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4 "coronary artery bypass graft"
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Original Articles
Meta-analysis
Impact of perioperative high-intensity statin treatment on the occurrence of postoperative atrial fibrillation after coronary artery bypass grafting: a meta-analysis
Yeiwon Lee, Somin Im, Yoonjin Kang, Suk Ho Sohn, Myoung-jin Jang, Ho Young Hwang
Acute Crit Care. 2024;39(4):507-516.   Published online November 25, 2024
DOI: https://doi.org/10.4266/acc.2024.00633
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AbstractAbstract PDF
Background
This meta-analysis was conducted to evaluate the impact of high-intensity statin treatment on new-onset postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG).
Methods
Four databases were searched for studies that enrolled patients who underwent CABG and investigated the impact of perioperative use of high-intensity statins on the occurrence rate of POAF. The primary outcome was the incidence of POAF. Secondary outcomes were operative mortality and perioperative myocardial infarction (PMI). Publication bias was assessed using a funnel plot and Egger’s test.
Results
Nine articles (eight randomized controlled trials and one non-randomized study: n=3,072) were selected. Rosuvastatin (20 mg) was used in four studies, while atorvastatin (40–80 mg) was used in the other five studies. Reported incidences of POAF in the included studies ranged from 11% to 48.8%. Pooled analyses showed that the incidence of POAF was significantly lower in patients treated with high-intensity statins than in patients in the control group patients (odds ratio, 0.43; 95% CI, 0.27–0.68; P<0.001). Subgroup analyses showed that the impact of high-intensity statins was significant in studies using atorvastatin but not in studies using rosuvastatin. There was no significant subgroup difference in the primary endpoint between studies using a placebo and those using low-dose statins. Secondary outcomes, including operative mortality and the incidence of PMI, were not affected by high-intensity statin treatment.
Conclusions
Perioperative use of high-intensity statins is associated with a 57% reduction in the occurrence of POAF among patients undergoing CABG.
Cardiology
A comparative study of stored arterial versus venous blood collected using the acute normovolemic hemodilution method in coronary artery bypass grafting patients in Iran
Mojtaba Mansouri, Alireza Yazdani, Gholamreza Masoumi, Mohsen Mirmohammadsadeghi, Amir Mirmohammadsadeghi
Acute Crit Care. 2023;38(3):353-361.   Published online June 15, 2023
DOI: https://doi.org/10.4266/acc.2022.01382
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  • 55 Download
AbstractAbstract PDF
Background
In the present study, arterial and venous blood was collected from patients who were candidates for elective coronary artery bypass grafting (CABG); the blood was stored for 28 days and cellular, biomechanical, and hematological changes in blood were compared to determine whether stored arterial blood is superior to stored venous blood.
Methods
The present follow-up comparative study included 60 patients >18 years of age, with hemoglobin >14 mg/dl and ejection fraction >40% who were candidates for CABG. After induction of anesthesia, 250 ml of arterial or venous blood was drawn from patients (arterial blood group and venous blood group). Laboratory blood samples were taken at specified times from the collected blood and re-injected into the patients after CABG.
Results
Significant differences were observed in pH, partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), bicarbonate (HCO3), and glucose values at several time points between the groups. Other parameters such as urea and creatinine did not show any significant differences between the groups.
Conclusions
Twenty-eight days of storage can have a negative effect on some of the cellular, biochemical, and hematological components of arterial and venous blood; however, the quality of stored arterial blood and venous blood does not differ significantly.
Nonlinear Analysis of Heart Rate Variability: Possible Predictor for Atrial Fibrillation after Coronary Artery Bypass Graft (CABG) Surgery
Kyung Sil Im, Jong Bun Kim, Jae Myeong Lee, Kuhn Park, Hyun Ju Jung, Jeong Yun Rhee
Korean J Crit Care Med. 2007;22(1):25-29.
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AbstractAbstract PDF
BACKGROUND
Heart Rate Variability (HRV) is a valuable marker of autonomic tone and may assist evaluating the prognosis in patients with heart disease. The purpose of this study was to assess whether preoperative heart rate variability analysis predicts atrial fibrillation in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: This study was designed as a prospective observational study. After IRB approval was obtained by our institution, 76 patients scheduled for elective CABG surgery underwent a 10-min electrocardiogram recordings 1~2 hours prior to surgery. Heart rate variability analysis was performed with spectral analysis and point correlation dimension. RESULTS: There was no significant difference in the low and high frequency component (LF/HF) ratio preoperatively between patients with atrial fibrillation and patients with normal sinus rhythm postoperatively (3.0+/-2.45, 4.25+/-3.70, p=0.085). Baseline peak point correlation dimension (pPD2) was significantly higher in patients with atrial fibrillation than in patients with normal sinus rhythm postoperatively (4.2+/-0.8, 3.8+/-0.7, p=0.042). CONCLUSIONS: Patients who developed atrial fibrillation postoperatively had a higher baseline pPD2 value preoperatively. Point correlation dimensions may predict the occurrence of postoperative atrial fibrillation after CABG surgery. However, further studies are needed to confirm whether point correlation dimensions are an effective predictor for postoperative atrial fibrillation.
Case Report
Vocal Cord Paralysis after the Coronary Artery Bypass Graft: A Case Report
Kwang Su Kim, Seong Wook Jeong, Sang Hyun Kwak, Myung Ha Yoon, Kyung Yeon Yoo, Chang Young Jeong, Sung Su Chung
Korean J Crit Care Med. 2005;20(2):170-173.
  • 1,827 View
  • 33 Download
AbstractAbstract PDF
Surgical trauma has long been recognized as the most common cause of unilateral and bilateral vocal cord paralysis. We experienced a case of bilateral vocal cord paralysis after off-pump coronary artery bypass graft. The patient was repeated intubation and extubation after operation in surgical intensive care unit. Fiberoptic bronchoscopy revealed bilateral vocal cord paralysis in the patient. The patient recovered after permanent tracheotomy. We reported a case of vocal cord paralysis after coronary artery bypass graft.

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