European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Mar 2015
Randomized Controlled TrialInfluence of intraoperative cerebral oximetry monitoring on neurocognitive function after coronary artery bypass surgery: a randomized, prospective study.
Postoperative cognitive decline is common after cardiac surgery, but it is often unrecognized at the time of hospital discharge. However, it has a great impact on patient's quality of life. Cerebral oximetry with the INVOS (IN Vivo Optical Spectroscopy) system provides the possibility of non-invasive, continuous measurement of regional cerebral oxygen saturation (rSO2), which can improve patients' outcome. The aim of this study was to examine whether cerebral oximetry can decrease the incidence of cognitive decline after coronary artery bypass grafting. ⋯ Postoperative cognitive outcome was significantly better in patients with intraoperative cerebral oximetry monitoring. Prolonged rSO2 desaturation is a predictor of cognitive decline and has to be avoided.
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Eur J Cardiothorac Surg · Mar 2015
Randomized Controlled TrialSignificant reduction in ventilator-associated pneumonia with the Venner-PneuX System in high-risk patients undergoing cardiac surgery: the Low Ventilator-Associated-Pneumonia study.
This study assessed whether the Venner-PneuX endotracheal tube (ET) system, which has sub-glottic suction as well as irrigation ports and continuous cuff-pressure monitoring, is associated with a reduction in ventilator-associated pneumonia (VAP) when compared with the standard ET in high-risk patients undergoing cardiac surgery. ⋯ The Venner-PneuX VAP prevention system is associated with a significant reduction in VAP. This can potentially lead to significant cost reductions and should be implemented as part of the VAP reduction bundle.
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Eur J Cardiothorac Surg · Mar 2015
Randomized Controlled TrialComparison between off-pump and on-pump coronary artery bypass grafting in patients with severe lesions at the circumflex artery territory: 5-year follow-up of the MASS III trial.
The technical difficulty in the revascularization of the circumflex artery territory with off-pump surgery may compromise the outcome of this method in clinical follow-up. We aimed to evaluate cardiac events in patients with stable coronary artery disease and severe obstruction of the circumflex system, undergoing coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass. ⋯ ISRCTN59539154 (http://www.controlled-trials.com).
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Eur J Cardiothorac Surg · Nov 2014
Randomized Controlled TrialSimultaneous hybrid carotid stenting and coronary bypass surgery versus concomitant open carotid and coronary bypass surgery: a pilot, feasibility study.
Concomitant carotid and cardiac surgery carries an increased perioperative morbidity and mortality risk. Whether the hybrid procedure of carotid artery stenting (CAS) and coronary bypass surgery decreases the risk of stroke and other complications is still unknown. The aim of this study was to assess early outcomes after simultaneous hybrid CAS and coronary bypass grafting versus open concomitant carotid and coronary bypass surgery. ⋯ Although limited by a small sample size, our results show that the hybrid procedure of carotid stenting and coronary surgery might be a good therapeutic option but further extended studies are needed to assess its real value.
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Eur J Cardiothorac Surg · Oct 2014
Randomized Controlled TrialCoronary artery bypass grafting-related bleeding complications in real-life acute coronary syndrome patients treated with clopidogrel or ticagrelor.
Ticagrelor reduces thrombotic events compared with clopidogrel in patients with acute coronary syndrome, but may also increase bleeding complications. Coronary artery bypass grafting (CABG)-related bleeding complications have not previously been compared in clopidogrel and ticagrelor-treated patients outside the controlled environment of clinical trials. ⋯ There was no difference in major bleeding complications overall or when ticagrelor or clopidogrel was used in accordance with guidelines. In patients on dual antiplatelet medication up to 1 day before surgery, there tended to be more bleeding complications in ticagrelor-treated patients.