Skip to content
2000
  1. Home
  2. A-Z Publications
  3. New Emirates Medical Journal
  4. Volume 5, Issue 1
  5. Article
Volume 5, Issue 1
  • ISSN: 0250-6882
  • E-ISSN: 0250-6882
file format pdf download PDF
side by side viewer icon HTML

Abstract

Background

Cardiovascular disease (CVD) remains the leading cause of death worldwide despite the coexistence of the current COVID-19 pandemic. Current emergency management involves revascularization of the coronary arteries.

Aims

Retrospectively evaluate the association between the used number of shunts and postoperative complications.

Objectives

Several complications are reported after coronary artery bypass graft (CABG) surgery, such as postoperative arrhythmia and postoperative stroke. However, the risk factors for the development remain not elaborated.

Materials and Methods

A retrospective cohort study involved 290 patients for the period 2017-2021 treated surgically for ischemic heart disease. The surgery includes shunts of the internal thoracic arteries with the post-occlusion coronary arteries. The number of shunts is varied depending on the size and number of occluded arteries. According to the number of shunts, the patient may be operated on with artificial circulation (CPB; cardiopulmonary bypass), or without a working heart (OFF pump; without artificial circulation. For statistical analysis, T-test, one-way ANOVA test, X2 test, COX proportional hazards, and Pearson correlation test were used by using the Statistica program.

Results

The most frequently reported complication is postoperative hydrothorax, in 28 (11.20%) patients. Patients with post-CABG LV aneurysm had a longer CPB time and aortic cross-clamp time, t-value -5.58113, p < 0.000000; t-value -4.72802, p < 0.000004, respectively. Patients with postoperative hydrothorax with low BMI and longer CPB and Aortic cross-clamp time, t-value of-2.33929, p <0.020021; t-value 3.83233, P < 0.000157; t-value 2.71109, p < 0.007119, respectively. Subsequently, post-operative hydrothorax increases the intensive care unit (ICU) and total hospitalization days, t-value 5.80811, p < 0.000000; t-value 7.37431, p < 0.000000, respectively. Patients who have preoperative progressive angina have a higher number of complications, t-value of 2.108504, p < 0.035866. Post-myocardial infarction patients with myocardial sclerosis (PMIMS) have a higher number of complications, t value of 2.516784, p < 0.012396. A direct correlation between the number of complications and age/CPB time/ aortic cross-clamp time/ICU hospitalization days/total hospitalization days, r= 0.138565, 0.204061, 0.162078, 0.487048, 0.408381; respectively.

Conclusion

Postoperative complication rate associated with the pre-existence of progressive angina and PMIMS. Elderly people undergoing CABG are at higher risk of psychosis, arrhythmia, longer total and ICU hospitalization days, and stroke. Advanced age, longed CPB time, prolonged aortic cross-clamp time, long ICU hospitalisation, and long total hospitalization days are risks of more frequent post-CABG complications.

Others

The number of complications is not associated with the dead and alive status of patients or with the number of shunts.

© 2024 The Author(s). Published by Bentham Science Publisher.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Loading

Article metrics loading...

/content/journals/nemj/10.2174/0250688204666230410084313
2024-01-01
2025-06-19

  • From This Site

    /content/journals/nemj/10.2174/0250688204666230410084313
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
The full text of this item is not currently available.

