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Poon, Chui-yuk Mabel. "The patients lived experiences after coronary artery bypass graft surgery /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31596071.
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Riedel, Bernard J. C. J. "Epidural analgesia for coronary artery bypass graft surgery." Master's thesis, University of Cape Town, 1999. http://hdl.handle.net/11427/25890.
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On reviewing the medical literature, there is a clear resurgence of interest in the use of TEA (thoracic epidural analgesic) in cardiac anaesthesia. This resurgence was brought about by laboratory-based evidence that TEA-induced sympatholysis may be cardioprotective through the promotion of myocardial blood flow to areas at-risk and subsequent early, small clinical studies suggesting that TEA was feasible, and possibly also beneficial in CABG surgery [Joachimsson et. al, 1989; Liem (1-3) et. al, 1992; Stenseth et. al, 1994]. Despite the positive results of these early studies and suggestions that TEA may be the preferred anaesthetic/analgesic technique in select groups of patients (promoting early extubation and fast-tracking) undergoing cardiac surgery, many anaesthetists are still reluctant, however, to use this technique because of the theoretical increased risk of the patient suffering a spinal haematoma and subsequent paraplegia. In order to outweigh this theoretical risk it is important that we show that added benefit, in addition to the provision of analgesia and expedited postoperative convalescence, can be obtained by using TEA. It is therefore our duty as anaesthetists and perioperative physicians to determine whether TEA may also affect the pathophysiology of the disease process, especially in the perioperative period - and thereby influencing the subsequent long term outcome and quality of life of the patient. An example of this latter point would be the potential role of TEA in; • reducing the incidence of perioperative myocardial infarction (P-MI), through the suggested cardioprotective effects of TEA, • reducing the incidence of early postoperative graft failure, through either; * reduction of native coronary artery and/or graft (conduit) spasm, or * reduction of postoperative hypercoagulability.
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Okrainec, Karen. "Cardiac medical therapy following coronary artery bypass graft surgery." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80344.
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Despite the benefits of coronary artery bypass graft surgery (CABG), graft closure can still occur and lead to the development of unstable angina, myocardial infarction (MI) and death. Secondary prevention is thus greatly needed in order to prevent future cardiovascular events in the post-CABG patient. Few studies have examined the benefits of cardiac medical therapy specifically among CABG patients. A review of randomized controlled trials (RCT's) was first conducted in order to understand what constitutes appropriate cardiac medical therapy in the post-CABG patient.<br>The use of aspirin, clopidogrel, coumadin, anti-lipid agents, anti-ischemic medications (beta-blockers, CCB's, nitrates) and ACE inhibitors was then examined among patients enrolled in the Routine versus Selective Exercise Treadmill Testing After Coronary Artery Bypass Graft Surgery (ROSETTA-CABG) Study. We examined the use of these medications among all patients as well as patients with various co-morbidities.
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Pettersson, Nils, and Gabriella Johnsson. "Riskfaktorer för postoperativa sårinfektioner efter Coronary Artery Bypass Graft." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-225259.
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Bakgrund: Postoperativa sårinfektioner [PSI] är en allvarlig komplikation och ett hälsoproblem som orsakar lidande för patienten. Såsom vid alla operativa ingrepp förekommer en risk att få PSI i operationssåret/-såren efter Coronary Artery Bypass Graft [CABG], men det finns redan en rad kända riskfaktorer som ökar risken för PSI. Syfte och metod: Syftet med rapporten var att undersöka om kombinationen av ett antal sedan tidigare kända riskfaktorer ökade risken för PSI efter CABG på ett mellansvenskt sjukhus åren 2009-2012. En retrospektiv journalgranskningsstudie med totalt 228 patienter genomfördes. Resultat: Av 228 undersökta hade totalt 50 patienter rapporterat sårinfektion och 73 patienter hade ≥ 3 riskfaktorer. Bland de som hade ≥ 3 riskfaktorer rapporterade 32,9% PSI och bland de som hade < 3 riskfaktorer rapporterade 16,8% PSI. Risken att få PSI efter CABG-kirurgi är nästan dubbelt så stor (RR=1,960) hos patienter med ≥ 3 riskfaktorer jämfört med patienter med < 3 riskfaktorer (X2=7,516 df=1 p=0,006). Slutsats: Det finns en signifikant högre risk för PSI efter CABG vid förekomst av tre eller fler än tre patientrelaterade riskfaktorer jämfört med färre än tre riskfaktorer. Fler, större studier av detta slag efterfrågas då denna rapport kan ge en fingervisning om hur situationen föreligger på ett mellansvenskt sjukhus.<br>Objective: Postoperative surgery site infections [SSI] is not only a severe complication but a health problem which often cause suffering and prolonged hospitalization among afflicted patients. As with all surgical procedures, a coronary artery bypass graft [CABG] always implicates a risk for SSI and a number of risk factors have to be taken into account when dealing with it. The objective of this report is to investigate if a combination of several patient-related risk factors implicates greater risk of getting SSI after CABG. Method: A quantitative retrospective journal review of 228 patients who completed a CABG between 2009-2012 was performed on a university hospital in central Sweden. Result: Among 228 patients a total of 50 reported SSI and 73 patients had ≥ 3 patient-related risk factors. Among those who had ≥ 3 risk factors 32.9% reported SSI and among those who had < 3 risk factors 16.8% reported SSI. The risk of getting SSI after CABG is almost twice as high (RR = 1.960) in patients with ≥ 3 risk factors compared to patients with < 3 risk factors (X2 = 7.516 df = 1 p = 0.006). Conclusion: There is a significantly higher risk of getting SSI after CABG in the presence of three or more than three patient-related risk factors, compared with fewer than three risk factors. More, larger studies of this kind are in demand since this report provides an indication of how the situation may prevail on a central Swedish university hospital.
