Using University of Michigan Health and Retirement Study data, the authors evaluated marital status at the time of cardiac surgery and subsequent survival or deterioration in the ability to perform activities of daily living (ADLs) independently. At follow-up, those who were married had a 19.4% incidence of death or new disability, which was simila
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Coronary Disease - Surgery
October 5, 2015
Pts undergoing cardiac surgery requiring CPB were randomized to remote ischemic preconditioning of the upper extremity or sham intervention. The end point was combined death, MI, stroke, and acute renal failure during hospitalization, and secondary endpoints were the occurrence of any such event within 90 days. Outcomes were similar between the gro
October 5, 2015
Pts undergoing CABG on-pump were randomized to remote preconditioning (upper arm ischemia) or sham intervention prior to surgical incision. The primary end point was a combination of cardiovascular death, stroke, MI, and revascularization. At 1 year there was no difference between the groups in the incidence of the end point, and other important cl
September 26, 2015
In this RCT, patients at increased risk for cardiac surgery requiring CPB were assigned to steroids at the time of anesthetic induction and again at the time of CPB induction or no steroids. Primary outcomes were 30-day mortality and major morbidity. Steriods had no effect on the primary outcomes. There was no evidence that stero
September 24, 2015
The investigators of this study compared survival of bare metal stent percutaneous coronary intervention (BMS-PCI) versus drug-eluting stent PCI (DES-PCI) versus single artery CABG (SA-CABG) versus multiarterial CABG (MA-CABG) in patients with multivessel coronary artery disease.
September 18, 2015
This sub-study of the Randomized On/Off Bypass (ROOBY) trial compared clinical outcomes and 1-year graft patency between CABG cases where residents vs. attending surgeons were the primary operator. Graft patency rates were similar between resident- vs. attending-completed distal anastomoses for on-pump (83.0% vs. 82.4%) and off-pump (77.2% vs.
September 4, 2015
This study from the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative evaluated outcomes of CABG in 33 hospitals 2011-2013, assessing the association of blood transfusion (39.9% of pts) and the incidence of postoperative pneumonia (3.6% of pts). Blood transfusion was associated with an increased risk of pneumonia (OR 3.
August 22, 2015
Outcomes of robotic vs nonrobotic cardiac surgery were evaluated using 1:2 propensity score matching of patients in the Nationwide Inpatient Sample. Operations included valves/septae (10%), coronary arteries (47%), and other. Mean costs were 7.5% higher for robotic cases. Robotic procedures had shorter length of stay (5 vs 6 days), lower mortality
August 18, 2015
This paper is now one of the largest meta-analyses performed to compare off and on pump CABG. It demonstrates comparable outcomes between the two groups.
July 29, 2015
The University of Virginia group retrospectively analyzed all non-emergent cardiac cases performed at their center from 2008 to 2013, and separated the nonemergent cases into two groups: "Early start" cases had an incision time before 3 PM, and "late start" cases, after 3 PM.