References

  1. GaudinoM. BenedettoU. FremesS. Biondi-ZoccaiG. SedrakyanA. PuskasJ.D. AngeliniG.D. BuxtonB. FratiG. HareD.L. HaywardP. NassoG. MoatN. PericM. YooK.J. SpezialeG. GirardiL.N. TaggartD.P. Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery.N. Engl. J. Med.2018378222069207710.1056/NEJMoa171602629708851
     [Google Scholar]
  2. LeyviG. ForestS.J. SrinivasV.S. GreenbergM. WangN. MaisA. SnyderM.J. DeRoseJ.J.Jr Robotic coronary artery bypass grafting decreases 30-day complication rate, length of stay, and acute care facility discharge rate compared with conventional surgery.Innovations (Phila.)20149536136710.1097/imi.000000000000009525238421
     [Google Scholar]
  3. PooriaA. PouryaA. GheiniA. Postoperative complications associated with coronary artery bypass graft surgery and their therapeutic interventions.Future Cardiol.202016548149610.2217/fca‑2019‑004932495650
     [Google Scholar]
  4. PalmeriniT. SaviniC. Di EusanioM. Risks of Stroke After Coronary Artery Bypass Graft – Recent Insights and Perspectives.Interv. Cardiol.201192778310.15420/icr.2011.9.2.7729588782
     [Google Scholar]
  5. SabikJ.F.III BlackstoneE.H. GillinovA.M. SmediraN.G. LytleB.W. Occurrence and risk factors for reintervention after coronary artery bypass grafting.Circulation20061141_supplementSuppl.I454I46010.1161/CIRCULATIONAHA.105.00114916820618
     [Google Scholar]
  6. MontriefT. KoyfmanA. LongB. Coronary artery bypass graft surgery complications: A review for emergency clinicians.Am. J. Emerg. Med.201836122289229710.1016/j.ajem.2018.09.01430217621
     [Google Scholar]
  7. BrownP.P. KugelmassA.D. CohenD.J. ReynoldsM.R. CullerS.D. DeeA.D. SimonA.W. The frequency and cost of complications associated with coronary artery bypass grafting surgery: results from the United States Medicare program.Ann. Thorac. Surg.20088561980198610.1016/j.athoracsur.2008.01.05318498806
     [Google Scholar]
  8. RoachG.W. KanchugerM. ManganoC.M. NewmanM. NussmeierN. WolmanR. AggarwalA. MarschallK. GrahamS.H. LeyC. OzanneG. ManganoD.T. HerskowitzA. KatsevaV. SearsR. Adverse cerebral outcomes after coronary bypass surgery.N. Engl. J. Med.1996335251857186410.1056/NEJM1996121933525018948560
     [Google Scholar]
  9. PalmeriniT. Biondi-ZoccaiG. ReggianiL.B. SangiorgiD. AlessiL. De ServiS. BranziA. StoneG.W. Risk of stroke with coronary artery bypass graft surgery compared with percutaneous coronary intervention.J. Am. Coll. Cardiol.201260979880510.1016/j.jacc.2011.10.91222917004
     [Google Scholar]
  10. van der LindenJ. HadjinikolaouL. BergmanP. LindblomD. Postoperative stroke in cardiac surgery is related to the location and extent of atherosclerotic disease in the ascending aorta.J. Am. Coll. Cardiol.200138113113510.1016/S0735‑1097(01)01328‑611451262
     [Google Scholar]
  11. NaylorA.R. MehtaZ. RothwellP.M. BellP.R.F. Carotid artery disease and stroke during coronary artery bypass: a critical review of the literature.Eur. J. Vasc. Endovasc. Surg.200223428329410.1053/ejvs.2002.160911991687
     [Google Scholar]
  12. CharlesworthD.C. LikoskyD.S. MarrinC.A.S. MaloneyC.T. QuintonH.B. MortonJ.R. LeavittB.J. CloughR.A. O’ConnorG.T. Development and validation of a prediction model for strokes after coronary artery bypass grafting.Ann. Thorac. Surg.200376243644310.1016/S0003‑4975(03)00528‑912902080
     [Google Scholar]
  13. HorneroF. MartínE. RodríguezR. CastellàM. PorrasC. RomeroB. MarotoL. Pérez De La SotaE. A multicentre Spanish study for multivariate prediction of perioperative in-hospital cerebrovascular accident after coronary bypass surgery: the PACK2 score.Interact. Cardiovasc. Thorac. Surg.201317235335810.1093/icvts/ivt10223628652
     [Google Scholar]
  14. MathisenL. AndersenM.H. HolP.K. TennøeB. LundC. RussellD. LundbladR. HalvorsenS. WahlA.K. HanestadB.R. FosseE. Preoperative cerebral ischemic lesions predict physical health status after on-pump coronary artery bypass surgery.J. Thorac. Cardiovasc. Surg.200513061691169710.1016/j.jtcvs.2005.08.00816308017