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Strickler, Amy Ann. "Functional Capacity Outcomes following Coronary Artery Bypass Graft Surgery." Thesis, Virginia Tech, 1998. http://hdl.handle.net/10919/36680.
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The objective of this study was to determine if this is possible to predict 3 mo post-CABG treadmill VO2pk outcomes from a combination of pre-surgical physical fitness and health and clinical status variables. To determine the VO2pk, subjects performed a maximal treadmill test using a ramp protocol and gas analysis. When all pre-surgical variables where included in a multiple linear regression, the analysis yielded a model that included the prior to surgery VSAQ, orthopedic limitations, and angiotensin converting enzymes (ACE) inhibitor drugs as significant predictors (R2 = 0.50, N = 63). When an RER of 1.1 was achieved during the treadmill test, myocardial infarction (MI) and if so, the length of time lapse from the MI, chronic heart failure, lipid lowering drugs, BMI, ACE inhibitor drugs, and orthopedic limitations (R2 = 0.56, N =29) were significant predictors. The data suggest that there is some relationship between post-surgical outcomes and pre-surgical physical fitness.<br>Master of Science
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Krijne, Ruud. "Use of the internal mammary artery as a coronary artery bypass graft." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1994. http://arno.unimaas.nl/show.cgi?fid=6957.
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Yogaratnam, Jeysen Zivan. "The effects of preconditioning coronary artery disease patients with hyperbaric oxygen prior to coronary artery bypass graft surgery & cardiopulmonary bypass." Thesis, University of Hull, 2011. http://hydra.hull.ac.uk/resources/hull:4803.
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IntroductionCoronary artery bypass graft (CABG) is associated with periods of ischaemia and reperfusion, which may lead to myocardial dysfunction. In clinical studies, hyperbaric oxygen (HBO2) treatment following an acute myocardial infarction (AMI), has been shown to limit myocardial injury and improve myocardial function. The primary efficacy objective of this study was to determine if systemically preconditioning coronary artery disease (CAD) patients with HBO2, prior to first time elective on cardiopulmonary bypass (CPB) CABG surgery, leads to a remote preconditioning like effect that is capable of improving myocardial function following CABG. The main secondary objectives of this study were to assess the safety of HBO2 preconditioning and, its effects on myocardial injury and post operative intensive care unit (ICU) length of stay. The exploratory secondary objectives were to assess the effects of HBO2 preconditioning on surrogate serum biomarkers of endothelial and neutrophilic adhesiveness and, myocardial biomarkers of cardioprotection. Methods In this single centre, randomised control study, 81 patients, who were having first time elective on CPB CABG surgery, were recruited. 40 were randomised to the Control Group and 41 to the HBO2 Group. Treatment with HBO2 preconditioning was completed approximately 2 hours prior to CPB and consisted of two 30 minute sessions of 100% oxygen at 2.4 atmospheres (ATA) separated 5 minutes apart. Efficacy was measured by determining peri-operative haemodynamic measurements using a pulmonary artery (PA) catheter. Safety was measured by collecting peri-operative data on myocardial injury and adverse events (AEs) and, post operative days spent in ICU. Using collected peri-operative venous blood, myocardial injury was determined by measuring the concentration of serum Troponin-T. In these same venous blood samples, endothelial and neutrophilic adhesiveness was indirectly assessed by measuring the concentrations of sE-selectin, sP-Selectin and sICAM-1 and, sPSGL-1, respectively. Using intra-operative right atrial biopsies, the degree of cardioprotection provided by HBO2 preconditioning was determined by measuring the quantity of myocardial eNOS and Hsp72. Analysis of the serum and myocardial biomarkers were done by ELISA.Results Compared to the Control Group, the HBO2 Group demonstrated a significant improvement in left venticular stroke work (LVSW) 24 hours post CPB (p=0.005). While there were no significant safety findings, there were fewer cardiovascular, pulmonary, renal and neurological AEs in the HBO2 Group. This group also had a significantly shorter post operative ICU length of stay. 1 hour post HBO2 preconditioning, the concentration of sPSGL-1 increased significantly in the HBO2 Group. At all time points, the peri-oprative concentration of sPSGL-1 was higher in the HBO2 Group but none of the changes were significant. The latter was also the case for the peri-operative concentration of sP-Selectin, apart from following the period of ischaemic and reperfusion, when it was lower in the HBO2 Group. Intra-operatively, the concentration of sE-Selectin increased significantly in the HBO2 Group and was higher in this group throughout the peri-operative period. During this intra-operative period also, the concentration of sICAM-1 was higher in the HBO2 Group and the increase was particularly significant following the period of ischaemia and reperfusion. 