Release of serum S-100β protein and neuron-specific enolase after off-pump coronary artery bypass grafting with and without intracranial and cervical artery stenosis.

Purpose: The aim of this study was to quantify the amount of brain damage suffered by patients who underwent off-pump coronary artery bypass grafting (OPCAB) in which S-100β protein and neuron-specific enolase were used.

Methods: Thirty-four patients undergoing scheduled OPCAB were enrolled in the study. The patients were divided into two groups according to the results of their magnetic resonance angiography (MRA) and cervical ultrasonography: 13 patients had cervical or intracranial arterial stenosis (Group A), and 21 patients did not (Group B).

Application of Akaike information criterion to evaluate warfarin dosing algorithm.

Introduction: Several factors responsible for inter-individual differences in response to warfarin have been confirmed; however, unidentified factors appear to remain. The purpose of this study was to examine a simple method to evaluate whether optional variables are appropriate as factors to improve dosing algorithms.

Materials And Methods: All patients were Japanese.

Improvement of tricuspid regurgitation after pulmonary thromboendarterectomy.

Chronic thromboembolic pulmonary hypertension causes right ventricular dilation with various degrees of tricuspid regurgitation, leading to right heart failure. Pulmonary thromboendarterectomy can substantially improve pulmonary hemodynamics and right ventricular dilation. The aim of this study was to determine whether the reduction of tricuspid regurgitation persists during follow-up.

Global ST-segment elevation associated with impending cardiac rupture during diagnostic cardiac catheterization.

Cardiac rupture is a life-threatening complication during diagnostic cardiac catheterization, however, it rarely occurs nowadays. The present case report describes cardiac rupture during diagnostic cardiac catheterization using a 4F pigtail catheter and a 0.035" flexible guidewire, and global ST-segment elevation associated with impending cardiac rupture.

Mid-term results of surgery for chronic thromboembolic pulmonary hypertension.

Pulmonary thromboendarterectomy is an effective surgical treatment for chronic thromboembolic pulmonary hypertension (CTEPH). In this study, we review our short- and mid-term results in the recent series of patients undergoing pulmonary thromboendarterectomy. Twenty-three patients (54+/-12 years) were re-evaluated 7-59 months (mean, 34 months) after surgery.

The effect of preoperative aspirin administration on postoperative level of von Willebrand factor in off-pump coronary artery bypass surgery.

The effect of preoperative administration of aspirin on endothelial function in the patients undergoing off-pump coronary artery bypass (OPCAB) surgery is still unclear. Fifty consecutive patients undergoing OPCAB between May 2006 and May 2007 were equally divided into two groups - one without preoperative aspirin (group A; the first 25 patients) and the other with preoperative aspirin (group B; the next 25 patients). We investigated the degree of postoperative endothelial dysfunction by measuring the von Willebrand factor activity, which is a possible indicator of endothelial damage.

Evaluation of early and midterm results of offpump coronary artery bypass in patients with left main disease.

Purpose: This study evaluated the early and midterm results of offpump coronary artery bypass (OPCAB) for left main coronary artery (LMCA) stenosis.

Methods: Patients treated between November 2001 and December 2006, during which isolated coronary artery bypass grafting (CABG) was performed without cardiopulmonary bypass in principle, were included. Isolated CABG was performed in 206 patients, of whom 62 (30.

Off-pump coronary artery bypass grafting for poorly controlled diabetic patients.

Objective: To estimate the postoperative outcome of off-pump coronary artery bypass grafting (OPCAB) for patients with poorly controlled diabetes mellitus as evaluated by preoperative hemoglobin A1c (HbA1c).

Patients And Methods: The preoperative value of HbA1c in 101 diabetic patients who had undergone OPCAB from January 2000 to January 2007 was reviewed. A value of 6.

Efficacy of Elective Intra-aortic Balloon Pump Therapy for High-Risk Off-Pump Coronary Artery Bypass: A Prospective Comparative Study.

Objective: This study evaluated the usefulness of elective intra-aortic balloon pumping (IABP) in high-risk off-pump coronary artery bypass grafting (OPCAB).

Materials And Methods: From October 2002 through September 2006, total of 143 patients were operated with OPCAB. These patients were divided into two groups and clinical outcomes were compared: Group E (N = 30): Elective IABP group and Group C (N = 113): Control group, OPCAB without IABP.

Usefulness of intraoperative fluorescence imaging to evaluate local anatomy in hepatobiliary surgery.

Background/purpose: One of the major complications encountered in hepatobiliary surgery is the incidence of bile duct and blood vessel injuries. It is sometimes difficult during surgery to evaluate the local anatomy corresponding to hepatic arteries and bile ducts. We investigated the potential utility of an infrared camera system as a tool for evaluating local anatomy during hepatobiliary surgery.

Limitations of right internal thoracic artery to left anterior descending artery bypass: a comparative quantitative study of postoperative angiography of the bilateral internal thoracic artery bypass grafts.

Background: It remains controversial whether right internal thoracic artery (RITA) to left anterior descending artery (LAD) bypass has qualitative limitations which cannot be evaluated based on the patency rate alone.

Methods: The 111 subjects underwent graft angiography after bypass grafting of the left or right internal thoracic artery (ITA) to the LAD. The vascular caliber was measured at the origin of the ITA, at an ITA site adjacent to the anastomotic site, and at an LAD site immediately below the anastomotic site, regarding the outer diameter of the catheter as a reference.

Low systemic vascular resistance state following off-pump coronary artery bypass grafting.

