data.Results: The plasma corin enzyme was increased, and the ratios of proBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 were reduced in both training groups in compared with control group (p = 0.004, p = 0000, p = 0.016, p = 0.003, p = 0.009, and p = 0.016) when there was no significant difference was found between training groups (p = 0.074, p = 450, and p = 0.295).Conclusion: Both high intensity interval training and moderate continuous training in compared with inactivity have positive effects on ratios of ProBNP1-108/BNP1-32, NT-pro-BNP1-76/BNP1-32 and could be effective to promote the health of coronary arteries and prevention of HF in post-CABG patients.

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Management of patients after coronary artery bypass grafting surgery: a guide for primary care practitioners

Cited by 18 publications

References 50 publications

Factors Associated With Lack of Long-Term Follow-Up Data After Global Cardiac Surgery Missions

Factors Associated With Lack of Long-Term Follow-Up Data After Global Cardiac Surgery Missions

Giant Pancreatic Pseudocyst after Coronary Artery Bypass Graft in a Hemodialysis Patient: A Case Report

Impact of high intensity interval and moderate continuous training on plasma ratios of ProBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 after coronary artery bypass grafting surgery

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