24 hours post CPB, the concentrations of all the serum soluble adhesion molecules were higher in the HBO2 Group. No significant differences were observed between the groups with respect to the concentrations of serum Troponin-T and, the quantity of myocardial eNOS and Hsp72. However, in the HBO2 Group, the peri-operative concentrations of serum Tropinin-T, eNOS and Hsp72 were lower. Furthermore, while there was a pre-CPB reduction of both eNOS and Hsp72, following ischaemia and reperfusion, the quantity of both these myocardial biomarkers were increased. Conclusion From this study, it can be concluded that HBO2 preconditioning of patients with CAD prior to on CPB CABG, is capable of improving myocardial function 24 hours post CABG. Additionally, the data suggest that this may also be a safe modality of treatment as it did not lead to significant post operative AEs, limited peri-operative myocardial injury and reduced post operative ICU length of stay. It also led to increased post operative concentrations of the measured surrogate biomarkers of endothelial and neutrophilic adhesiveness, with a number of significant peri-operative changes. Finally, while HBO2 treatment did not lead to significant changes in the myocardial biomarkers of cardioprotection, the quantities of these increased in the HBO2 Group following ischaemia and reperfusion, suggesting that it may be capable of inducing endogenous cardioprotection following ischaemia and reperfusion.
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Dubyts, Deanna Christine. "The experience of waiting for coronary artery bypass graft surgery." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/27716.
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The purpose of this study W8S to explore and describe the experience of waiting for coronary artery bypass graft (CABG) surgery from the perspective of the individual who h8s a prolonged wait for this surgery. A phenomenological approach was used to guide the study. Data were collected through 17 semi-structured, audio-taped interviews with 7 men and 2 women awaiting CABG surgery. Analysis occurred concurrently with data collection. It was found that there were three interrelated core facets of the experience: the illness, the prospective surgery, and the wait. Each facet held distinct meaning: the illness represented a loss of normalcy and a threat to life; the surgery, both an opportunity to regain normalcy and a threat; and the wait, a "no control" situation which enhanced the losses and threats of the other facets, engendered further losses, and delayed the expected gain from surgery. Within each facet, representative emotional reactions, and coping strategies were identified. The findings indicate that these clients require regular contact and that nursing care must address all three facets of the experience.<br>Applied Science, Faculty of<br>Nursing, School of<br>Graduate
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Al-Ruzzeh, Sharif Mohamed Hasan Khalaf. "Outcome of coronary artery bypass graft surgery with and without cardio-pulmonary bypass." Thesis, Imperial College London, 2003. http://hdl.handle.net/10044/1/8394.
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Poon, Chui-yuk Mabel, and 潘翠玉. "The patients lived experiences after coronary artery bypass graft surgery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45011692.
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Springer, Karen L. "Perceptions of learning needs of coronary artery bypass graft patients." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036191.
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With the decreasing length of hospitalization for the Coronary Artery Bypass Graft (CABG) patient population, it is becoming increasingly difficult to provide patients with necessary education. The purpose of this study was to examine patients' perceptions of the importance of patient teaching information, and how realistic they perceive it is to learn the information following CABG surgery. Patients' learning and understanding are increased when the information is perceived as important.The findings of this study indicated that CABG patients rated the areas of medication, diet and activity information as the most important to learn during the early recovery period. The patients indicated that it was less realistic to learn in the areas of anatomy and physiology, risk factors, medications, diet, activity, post surgical care, psychological factors, and other pertinent information during the early recovery period. The information gained from this study could be used to enhance educational content for patients who have undertaken CABG surgeries.<br>School of Nursing
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Shaw, P. J. "Neurological and neurophysiological complications of coronary artery bypass graft surgery." Thesis, University of Newcastle Upon Tyne, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380746.