Objective: To determine the prevalence, hemodynamic characteristics, and risk factors for low systemic vascular resistance (SVR) state following after off-pump coronary artery bypass (OPCAB).

Patients And Methods: SVR data could be obtained for 116 OPCAB patients. Low SVR was defined as an indexed systemic vascular resistance (SVRi) of <1,800 dyne x s/cm(5) x m(2) at the end of operation.

A case of pulmonary artery bypass surgery for a patient with isolated Takayasu pulmonary arteritis and a review of the literature.

A 45-year-old female was presented with progressive dyspnea and bilateral leg edema. Pulmonary angiography revealed total occlusion of the right pulmonary artery and significant stenosis of the left pulmonary artery. The inferior lobar artery as well as the segmental arteries were well patent.

Evaluation of cerebral pathologic changes and long-term behavioral disorder after deep hypothermic circulatory arrest in dogs.

The purpose of this study is to evaluate the extent of brain damage following deep hypothermic circulatory arrest (DHCA), using behavior and pathological findings. The dogs underwent 60, 90 or 120 min of DHCA. After 72 h or 6 months, their cerebrum pathological findings were examined.

Pitfalls of skeletonized internal thoracic artery: comparison of graft kinking between skeletonized and pedicled grafts based on postoperative angiography findings.

Background And Aim Of The Study: Skeletonization of the internal thoracic artery (ITA) has several advantages: sequential bypass grafting can be easily performed, and a graft of increased length can make the distal coronary artery accessible. However, kinking of the grafts has been observed on postoperative angiograms in a few cases. We investigated whether there were significant differences in the frequency of graft kinking and stenosis degree at the kink site between pedicled and skeletonized grafts.

Efficacy and vasodilatory benefit of magnesium prophylaxis for protection against spinal cord ischemia.

Prevention of paraplegia remains an imperative issue in thoracoabdominal aortic surgery. The aim of this study was to assess the efficacy of a prophylactic magnesium infusion in a rat spinal cord ischemia model and to demonstrate spinal blood flow increase caused by the infusion. The study was conducted in two parts.

Late-term regression of stenosis at the kink site in the internal thoracic artery in two cases.

A kink in the internal thoracic artery (ITA) is a rare postoperative complication after coronary artery bypass surgery. The kink can be accompanied by significant stenosis and has been observed after the ITAs are harvested by the skeletonization method. In this report, we present two cases in which early postoperative angiography showed the kink accompanied by significant stenosis, and late angiography revealed regression of stenosis at the kink site.

A case complicated with Horner's syndrome after off-pump coronary artery bypass.

In the present report, a case complicated with Horner's syndrome after off-pump coronary artery bypass (OPCAB) was presented. This case showed ptosis and miosis in the left eye promptly after OPCAB. No abnormal neurological findings other than Horner's syndrome were observed in postoperative examinations including head magnetic resonance imaging (MRI), and this case was thought to have Horner's syndrome as a complication after cardiac surgery through median sternotomy.

Relation of inflammatory cytokines to atrial fibrillation after off-pump coronary artery bypass grafting.

Objective: It has been observed that a systemic inflammatory response after on-pump coronary artery bypass grafting (CABG) participates in the pathogenesis of postoperative atrial fibrillation (AF). In patients undergoing off-pump CABG, it is plausible that inflammation is associated with the development of postoperative AF. The present study examined relation of proinflammatory cytokines, which play an important role in the upstream of inflammatory cascade, to the development of AF after off-pump CABG.

A ruptured aneurysm in persistent sciatic artery: a case report.

Persistent sciatic artery (PSA) is a rare congenital anomaly, but in many cases it is a clinically important condition. PSA is susceptible to atherosclerotic degeneration, resulting in aneurysmal dilatation, occlusive thrombosis, or thromboembolization. PSA aneurysm is associated with distal embolization, sciatic neuropathy, or rupture.

Is it safe to initiate selective cerebral perfusion with normothermia?

Objective: Preceding selective cerebral perfusion (P-SCP) is a method whereby SCP and systemic perfusion start simultaneously, and the arch vessels are clamped. Cerebral circulation is isolated from systemic circulation to avoid cerebral embolization due to detachment of atherosclerotic material from the aorta, caused by the "sandblasting" effect of high-velocity jets of blood exiting the aortic cannula. However, neither the safety of SCP at normothermia nor the influence of extended SCP time has been sufficiently clarified.

Steal phenomenon with kinked graft caused a loss of viability in a dialysis patient.

A 74-year-old man with chronic renal failure under hemodialysis via the left upper extremity underwent an off-pump coronary artery bypass (OPCAB). The left internal thoracic artery (LITA), which was harvested in a skeletonized manner, was anastomosed to the left anterior descending artery (LAD). Postoperatively, he complained of chest pain only during dialysis.

Early results of off-pump coronary artery bypass: retrospective consecutive comparative study.

Objective: The purpose of this study is to compare the operative results of off-pump coronary artery bypass (OPCAB) and on-pump (conventional) coronary artery bypass (CCAB), to clarify qualitative problems and whether OPCAB is less invasive or not.

Methods: OPCAB was consecutively performed in 63 patients and CCAB in 63 patients between July 1998 and December 2003.

Results: The mean number of bypass grafts was 2.

[Kinking of skeletonized internal thoracic artery graft].

A 66-year-old woman underwent coronary artery bypass grafting (CABG). Postoperative angiography on postoperative day (POD) 11 revealed that right internal thoracic artery (RITA) anastomosed to left anterior descending artery (LAD) had a kinking. The angiography performed 30 months after operation revealed no specific changes in the kinking of RITA and in the left ventricular function.