     [Google Scholar]
  15. KhanM.F. HerleA. Reza MovahedM. Risk Factors for Post-Coronary Artery Bypass Grafting (CABG) Atrial Fibrillation and the Role of Aspirin and Beta Blockers in its Prevention.J. Atr. Fibrillation20135580010.4022/JAFIB.80028496818
     [Google Scholar]
  16. KarkoutiK. CohenM.M. McCluskeyS.A. SherG.D. A multivariable model for predicting the need for blood transfusion in patients undergoing first-time elective coronary bypass graft surgery.Transfusion200141101193120310.1046/j.1537‑2995.2001.41101193.x11606816
     [Google Scholar]
  17. SellmanM. IntontiM.A. IvertT. Reoperations for bleeding after coronary artery bypass procedures during 25 years.Eur. J. Cardiothorac. Surg.199711352152710.1016/S1010‑7940(96)01111‑69105818
     [Google Scholar]
  18. HorwichP. ButhK.J. LégaréJ.F. New onset postoperative atrial fibrillation is associated with a long-term risk for stroke and death following cardiac surgery.J. Card. Surg.201328181310.1111/jocs.1203323186205
     [Google Scholar]
  19. AmarD. ShiW. HogueC.W.Jr ZhangH. PassmanR.S. ThomasB. BachP.B. DamianoR. ThalerH.T. Clinical prediction rule for atrial fibrillation after coronary artery bypass grafting.J. Am. Coll. Cardiol.20044461248125310.1016/j.jacc.2004.05.07815364327
     [Google Scholar]
  20. VillarealR.P. HariharanR. LiuB.C. KarB. LeeV.V. ElaydaM. LopezJ.A. RasekhA. WilsonJ.M. MassumiA. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery.J. Am. Coll. Cardiol.200443574274810.1016/j.jacc.2003.11.02314998610
     [Google Scholar]
  21. McKhannG.M. GregaM.A. BorowiczL.M.Jr BaumgartnerW.A. SelnesO.A. Stroke and encephalopathy after cardiac surgery: an update.Stroke200637256257110.1161/01.STR.0000199032.78782.6c16373636
     [Google Scholar]
  22. MarzoogB.A. VlasovaT.I. Myocardiocyte autophagy in the context of myocardiocytes regeneration: a potential novel therapeutic strategy.Egypt. J. Med. Hum. Genet.20222314110.1186/s43042‑022‑00250‑8
     [Google Scholar]
  23. CarnesC.A. ChungM.K. NakayamaT. NakayamaH. BaligaR.S. PiaoS. KanderianA. PaviaS. HamlinR.L. McCarthyP.M. BauerJ.A. Van WagonerD.R. Ascorbate attenuates atrial pacing-induced peroxynitrite formation and electrical remodeling and decreases the incidence of postoperative atrial fibrillation.Circ. Res.2001896E32E3810.1161/hh1801.09764411557745
     [Google Scholar]
  24. De VecchiE. PalaM.G. Di CredicoG. AgapeV. PaoliniG. BoniniP.A. GrossiA. ParoniR. Relation between left ventricular function and oxidative stress in patients undergoing bypass surgery.Heart199879324224710.1136/hrt.79.3.2429602656
     [Google Scholar]
  25. DimmerC. TavernierR. GjorgovN. Van NootenG. ClementD.L. JordaensL. Variations of autonomic tone preceding onset of atrial fibrillation after coronary artery bypass grafting.Am. J. Cardiol.1998821222510.1016/S0002‑9149(98)00231‑89671003
     [Google Scholar]
  26. KalmanJ.M. MunawarM. HowesL.G. LouisW.J. BuxtonB.F. GutteridgeG. TonkinA.M. Atrial fibrillation after coronary artery bypass grafting is associated with sympathetic activation.Ann. Thorac. Surg.19956061709171510.1016/0003‑4975(95)00718‑08787468
     [Google Scholar]
  27. BudeusM. HennersdorfM. RöhlenS. SchnitzlerS. FelixO. ReimertK. FeindtP. GamsE. WienekeH. SackS. ErbelR. PeringsC. Prediction of atrial fibrillation after coronary artery bypass grafting: The role of chemoreflexsensitivity and P wave signal averaged ECG.Int. J. Cardiol.20061061677410.1016/j.ijcard.2004.12.06216321669
     [Google Scholar]
  28. TsikourisJ.P. KlugerJ. SongJ. WhiteC.M. Changes in P-wave dispersion and P-wave duration after open heart surgery are associated with the peak incidence of atrial fibrillation.Heart Lung200130646647110.1067/mhl.2001.11836311723451
     [Google Scholar]
  29. EngelmannM.D.M. SvendsenJ.H. Inflammation in the genesis and perpetuation of atrial fibrillation.Eur. Heart J.200526202083209210.1093/eurheartj/ehi35015975993