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Strid, Fredrika, and Josefine Thorsén. "Patientrelaterade riskfaktorer för postoperativ sårinfektion efter Coronary Artery Bypass Graft - CABG." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-225415.
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Introduction Postoperative wound infections leads to increased patient suffering and cost society money because it leads to longer hospital stays. Previous research shows that patient related risk factors such as smoking, diabetes, Chronic Obstructive Pulmonary Disease (COPD), advanced age (>65 years) a low preoperative hemoglobin level (<140g/L) and a high BMI (> 30) increases the risk of suffering a postoperative wound infection. Aim To investigate whether patients that underwent surgery with Coronary artery Bypass Graft (CABG) in a university hospital in central Sweden in 2013 and had any of these risk factors more often suffer from post-operative wound infection. Method The study has a descriptive design and is based on an ongoing infection registration area of operations. The study included 148 patients out of 255 (58%) undergoing CABG in 2013. Possible risk factors were collected through medical record review. Results There was no significant correlation between surgical wound infection and patient-related risk factors such as smoking (not quit smoking four weeks before surgery), diabetes, COPD, advanced age (>65 years), low preoperative hemoglobin (<140g/L) or a high BMI (>30) and suffered a postoperative wound infection. Conclusion More research and a larger sample is needed in the field to produce a reliable result could be presented.<br>Bakgrund Postoperativa sårinfektioner ger ett ökat lidande för patienten och kostar samhället pengar då det leder till längre vårdtider. Tidigare forskning visar att patientrelaterade riskfaktorer som rökning, diabetes, kronisk obstruktiv lungsjukdom (KOL), hög ålder (>65år) ett lågt preoperativt hemoglobinvärde (<140g/L) och ett högt BMI (>30) ökar risken för att drabbas av postoperativ sårinfektion. Syfte Att undersöka huruvida patienter som operatats med Coronary Artery Bypass Graft (CABG) på ett universitetssjukhus i Mellansverige under 2013 och hade någon av dessa riskfaktorer och om de i högre utsträckning drabbas av postoperativ sårinfektion. Metod Studien har en deskriptiv design och utgår från en fortgående infektionsregistrering på verksamhetsområdet. I studien ingick 148 patienter av 255 (58%) som genomgått CABG under 2013. Eventuella riskfaktorer samlades in genom journalgranskning. Resultat Det fanns inget samband mellan postoperativ sårinfektion och patientrelaterade riskfaktorer som rökning (ej slutat röka fyra veckor innan operation), diabetes, KOL, hög ålder (>65 år), lågt preoperativt hemoglobinvärde (<140 g/L) eller ett högt BMI (>30) och att drabbats av en postoperativ sårinfektion. Slutsats Mer forskning och större urval behövs inom området för att ett tillförlitligt resultat ska kunna presenteras.
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Theobald, Karen. "Influences on Post-Discharge Recovery Following Coronary Artery Bypass Graft Surgery." Thesis, Griffith University, 2001. http://hdl.handle.net/10072/367398.
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Many things change following Coronary Artery Bypass Graft (CABG) surgery for both the patient and his/her carer. The major aim of this research was to provide an indepth examination of these changes to investigate influences on recovery. The study was devised on the premise that this information would provide a significant basis for hospital discharge planning.
A qualitative research approach, naturalistic inquiry, guided the study. Sixty people were interviewed, including thirty patients and their carers. Interviews were undertaken four to five weeks following discharge from hospital after CABG surgery. Subsequently, twelve months after the initial interview, patients and carers were again contacted to verify the findings generated from the first phase of the study, and to gain further data on his/her current health status.
Data analysis revealed a number of maj or themes and sub themes for patients and carers. Almost half the patients stated that heart surgery was a huge personal shock. Adjusting to life after surgery was difficult, and patients experienced some form of physical pain or change. An unexpected finding was the extent to which many of the patients were attuned to their post-operative physical adjustments. They spoke of mental and emotional changes as well as concerns over the financial burden of the surgery. Coming to terms with lifestyle adjustments and worrying about the future were other themes that emerged in patients’ accounts. They offered suggestions to improve support services, like establishing a twenty-four hour telephone chat line and forming community clubs to link up with other patients. In assisting to better prepare for discharge home, they suggested providing more information about what to expect during recovery, like the up and down days that they might experience.
