Importance of Full-Length Scan of Arterial Grafts in Coronary Artery Bypass Grafting.

Cardiac ischemia after coronary artery bypass grafting is often caused by graft occlusion. Short- and long-term graft patency is related to the quality of the surgical technique during harvesting and anastomosis. Transit time flow measurement is a recognized technique for the quality control of grafts but may not rule out structural abnormalities in the conduits, which can cause graft occlusion.

Operative treatment of combined aortic stenosis and coronary artery disease.

Introduction: The aortic valve replacement is a standard operating procedure in patients with severe aortic stenosis. Structure of patients undergoing surgery ranges from young population with isolated mitral valvular disease to the elderly population, which is in addition to the underlying disease additionally burdened with comorbidity. One of the most commonly present factors that further complicate the surgery is coronary heart disease that occurs in, almost, one third of patients with aortic stenosis.

Improvement of ejection fraction after coronary artery bypass grafting surgery in patients with impaired left ventricular function.

Objectives: The present study evaluates our experience with aorto-coronary bypass grafting in patients with severe dysfunction of left ventricle (LV) and low ejection fraction-EF(<35%). Revascularization of myocardium in this settings remains contraversial because of concerns over morbidity, mortality and quality of life.

Material And Methodes: Forty patients with severe coronary artery disease and dysfunction of LV (low ejection fraction <35%) underwent coronary artery bypass grafting in period of 3 years.

Surgical treatment of left ventricular pseudoaneurysm.

Introduction: Left ventricular pseudoaneurysm is a rare condition because in most instances ventricular free-wall rupture leads to fatal pericardial tamponade. Rupture of the free wall of the left ventricle is a cata-strophic complication of myocardial infarction, occurring in approximately 4% of pa-tients with infarcts, resulting in immediate collapse of the patient and electromechanical dissociation. In rare cases the rupture is contained by pericardial and fibrous tissue, and the result is a pseudoaneurysm.

Surgical treatment of left ventricular pseudoaneurysm.

Introduction: Left ventricular pseudoaneurysm is a rare condition because in most instances ventricular free-wall rupture leads to fatal pericardial tamponade. Rupture of the free wall of the left ventricle is a catastrophic complication of myocardial infarction, occurring in approximately 4% of patients with infarcts, resulting in immediate collapse of the patient and electromechanical dissociation. In rare cases the rupture is contained by pericardial and fibrous tissue, and the result is a pseudoaneurysm.

Bloodless off pump coronary artery bypass grafting treatment of choice for Jehova's witness patients.

Jehovah's witnesses (JW) belong to a religious group refusing to accept blood transfusion Surgical treatment remains a challenge in this subset of patients. From 1945, JW introduced a ban on accepting blood transfusions, even in life-threatening situations while autologous blood must also be refused if it is predeposited-thus excluding preoperative autodonation. However, autologous blood is acceptable if it is not separated from the patients' circulation at any time.

Calcified right atrial and pulmonary artery mass after ventriculoatrial shunt insertion.

Insertion of ventriculoatrial (VA) shunts is an effective method of draining cerebrospinal fluid from the cerebral ventricle to the right atrium and significantly improves the survival of patients with hydrocephalus. Some patients who received a VA shunt subsequently developed complications, including thrombus formation around the intracardiac end of the catheter and thromboembolism. The relative rarity of complications and the long latency between shunt insertion and the development of symptoms in VA shunt recipients may result in misdiagnosis or delayed diagnosis.

Coronary bypass grafting without use of cardiopulmonary bypass for dextrocardia.

Dextrocardia is a condition in which the heart is pointed toward the right side of the chest instead of normally pointing to the left. The rate of atherosclerotic heart disease in subjects with this condition is similar to that of the general population. We present a patient with situs inversus totalis with dextrocardia who underwent coronary artery bypass grafting without use of cardiopulmonary bypass (OPCAB).

Ruptured aneurysm of the noncoronary sinus of valsalva into the right atrium.

Sinus of Valsalva (SV) aneurysm is rare cardiac lesion with variable clinical presentation. We presented a case of a 41-year-old female who was admitted to our Center because of severe heart failure and a signs of ruptured aneurysm of the SV into the right atrium. Transthoracic echocardiography confirmed communication between noncoronary SV and right atrium measuring 12 mm in diameter, tricuspid insufficiency, biatrial dilatation and preserved left ventricular function.

The effect of combined clopidogrel and aspirin therapy after off-pump coronary surgery: a pilot study.

Objective: : The purpose of this randomized study was to evaluate the effect on graft patency by adding clopidogrel to aspirin in off-pump coronary artery bypass (OPCAB) grafting and the possible side effects of such therapy.

Methods: : Twenty patients who underwent standard OPCAB through median sternotomy were randomized immediately after surgery in two groups. Patients in group A (n = 10) received 100 mg of aspirin starting preoperatively, continuing indefinitely.

Homocysteine in angiographically proven coronary disease.

The research included 200 subjects, of which 150 had angiographically proven coronary disease with the coronary artery stenosis of 50% or more, and 50 subjects who did not have angiographically proven coronary disease. Patients were chosen randomly out of approximately 1000 patients who underwent angiography. All the subjects were treated at the Clinical Center of University of Tuzla--at the Clinic for Cardiovascular Diseases.

Results of coronary bypass grafting in treatment of left main stenosis.

Study comparing the results of coronary artery bypass grafting (CABG) with and without cardiopulmonary bypass (CPB) in the treatment of left main stenosis (LMS) has not yet been made in Bosnia and Herzegovina. The main aim of this study was to compare result of CABG performed on 176 patients, in Cardiovacular clinic of University Clinical Center in Tuzla from May 1999 to January 2005, by these two methods in LMS group of patients in the early and late postoperative period. The study was divided in two parts.