     [Google Scholar]
  30. BruinsP. VelthuisH. YazdanbakhshA.P. JansenP.G.M. van HardeveltF.W.J. de BeaumontE.M.F.H. WildevuurC.R.H. EijsmanL. TrouwborstA. HackC.E. Activation of the complement system during and after cardiopulmonary bypass surgery: postsurgery activation involves C-reactive protein and is associated with postoperative arrhythmia.Circulation199796103542354810.1161/01.CIR.96.10.35429396453
     [Google Scholar]
  31. AbdelhadiR.H. GurmH.S. Van WagonerD.R. ChungM.K. Relation of an exaggerated rise in white blood cells after coronary bypass or cardiac valve surgery to development of atrial fibrillation postoperatively.Am. J. Cardiol.20049391176117810.1016/j.amjcard.2004.01.05315110218
     [Google Scholar]
  32. MarzoogB.A. Autophagy in Endothrlial Cell Dysfunction.Curr. Mol. Med.2022
     [Google Scholar]
  33. MarzoogB. Lipid Behavior in Metabolic Syndrome Pathophysiology.Curr. Diabetes Rev.2022186e15092119649710.2174/157339981766621091510132134525924
     [Google Scholar]
  34. MarzoogB.A. Transcription Factors – the Essence of Heart Regeneration: A Potential Novel Therapeutic Strategy.Curr. Mol. Med.202323323223810.2174/156652402266622021612365035170408
     [Google Scholar]
  35. MarzoogB.A. Recent advances in molecular biology of metabolic syndrome pathophysiology: endothelial dysfunction as a potential therapeutic target.J. Diabetes Metab. Disord.20222121903191110.1007/s40200‑022‑01088‑y36065330
     [Google Scholar]
  36. Abdullah MarzoogB. Adaptive and Compensatory Mechanisms of the Cardiovascular System and Disease Risk Factors in young males and females.Emir. Med. J.202341e281122210.2174/04666221128110145
     [Google Scholar]
  37. MarzoogB.A. Endothelial Cell Autophagy in the Context of Disease Development.Anat. Cell Biol.2023561162410.5115/acb.22.09836267005
     [Google Scholar]
  38. MarzoogB.A. VlasovaT.I. Membrane lipids under norm and pathology.Eur J Clin Exper Med2021191597510.15584/ejcem.2021.1.9
     [Google Scholar]
  39. Abdullah MarzoogB. Autophagy as an anti-senescent in aging neurocytes.Curr. Mol. Med.202323epub ahead of print10.2174/156652402366623012010271836683318
     [Google Scholar]
  40. TomicV. RusswurmS. MöllerE. ClausR.A. BlaessM. BrunkhorstF. BruegelM. BodeK. BloosF. WippermannJ. WahlersT. DeignerH.P. ThieryJ. ReinhartK. BauerM. Transcriptomic and proteomic patterns of systemic inflammation in on-pump and off-pump coronary artery bypass grafting.Circulation2005112192912292010.1161/CIRCULATIONAHA.104.53115216275880
     [Google Scholar]
  41. PuskasJ.D. EdwardsF.H. PappasP.A. O’BrienS. PetersonE.D. KilgoP. FergusonT.B.Jr Off-pump techniques benefit men and women and narrow the disparity in mortality after coronary bypass grafting.Ann. Thorac. Surg.20078451447145610.1016/j.athoracsur.2007.06.10417954045
     [Google Scholar]
  42. AfilaloJ. RastiM. OhayonS.M. ShimonyA. EisenbergM.J. Off-pump vs. on-pump coronary artery bypass surgery: An updated meta-analysis and meta-regression of randomized trials.Eur. Heart J.201233101257126710.1093/eurheartj/ehr30721987177
     [Google Scholar]
  43. MøllerC.H. PenningaL. WetterslevJ. SteinbrüchelD.A. GluudC. Off-pump versus on-pump coronary artery bypass grafting for ischaemic heart disease.Cochrane Libr.20123CD00722410.1002/14651858.CD007224.pub222419321
     [Google Scholar]
/content/journals/nemj/10.2174/0250688204666230410084313
Loading
Post-coronary Artery Bypass Graft Complications; Potential Causes and Risk Factors
NEW Emirates Medical J 5, e100423215574 (2024); https://doi.org/10.2174/0250688204666230410084313
/content/journals/nemj/10.2174/0250688204666230410084313
/content/journals/nemj/10.2174/0250688204666230410084313
Loading

Data & Media loading...


  • Article Type:     Research Article
Keyword(s): Angina; Angioplasty; CABG; Complication; CVD & CVS; Diabetes mellites; Myocardial infarction; Risk factor; Surgery

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test