Aim: The aim of this paper was to report the authors' experience on biventricular epicardial pacing (BEP) as first-choice procedure concomitant to on-pump heart surgery for other definite indications.
Methods: BEP was performed in 13 consecutive patients with stage IV heart failure (HF) undergoing on-pump cardiac surgery for other definite indications. All patients were treated with optimized pharmacologic therapy, and showed complete left bundle branch block and reduced (<30%) left ventricular ejection fraction.
Results: In all patients, effective BEP was achieved. All patients were discharged alive; functional, ECG and echocardiographic parameters showed significant improvement, better observed at 4-month interval. However, a high mortality rate was noticed during follow up (about 70% at 6 months) with a significant number of sudden cardiac deaths. The absence of functional improvement in the mid-term period (4-month control) related to a poor prognosis.
Conclusions: Epicardial lead placement during cardiac surgery of severe HF patients is safe and effective. A clear evaluation of the effect of BEP alone is precluded because of the interference of the concomitant indications for cardiac surgery and the absence of randomization. The high rate of sudden death noticed in this study raises the important question of whether implantation of a defibrillator would be warranted in such population.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Machine learning-derived multivariable predictors of postcardiotomy cardiogenic shock in high-risk cardiac surgery patients.
JTCVS Open
December 2024
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
Objective: To develop a model for preoperatively predicting postcardiotomy cardiogenic shock (PCCS) in patients with poor left ventricular (LV) function undergoing cardiac surgery.
Methods: From the Society of Thoracic Surgeons Adult Cardiac Database, 11,493 patients with LV ejection fraction ≤35% underwent isolated on-pump surgery from 2018 through 2019, of whom 3428 experienced PCCS. In total, 68 preoperative clinical variables were considered in machine-learning algorithms trained and optimized using scikit-learn software.
Robotic-Assisted Aortic Valve Replacement and Coronary Artery Bypass Grafting.
Ann Thorac Surg
December 2024
Department of Cardiovascular and Thoracic Surgery, West Virginia University.
Purpose: Left chest robotic left internal thoracic artery (LITA) to left anterior descending (LAD) coronary revascularization has been established. We hereby describe robotic aortic valve replacement and coronary artery bypass via a right lateral approach.
Description: A 73-year-old female with severe aortic insufficiency, 70% LAD stenosis, and ejection fraction of 35% presents with recalcitrant symptoms.
The value of off-pump coronary artery bypass grafting in the surgery for combined valvular and coronary heart disease.
Front Med (Lausanne)
November 2024
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Background: Combined valve and coronary surgery is a commonly performed surgical technique for treating coexisting valvular and coronary artery disease. This study aims to investigate the effect of reducing the duration of cardiopulmonary bypass by utilizing the off-pump coronary artery bypass grafting (OPCABG) technique on the short-term prognosis of patients.
Methods: In this retrospective cohort study, 884 patients were divided into groups undergoing OPCABG or on-pump CABG combined with valve surgery based on the CABG technique.
Outcomes of surgical ablation for atrial fibrillation in on- versus off-pump coronary artery bypass grafting.
Interdiscip Cardiovasc Thorac Surg
September 2024
Department of Cardiac and Vascular Surgery, Robert-Bosch-Hospital, Stuttgart, Germany.
Objectives: A considerable number of patients undergoing coronary artery bypass grafting surgery suffer from atrial fibrillation and should be treated concomitantly. This manuscript evaluates the impact of on-pump versus off-pump bypass grafting on the applied lesion set and rhythm outcome.
Methods: Between January 2017 and April 2020, patients who underwent combined bypass grafting and surgical ablation for atrial fibrillation were consecutively enrolled in the German CArdioSurgEry Atrial Fibrillation registry (CASE-AF, 17 centres).
Increasing Adoption of Left Atrial Appendage Occlusion in Isolated Coronary Artery Bypass Grafting.
Ann Thorac Surg
October 2024
Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan. Electronic address:
Background: Recent randomized trial data showed fewer strokes with left atrial appendage occlusion (LAAO) after cardiac surgery in patients with atrial fibrillation. This study developed a quality initiative to increase LAAO adoption.
Methods: Among 11,099 patients who underwent isolated coronary artery bypass grafting (CABG) between January 2019 and March 2021 at 33 hospitals in Michigan, those patients with atrial fibrillation who underwent first-time, on-pump CABG were eligible (n = 1241).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!