Background: The association of right coronary artery (RCA) stenosis in patients undergoing myocardial revascularization for left main coronary artery (LMCA) stenosis affects the prognosis. This study aimed to compare ...Background: The association of right coronary artery (RCA) stenosis in patients undergoing myocardial revascularization for left main coronary artery (LMCA) stenosis affects the prognosis. This study aimed to compare immediate results of patients with isolated LMCA stenosis and those with combined RCA stenosis. Patients and methods: We retrospectively evaluated 107 consecutive patients with LMCA disease who underwent coronary artery bypass grafts. The patients were divided into two groups: isolated LMCA stenosis (n = 36) and LMCA stenosis + RCA stenosis (n = 71). Different variables (preoperative, intra operative and post operative) were compared. Results: Patients with LMCA stenosis + RCA stenosis experienced higher prevalence of diabetes mellitus (p = 0.024) and smoker (p = 0.032). Also left ventricular EF was reduced (p = 0.004). Myocardial revascularization was more complete in patients with LMCA stenosis + RCA stenosis (p = 0.033), but in-hospital mortality rate was higher (12.6% vs 5.5%) in isolated LLMCA stenosis, but it did not reach statistical significance (p = 0.32). Except low output syndrome (LOS) that was frequent in presence of RCA stenosis (p = 0.026), no significant difference was found between groups for other complications. Conclusion: The presence of RCA stenosis in patients undergoing CABG for LMCA disease increases 30 day mortality but without significant impact on overall morbidities.展开更多
Redo cardiac surgery increases?mortality and morbidity. The aim of this study was to determine if aprotinin was superior to tranexamic acid concerning control bleeding loss after redo valve surgery. A retrospective st...Redo cardiac surgery increases?mortality and morbidity. The aim of this study was to determine if aprotinin was superior to tranexamic acid concerning control bleeding loss after redo valve surgery. A retrospective study was conducted from January 1994 until December 2014. 221 patients underwent redo cardiac valve surgery and separated into two groups: aprotinin group (n?=?85) and tranexamic acid group (n?=?136). Univariate tests were applied for data analysis. A total of 221 patients were enrolled in this study. This cohort was separated into two groups: aprotinin group (n?=?85) and tranexamic acid group (n?=?136). Euroscore in tranexamic acid group was higher: 5.96 ± 3.04 vs.?5.17 ± 2.83 in aprotinin group?(p?=?0.055). There was no statistical difference in postoperative mortality between the two groups (p?= 0.153). No statistical differences were reported concerning: total blood loss (p?= 0.51), red blood cells transfusion (p?= 0.215), reexploration for bleeding (p?= 0.537) and postoperative renal failure (p?= 0.79). There were statistical differences concerning mechanical ventilation time, which is longer in tranexamic acid group (p?= 0.008) and the use of inotropic drug support, which is more frequent in the tranexamic acid group (p?= 0.001). Our results demonstrated that tranexamic acid and aprotinin reduce transfusion requirement and blood loss. Due to financial reason, we chose tranexamic acid in preventing blood loss in redo valve surgery.展开更多
文摘Background: The association of right coronary artery (RCA) stenosis in patients undergoing myocardial revascularization for left main coronary artery (LMCA) stenosis affects the prognosis. This study aimed to compare immediate results of patients with isolated LMCA stenosis and those with combined RCA stenosis. Patients and methods: We retrospectively evaluated 107 consecutive patients with LMCA disease who underwent coronary artery bypass grafts. The patients were divided into two groups: isolated LMCA stenosis (n = 36) and LMCA stenosis + RCA stenosis (n = 71). Different variables (preoperative, intra operative and post operative) were compared. Results: Patients with LMCA stenosis + RCA stenosis experienced higher prevalence of diabetes mellitus (p = 0.024) and smoker (p = 0.032). Also left ventricular EF was reduced (p = 0.004). Myocardial revascularization was more complete in patients with LMCA stenosis + RCA stenosis (p = 0.033), but in-hospital mortality rate was higher (12.6% vs 5.5%) in isolated LLMCA stenosis, but it did not reach statistical significance (p = 0.32). Except low output syndrome (LOS) that was frequent in presence of RCA stenosis (p = 0.026), no significant difference was found between groups for other complications. Conclusion: The presence of RCA stenosis in patients undergoing CABG for LMCA disease increases 30 day mortality but without significant impact on overall morbidities.
文摘Redo cardiac surgery increases?mortality and morbidity. The aim of this study was to determine if aprotinin was superior to tranexamic acid concerning control bleeding loss after redo valve surgery. A retrospective study was conducted from January 1994 until December 2014. 221 patients underwent redo cardiac valve surgery and separated into two groups: aprotinin group (n?=?85) and tranexamic acid group (n?=?136). Univariate tests were applied for data analysis. A total of 221 patients were enrolled in this study. This cohort was separated into two groups: aprotinin group (n?=?85) and tranexamic acid group (n?=?136). Euroscore in tranexamic acid group was higher: 5.96 ± 3.04 vs.?5.17 ± 2.83 in aprotinin group?(p?=?0.055). There was no statistical difference in postoperative mortality between the two groups (p?= 0.153). No statistical differences were reported concerning: total blood loss (p?= 0.51), red blood cells transfusion (p?= 0.215), reexploration for bleeding (p?= 0.537) and postoperative renal failure (p?= 0.79). There were statistical differences concerning mechanical ventilation time, which is longer in tranexamic acid group (p?= 0.008) and the use of inotropic drug support, which is more frequent in the tranexamic acid group (p?= 0.001). Our results demonstrated that tranexamic acid and aprotinin reduce transfusion requirement and blood loss. Due to financial reason, we chose tranexamic acid in preventing blood loss in redo valve surgery.