Carers experienced a separate set of issues/needs and concerns as they came to terms with their loved one’s cardiac surgical recovery. The major findings for carers fell under four major themes, Events Surrounding Another’s Heart Surgery; Adjusting to the Surgery; Personal Changes Due to Surgery and Discovering Pathways to Recovery. Carers were shocked with the news that a family member required urgent cardiac surgery and theft reactions suggested a sequence of experiences that encountered in coming to terms with the event. Carers adjusted to the situation by taking on the role of watcher or minder and monitored the patient’s recovery. Some of the personal changes that carers dealt with, were changes in their activities and responsibilities; tiredness; experiencing a range of emotions and wonying about the unknown. Carers also offered suggestions for improved support services, like identifying a range of community services in close locality to his/her home. In better preparing for discharge home, some carers wanted more assistance and advice on how to be an effective carer.
This research study provides unique insights into the experiences of patients and carers after coronary bypass graft surgery in the first four to five weeks following discharge home from hospital. The study outlines the issues/concerns and needs of CABG patients and their carers after they leave hospital, highlighting those related to age, gender, and family support. For example, many patients commented that they were too young for this to occur. Gender differences included, that the majority of carers were females and male patients reported experiencing more pain following cardiac surgery. Family support was a critical factor in enhancing recovery. Study findings suggest the need for a re-examination of hospital discharge preparation and the further provision and monitoring of home support services.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School of Nursing<br>Full Text
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Mussa, Mohamedshafi Yakub. "The radial artery as a coronary artery bypass graft : studies to reduce peri-operative vasospasm." Thesis, University of Cambridge, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611084.
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MacGinley, Robert. "Granulation tissue as a vascular graft /." [St. Lucia, Qld.], 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16819.pdf.
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Goudie, Beth Ann. "The transition from hospital to home following coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22742.pdf.
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Annapoorna, Mary. "Cardiopulmonary predicators of dysfunctional ventilator weaning response after coronary artery bypass Graft." View the abstract Download the full-text PDF version, 2007. http://etd.utmem.edu/ABSTRACTS/2007-017-annapoorna-index.html.
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Thesis (Ph.D.)--University of Tennessee Health Science Center, 2007.<br>Title from title page screen (viewed on July 18, 2008). Research advisor: Dr. Carol Lynn Thompson, PhD. Document formatted into pages (xiv,151 p. : ill.). Vita. Abstract. Includes bibliographical references (p. 132-144).
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de, Mel A. "Bio-functionalisation of a nanocomposite based coronary artery bypass graft : conferring heamocompatibility." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1335720/.
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Coronary artery bypass surgery is a life saving surgical solution for patients presented with greater than 70% occluded or stenosed arteries. For these patients, autologous vein is the graft of choice. Alarmingly, 5-30% of patients have no suitable veins available due to previous use or diseased vein wall, thus the critical clinical need for nonthrombogenic vascular grafts is underscored. Our group has synthesised and patented a nanocomposite polymer based on polyhedral oligomeric silsesquioxane modified polycarbonate urea-urethane (POSS-PCU) nanocomposite polymer. The polymer was extruded using coagulation technique to match mechanical properties of a native artery. Optimising the interactions with blood on the graft surface is of keen interest. Endothelialisation is a favourable solution for enhancing antithrombogenic properties. The protective effect of the endothelium is recognised to be governed by nitric oxide (NO). A graft designed for in-situ endothelialisation will have an interval, where it will be prone to platelet adhesion before complete endothelialisation. Therefore it is desirable to induce antithrombogenic properties during this initial period and the induction of NO is desirable. In this study, current research on biofunctionalisation of biomaterials to enhance antithrombogenic properties by inducing in-situ endothelialisation and NO release were reviewed. The possibility of biofunctionalisation of POSS-PCU polymer whilst retaining its original polymer chemistry was investigated by using amine functionalised nanoparticles including POSS and fumed silica to anchor bioactive peptides (RGD) and amino acids (larginine). The antithrombogenic properties of the biofunctionalised polymer were demonstrated to be due to NO release and endothelialisation. The biofunctionalised polymer was exposed to whole blood, endothelial progenitor cells and platelets. Overall this study presents a novel method of biofunctionalising vascular bypass grafts to induce endothelialisation as tested in a bioreactor and also a means of exploiting the possibility of adhesion of platelets to induce NO synthesis. Overall I aimed to look into methods of functionalising graft surface to induce nitric oxide synthesis when the graft is implanted and is in contact with blood.
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Banner, Davina Jayne. "Women's experiences of coronary artery bypass graft surgery : a grounded theory approach." Thesis, University of the West of England, Bristol, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.438783.