Management [corrected] of conversions to cardiopulmonary bypass in beating heart coronary surgery.

This study investigated outcomes in patients undergoing coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB), who needed conversion to CPB. Between September, 1998 and September, 2003, 1000 CABG procedures were performed in a Cardiovascular Clinic, University Clinical Centre Tuzla. Multivessel CABG were selected arbitrarily for CABG without CPB (OPCAB) or CABG with CPB (ONCAB).

Transit time flowmetry in coronary surgery--an important tool in graft verification.

The aim of this study was to analyze the Transit time flow measurement (TTFM) experience in the first 1000 CABG operations. First 1000 patients had coronary artery bypass grafting (CABG) performed in Cardiovascular Clinic, University Clinical Centre Tuzla, Bosnia and Herzegovina, between September, 1998 and September, 2003. CABG without use of cardiopulmonary bypass (CPB)-(OPCAB) was used as the preferential surgical method both because this method is reported to have equal or better results than CABG with use of CPB (ONCAB), and because of the significant cost savings realized.

A comparation of coronary artery bypass grafting with and without cardiopulmonary bypass in EuroSCORE high risk patients.

Angiotensin converting enzyme (ACE) and nitric oxide (NO) have been suggested to be in - The objective of this study is to compare outcomes of coronary artery bypass grafting (CABG) in high-risk patients performed with- (ONCAB) and without -(OPCAB) use of cardiopulmonary bypass. From October 2001 till October 2005, 210 high-risk patients classified according to European System for Cardiac Operative Risk Evaluation (EuroSCORE) (score =or> 5) underwent CABG in Cardiovascular Clinic, University Clinical Centre Tuzla, Bosnia and Herzegovina. 138 patients operated as OPCAB were compared to 72 patients operated as ONCAB.

Training of cardiac surgeons for Bosnia and Herzegovina: outcomes in coronary bypass grafting surgery.

Background: Bosnia and Herzegovina did not have invasive cardiac diagnosis or cardiac surgery before the recent war. With assistance from the United States and Norway, a cardiovascular clinic was developed. This study reports center-specific and surgeon-specific clinical outcomes.

[Off-pump coronary bypass grafting in patient with left main occlusion and 75% stenosis of right coronary artery].

Patients with significant stenosis (>50%) of the left main coronary artery (LM) are considered high risk for coronary artery bypass grafting (CABG). LM disease is mainly considered a relative contraindication for off pump coronary artery bypass grafting (OPCAB) because of the reduced tolerancy of hamodynamic disturbances which occurs during mobilisation and exposition of the heart, necessary for this type of operations. The aim of the study is to show feasibility of OPCAB for patient with occlusion of the LM and 75% stenosis of the right coronary artery.

[Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol in coronary artery disease].

The retrospective study included 250 patients, treated at Clinic for cardiovascular diseases of Tuzla Clinical center, between 30.08.2003.

Respiratory risk factors in development of postoperative complications after the lung resection.

The objectives of the study were to identify possible associated respiratory risk factors and to assess incidence of overall postoperative complications after the lung resection. We reviewed 110 patients who underwent lung resections due to malignant neoplasms or benign lung diseases. The risk of postoperative complications was evaluated using the univariate analysis.

[Atrial fibrillation after surgical myocardial revascularisation].

Atrial fibrillation characterized by uncoordinated atrial activation. On the electrocardiogram is described by the replacement of consistent P waves by rapid oscillations or fibrillatory waves that vary in size and shape. The incidence of atrial fibrillation in patients under 22 years old is 2%, whereas for patients under 60 years old, the incidence is 8.

[Coronary disease and left branch block].

In the LBBB (the block of the left branch) control group there were 2 examinees Hi (6.45%). LAH and LHP were not found.

Intraoperative and intermediate-term angiographic results of coronary artery bypass surgery with Symmetry proximal anastomotic device.

Objective: The objective of this study was to investigate the patency in saphenous vein coronary bypass grafts in which the proximal anastomoses were performed with automatic connector devices or with a traditional suture technique.

Methods: Forty-six patients underwent coronary artery bypass grafting without cardiopulmonary bypass by using one thoracic graft and one or more saphenous vein grafts. Grafts were attached to the aorta with a Symmetry connector (St Jude Medical, Inc, St Paul, Minn) in 23 patients, and partial occlusion of the aorta and sutured anastomoses were used in 23 other patients.

[Respiratory risk factors in development of postoperative complications after lung resection].

The objectives of the study were to identify possible associated respiratory risk factors and to assess incidence of overall postoperative complications after lung resection. We reviewed 110 patients undergoing lung resections because of malignant neoplasms or benign lung diseases. The risk of postoperative complications was evaluated using unuvariate analysis.

[Beating heart surgery in the treatment of stenoses of the main branch of the left coronary artery].

This study reviewed the early experience with off-pump coronary artery bypass surgery in treatment of patients with severe left main coronary artery stenosis. From May 2002-December 2003, 75 patients with significant left main coronary artery stenosis (> or = 50%) underwent coronary artery bypass grafting. 35 patients were operated without the use of cardiopulmonary bypass (OPCAB) and compared with 40 patients operated with the use of cardiopulmonary bypass (ONCAB).

Conversions in off-pump coronary surgery.

Methods: There have been 784 coronary artery bypass grafting (CABG) procedures performed at a new center for treating cardiovascular disease in Tuzla, Bosnia and Herzegovina, and the surgical team has been fully trained in offpump coronary artery bypass (OPCAB) surgery. All surgical patients were considered for on-pump CABG (ONCAB) and OPCAB surgical procedures. Minimally invasive direct coronary artery bypass grafting and robotic procedures were done as OPCAB.