On the basis of the experience with the contemporary coronary chirurgery with classical bypass technology under the conditions of cardiopulmonary bypass (CPB) are specified the complications that occurred in the patient. These complications, generalized as 'postperfusion syndrome' are filled out with common brain complications like embolism, insultus and these in neurokognitive sphere of the brain activity. For decrease the complications by the coronary operations from 1975 are developed new technologies for coronary revascularization under the conditions of 'beating heart' without CPB (off-pump technologies). From 1980 Benetti F. and Buffalo (1981) in Latin America widely use the coronary revascularization of 'beating heart' without CPB (off-pump coronary artery bypass = OPCAB). For the realization of these operations are developed miniinvasive operative technologies through different operative admissions: small anterolateral thoracotomy, dorsolateral thoracotomy, xiphoid transdiaphragmatic, transabdominal etc. A considerable facilitation by OPCAB is achieved with using vacuum or mechanical stabilizers of the cardiac activity. In the course of last decade OPCAB operations are taken with endoscope technics Mack and coll. (1997), Wolf (1998) etc. The technology for decreasing of the operative technology is developed by adopting robot assistance by the coronary bypass operations (RAVECAB) from Boyd and coll. (2001), Kiaii and coll. (2000), Mohr, Falk and Diegeler (1999) etc. The miniinvasive coronary revascularization can be applied by exact draft patients and help for decreasing the postoperative complications and the lethality.
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Circ J
January 2025
Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine.
Background: Fatal arrhythmic events (FAEs), such as sudden cardiac death (SCD) and fatal ventricular arrhythmias, are a devastating complication in patients with coronary artery disease (CAD). Therefore, in this study we aimed to assess the incidence of FAEs in more recent Japanese patients with CAD and to examine whether risk stratification of FAEs can still be feasible using the left ventricular ejection fraction (LVEF).
Methods And Results: In the CREDO Kyoto PCI/CABG registry cohorts-2 and -3, there were 25,843 patients with LVEF data who received a first coronary revascularization (LVEF ≤35% group: N=1,671, 35%
Ann Thorac Surg
January 2025
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV.
Background: As percutaneous therapeutic options expand, the optimal management of severe aortic stenosis (AS) and concomitant coronary artery disease (CAD) is being questioned between coronary artery bypass grafting and surgical aortic valve replacement (CABG+SAVR) versus percutaneous coronary intervention and transcatheter aortic valve replacement (PCI+TAVR). We sought to compare perioperative and longitudinal risk-adjusted outcomes between patients undergoing CABG+SAVR versus PCI+TAVR.
Methods: Using the United States Centers for Medicare and Medicaid Services inpatient claims database, we evaluated all patient age 65 and older with AS and CAD undergoing CABG+SAVR or PCI+TAVR (2018-2022).
Ann Vasc Surg
January 2025
Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053. Electronic address:
Objective: To evaluate the safety and efficacy of excimer laser ablation (ELA) combined with drug-coated balloon(DCB)in the treatment of Chronic limb-threatening ischemia (CLTI) patients with de novo and in-stent restenosis (ISR) lesions in the femoropopliteal artery.
Methods: A retrospective, single-center analysis was performed on data collected between January 2017 and December 2021. The study included CLTI patients who underwent treatment with ELA combined with DCB for de novo and ISR lesions in the femoropopliteal artery.
Lancet
January 2025
British Heart Foundation Centre of Research Excellence, University of Edinburgh, Edinburgh, UK; Edinburgh Imaging, University of Edinburgh, Edinburgh, UK.
Background: The Scottish Computed Tomography of the Heart (SCOT-HEART) trial demonstrated that management guided by coronary CT angiography (CCTA) improved the diagnosis, management, and outcome of patients with stable chest pain. We aimed to assess whether CCTA-guided care results in sustained long-term improvements in management and outcomes.
Methods: SCOT-HEART was an open-label, multicentre, parallel group trial for which patients were recruited from 12 outpatient cardiology chest pain clinics across Scotland.
Am Heart J
January 2025
Clinical and Experimental Interventional Cardiology, University of Saarland, Homburg, Germany.
Background And Rationale: In-stent restenosis (ISR) remains the leading cause of treatment failure following percutaneous coronary intervention (PCI) with contemporary drug-eluting stents. Especially in small caliber coronary arteries, restenosis is common following PCI and represents a treatment challenge. Drug-coated balloons (DCB) are an attractive alternative to stents for treatment of both ISR and small vessel disease.
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