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Coronary heart disease (CHD) is the leading cause of morbidity and mortality for both sexes in the United Kingdom Traditionally, CHD has been viewed as a disease primarily affecting /Ten with women being largely overlooked in the media, health educatbn campaigns and clinical research. Healthcare services came to reflect the generalisations formulated from studies of white middle class ruales. Consequently, inequalities exist in the recognition, diagnosis end treatment of CHD in women. Despite a growing body of literature e<ploring gender differences in CHD and coronary artery bypass graft (CABG) surgery, awareness of women's unique experiences renlains poor. This study explored the experiences of women undergoing CABG surgery. Data were collected from 30 women preoperatively and at six weeks and six months postoperatively using in-depth semi-structured interviews. Data were contextualised through informal observations, theoretical memo analysis and the collection of basic and clinical demographic data. A constructivist grounded theory approach was adopted and data were analysed using extensive coding and constant comparison techniques. A SUbstantive theory of the public-private dialogue of normality emerged. The findings demonstrated that women faced significant disruption of normality as they attempted to privately normalise and integrate limitations, whilst minimising the public display of illness and vulnerability. The preoperative data revealed that women experienced difficulties recognising and acting on symptoms of CHD and endured significant stress whilst waiting for CABG surgery. FolloVNing surgery, they experienced significant functional limitations that forced them to relinquish normal activities and roles. As recovery progressed, women came to accept their changed health status and renegotiate normality.
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GIANNICOLA, GAIA. "COMPARISON OF TWO DISPERSION ARTERIAL CANNULAS IN CORONARY ARTERY BYPASS GRAFT SURGERY." Doctoral thesis, Università degli Studi di Milano, 2017. http://hdl.handle.net/2434/488200.
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Nonostante gli elevati progressi nelle macchine cuore-polmone e l'introduzione di nuove tecnologie, le complicanze neurologiche e le disfunzioni cognitive nei pazienti sottoposti a chirurgia di bypass aorto-coronarico (coronary artery bypass graft, CABG) con bypass cardiopolmonare (cardiopulmonary bypass, CPB) sono ancora molto frequenti. L’elevato carico embolico cerebrale durante gli interventi di CABG risulta essere l'ipotesi principale per la manifestazione di tali eventi. I fenomeni microembolici correlano con le caratteristiche e le comorbidità dei pazienti, con il sito di cannulazione arteriosa e con il design della punta della cannula arteriosa. In particolare, la tipologia di cannula utilizzata durante l’intervento influenza l’erogazione del flusso sanguigno che, se colpisce in modo non fisiologico la parete aortica, potrebbe immettere placche aterosclerotiche presenti sulla parete nel circolo sanguigno e danneggiare l'endotelio nella zona in cui il flusso colpisce la parete aortica. Per evitare tali effetti, la cannula arteriosa deve principalmente erogare elevata portata garantendo bassa pressione. Le cannule a dispersione di flusso sono state progettate con l’obiettivo di garantire queste condizioni. In numerosi studi in vitro sono state analizzate le caratteristiche di diverse cannule a dispersione di flusso e sono stati ampiamente riportati i deficit neurologici e cognitivi dopo interventi di CABG, ma nessuno ha studiato le prestazioni di cannule a dispersione di flusso in vivo e gli effetti sugli outcome neurologici e cognitivi dopo interventi di CABG.
Questo progetto si propone di valutare le prestazioni di due cannule arteriose a dispersione di flusso, Optiflow (Sorin Group Italia S.r.l., Italia) e EZ Glide (Edwards Lifesciences LLC, USA), in vivo e di studiare eventuali complicanze neurologiche e disfunzioni cognitive dopo intervento di CABG valutando possibili correlazioni con gli eventi microembolici registrati durante l’intervento. Per raggiungere questo obiettivo è stato disegnato uno studio prospettico, randomizzato (1:1), non in cieco e monocentrico. Una coorte di 23 pazienti (gruppo Optiflow N=11; gruppo EZ Glide N=12) è stata arruolata nello studio. Inizialmente, sono state valutate le prestazioni delle due cannule durante intervento di CABG in termini di emodinamica e perfusione, ed indagato possibili effetti emolitici. Sono stati successivamente analizzati gli eventi microembolici registrati durante la chirurgia e le possibili complicanze neurologiche e disfunzioni cognitive dopo CABG riportando gli eventi cardiovascolari e neurologici raccolti dopo l’intervento chirurgico e le valutazioni cognitive a tre mesi di follow-up. Infine, sono state valutate possibili correlazioni tra gli outcome cognitivi a tre mesi ed il numero di eventi microembolici registrati durante l'intervento chirurgico.
