Background: With increasing incidence of coronary artery disease (CAD) in Saudi Arabia and its fatal co-morbidity, this has resulted in a more complex pool of cases referred to cardiac surgeons. In selected cases, ach...Background: With increasing incidence of coronary artery disease (CAD) in Saudi Arabia and its fatal co-morbidity, this has resulted in a more complex pool of cases referred to cardiac surgeons. In selected cases, achieving optimal revascularization of diffuse CAD necessitates adjunctive techniques such as coronary endarterectomy (CE). The aim of our study is to evaluate the early mortality and post-operative morbidity related to CE. Method: Retrospective study from Jan 2009 to Dec 2010. Inclusion of 186 patients: 38 patients had CABG with CE and 148 patients had CABG alone. Results: Pre-operative percutaneous coronary intervention (PCI) was higher in the CE with CABG group (25.8%) compared with CABG alone (8.9%) (p = 0.009). Intra-operative data showed a higher mean cardiopulmonary bypass time (CBT) of 160 minutes and a mean cross-clamp time (XCT) of 109 minutes in the CE with CABG, compared to a mean CBT of 129 minutes and a mean XCT of 87 minutes in the CABG alone group (p = 0.001). The most common vessel endarterectomized was left anterior descending artery (LAD) (47%) followed by right coronary artery (RCA) (22%). Post-operatively, the mortality amongst the CE with CABG group (7.9%) was higher than CABG only group (1.4%), however it wasn’t statistically significant (p = 0.06). With regards to morbidity, hemodynamic instability requiring intra aortic balloon pump (HIR-IABP) was higher in the CE with CABG group (10.5%) compared to the CABG only group (1.4%) (p = 0.018). Conclusion: Our study showed that CE when combined with CABG wasn’t associated with a higher mortality rate when compared with CABG alone.展开更多
Objective: The purpose of this study was to evaluate the true incidence and the risk factors associated with carotid disease in the sitting of high risk patients undergoing coronary artery bypass graft (CABG) using ca...Objective: The purpose of this study was to evaluate the true incidence and the risk factors associated with carotid disease in the sitting of high risk patients undergoing coronary artery bypass graft (CABG) using carotid duplex scan and to find out if routine preoperative carotid duplex scan is needed among all these patients. Methods: This retrospective study included 402 consecutive patients who underwent bilateral carotid duplex scan admitted for CABG during the period from January 2006 to December 2008. We excluded patients in cardiogenic shock who were taken to operating room emergently. Results: The prevalence of associated risk factors showed diabetes mellitus recorded the highest (93.3%) whereas peripheral vascular disease the lowest (1.7%), hypertension (89.3%), dyslipidemia (72.6%), smoker (21.1%), left main disease (4.7%), and previous stroke (3%). Patients undergoing CABG has high incidence of carotid disease (68.7%) and severe stenosis is more in patients aged 60 and above (13.5%) versus (2.3%) in age 60, previous stroke and left main disease). Conclusion: This study showed that carotid screening is recommended for all patients who are undergoing CABG due to high incidence of carotid disease.展开更多
文摘Background: With increasing incidence of coronary artery disease (CAD) in Saudi Arabia and its fatal co-morbidity, this has resulted in a more complex pool of cases referred to cardiac surgeons. In selected cases, achieving optimal revascularization of diffuse CAD necessitates adjunctive techniques such as coronary endarterectomy (CE). The aim of our study is to evaluate the early mortality and post-operative morbidity related to CE. Method: Retrospective study from Jan 2009 to Dec 2010. Inclusion of 186 patients: 38 patients had CABG with CE and 148 patients had CABG alone. Results: Pre-operative percutaneous coronary intervention (PCI) was higher in the CE with CABG group (25.8%) compared with CABG alone (8.9%) (p = 0.009). Intra-operative data showed a higher mean cardiopulmonary bypass time (CBT) of 160 minutes and a mean cross-clamp time (XCT) of 109 minutes in the CE with CABG, compared to a mean CBT of 129 minutes and a mean XCT of 87 minutes in the CABG alone group (p = 0.001). The most common vessel endarterectomized was left anterior descending artery (LAD) (47%) followed by right coronary artery (RCA) (22%). Post-operatively, the mortality amongst the CE with CABG group (7.9%) was higher than CABG only group (1.4%), however it wasn’t statistically significant (p = 0.06). With regards to morbidity, hemodynamic instability requiring intra aortic balloon pump (HIR-IABP) was higher in the CE with CABG group (10.5%) compared to the CABG only group (1.4%) (p = 0.018). Conclusion: Our study showed that CE when combined with CABG wasn’t associated with a higher mortality rate when compared with CABG alone.
文摘Objective: The purpose of this study was to evaluate the true incidence and the risk factors associated with carotid disease in the sitting of high risk patients undergoing coronary artery bypass graft (CABG) using carotid duplex scan and to find out if routine preoperative carotid duplex scan is needed among all these patients. Methods: This retrospective study included 402 consecutive patients who underwent bilateral carotid duplex scan admitted for CABG during the period from January 2006 to December 2008. We excluded patients in cardiogenic shock who were taken to operating room emergently. Results: The prevalence of associated risk factors showed diabetes mellitus recorded the highest (93.3%) whereas peripheral vascular disease the lowest (1.7%), hypertension (89.3%), dyslipidemia (72.6%), smoker (21.1%), left main disease (4.7%), and previous stroke (3%). Patients undergoing CABG has high incidence of carotid disease (68.7%) and severe stenosis is more in patients aged 60 and above (13.5%) versus (2.3%) in age 60, previous stroke and left main disease). Conclusion: This study showed that carotid screening is recommended for all patients who are undergoing CABG due to high incidence of carotid disease.