I risultati hanno suggerito che la cannula Optiflow potrebbe garantire una migliore perfusione periferica in quanto sono state osservate basse pressioni della cannula anche durante elevate portate. Questa osservazione potrebbe suggerire una riduzione del rischio di possibili danni all’endotelio nella zona in cui il flusso colpisce la parete aortica e del rischio di immissione di placche aterosclerotiche nel circolo sanguigno. I risultati mostrano che la pressione della cannula Optiflow è influenzata solo da variazioni della pressione sanguigna dei pazienti, regolabile durante l'intervento chirurgico, e non dalla portata, mentre la pressione della cannula EZ Glide è influenzata solo da cambiamenti nella portata; in quest’ultimo caso, non possiamo escludere eventuali complicanze legate alle elevate pressioni della cannula generate per garantire una ottimale perfusione periferica. Nessuna differenza tra i due gruppi di studio è emersa sugli effetti emolitici. L’analisi degli eventi microembolici registrati tra la fase di cannulazione aortica e la decannulazione, non ha mostrato alcuna differenza tra i due gruppi di studio, ma il numero di eventi è risultato maggiore durante specifiche fasi chirurgiche come la cannulazione, l’inizio della CPB e la rimozione del clamp aortico. Nonostante sia stato registrato un numero di eventi microembolici elevato durante tali fasi chirurgiche, nessuno dei pazienti ha sviluppato complicanze neurologiche o disfunzioni cognitive fino a tre mesi dopo l'intervento chirurgico. I dati psicologici e neuropsicologici non hanno evidenziato differenze tra i due gruppi di studio; inoltre le perfomance cognitive dei singoli pazienti, non hanno mostrato deficit o peggioramenti tre mesi dopo l'intervento chirurgico. Infine, l’analisi sulla possibile correlazione tra i dati di ciascun test neuropsicologico e gli eventi microembolici non ha mostrato alcun risultato significativo.
Questo studio pilota ha evidenziato che entrambe le cannule arteriose a dispersione di flusso, Optiflow e EZ Glide, hanno ottime prestazioni e non correlano con complicanze neurologiche o disfunzioni cognitive dopo interventi di CABG. Sebbene la cannula Optiflow prometta di garantire prestazioni superiori alla cannula EZ Glide, sono necessari ulteriori studi per confermare i nostri risultati preliminari.<br>Neurological complications and cognitive dysfunctions in patients undergoing coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) remain common outcomes despite CPB machines advances and introduction of new technologies. Cerebral embolic load during CABG surgery is the main hypothesis for occurrence of those events. Embolization strongly relates to patients’ characteristics and comorbidities, arterial cannulation site and tip shape of the arterial cannula. Based on cannula tip shape used during surgery, the jet stream of arterial tip cannula differently affects atherosclerotic plaques and could also damage endothelium in the area where the cannula jet hits the aortic wall. Desired features of arterial cannulas, to prevent those effects, are mainly high flow with low pressure. Dispersion cannulas were designed to achieve those features. Studies described dispersion cannulas performances in vitro and neurological and cognitive outcomes after CABG, but none compared dispersion flow arterial cannulas performances in vivo and their effects on neurological and cognitive outcomes after CABG.
This project aims to evaluate performances of two dispersion flow arterial cannulas, Optiflow (Sorin Group Italia S.r.l., Italy) and EZ Glide (Edwards Lifesciences LLC, USA), in vivo and to study any neurological complications and cognitive dysfunctions after CABG surgery seeking any possible correlations with microembolic events. To do so, we designed a prospective, randomized (1:1), non-blinded, monocentric study. A cohort of 23 patients (Optiflow group N=11; EZ Glide group N=12) was enrolled. First, we analyzed cannulas performances during CABG surgery in terms of hemodynamic and perfusion and investigated possible hemolytic effect. We analyzed microembolic events recorded during surgery and possible neurological complications and cognitive dysfunctions after CABG both monitoring any cardiovascular and neurological events occurred after surgery and cognitive assessments at three-month follow-up visit. Finally, we sought for any possible correlation between cognitive outcomes assessed at three-month follow-up visit and number of microembolic events recorded during surgery.
Results suggested that Optiflow cannula could guarantee a better peripheral perfusion because low cannula pressures were observed during the full procedure and even during high flow rates. This observation could imply reduced risk of possible endothelium damages in the area in which the cannula jet hits the aortic wall and reduced risk of atherosclerotic plaques dislodgement. Indeed, results showed that Optiflow cannula pressure is only influenced by changes in patients’ blood pressure, that could be adapted during surgery, and not by flow rate, whereas EZ Glide cannula performance is only influenced by changes in flow rate; hence, for EZ Glide cannula, in the attempt of reaching optimal perfusion we cannot exclude possible complications due to high cannula pressure induced by high flow rates. No differences on hemolytic effects were found. When we studied the microembolic events recorded from aortic cannulation to decannulation phase, we found no differences between the two study groups, but in general the number of events was higher during specific ‘surgical events’ such cannulation, CPB onset and aortic cross clamp removal. Despite a higher number of microembolic events recorded during those 'surgical events', none of the patients had neurological complications or cognitive dysfunctions up to three months after surgery. Psychological and neuropsychological data showed no differences between the two study groups; when the analysis focused on single patient behavior, no deficit or worsening were observed at three-month follow-up visit compared to baseline. Finally, when we tested whether neuropsychological outcomes correlated with microembolic events we found no correlation.
This pilot study showed that both Optiflow and EZ Glide dispersion flow arterial cannulas have good performances and do not correlate with any neurological complications or cognitive dysfunctions after CABG surgery. Although the Optiflow cannula promises to guarantee higher performances than EZ Glide, future studies are needed to confirm our preliminary results.
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Brugård, Maria, and Peter Lindbergh. "Personalens följsamhet till riktlinjer avseende glukoskontroll postoperativt efter Coronary Artery Bypass Graft (CABG)." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-103896.
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<p> </p><p>The aim of the study was auditing medical records examine postoperative blood glucose levels after undergoing CABG surgery. Furthermore the aim was to determine if the ward staff abides the local guidelines frame of reference concerning each ward, regarding blood glucose measurements and blood glucose levels. The study included 70 patients undergoing CABG surgery at the cardiothoracic surgery, Uppsala University Hospital. The study was conducted by retrospective medical record auditing. Studied factors were postoperative blood glucose levels, number of registered blood glucose measurements, a current diagnosis of DM and preoperative HbA<sub>1c</sub>. Mean level of blood glucose levels stayed continuously above the local guidelines frame of reference for both TIVA/TIMA and the care ward throughout the continuity of patient care. The number of registered blood glucose measurements per postoperative day at TIVA/TIMA where within the local guidelines. The result showed that the local guidelines frame of reference concerning the ward were not reached. A difference could be seen between patients with DM and patients without DM regarding the previously mentioned factors. Preoperative elevated levels of HbA<sub>1c</sub> could have influenced the number of postoperative blood glucose measurements. Recommendations will therefore be too audit the current local guideline that concerns the treatment, therapy goals and the number of blood glucose measurements. Establishing criterions regarding termination of blood glucose measurements and the transfer day between TIVA/TIMA and the care ward are recommended.</p><p> </p>
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Valentine, Sarah, and n/a. "Neuropsychological functioning of patients before and after undergoing coronary artery bypass graft surgery." University of Otago. Dunedin School of Medicine, 2007. http://adt.otago.ac.nz./public/adt-NZDU20070803.140127.
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Cardiovascular disease (CVD) affects millions of people worldwide. Many of these people require treatment for their condition, and for roughly a million individuals each year, this treatment includes coronary artery bypass graft (CABG) surgery - a procedure that aims to restore proper blood flow to the arteries of the heart. Although the physical impact of CVD and CABG surgery are well-known, their cognitive impact has not been clearly established. Recent studies suggest that both CVD and CABG surgery may have a detrimental effect on neuropsychological functioning. The first goal of the present study was to cognitively assess patients with severe, chronic CVD to determine the association of heart disease with neuroopsychological functioning. The second goal was to then continue monitoring these patients once they had undergone CABG surgery to establish what cogntive effect this treatment has.
CABG surgery has traditionally been performed with the aid of a cardiopulmonary bypass (CPB) machine, but in the past decade, another technique, in which the heart remains beating, has been developed. Some have argued that this beating heart surgery (BHS) may be a superior alternative to the CPB procedure. Consequently, the third goal of the present study was to compare outcomes in patients undergoing these two surgical procedures.
The present study had a prospective, double blind design. Patients were randomly assigned to either CPB surgery (CPBS) or BHS. Sixty-three patients were recruited and underwent a comprehensive neuropsychological assessment preoperatively and 6 days, 6 weeks and 30 weeks postoperatively.
Despite including a higher risk group than previous comparative studies, there were virtually no differences between the CPBS and BHS groups. When the groups were combined and the sample was examined as a whole, the patients were cognitively impaired even before their surgery. Given that their premorbid abilities were estimated to be in the average range, their pre-surgery deficits were likely to be the result of a long-standing history of CVD.
Immediately after surgery (Day 6), the neuropsychological performance of the sample decreased further, but they had significantly improved by Week 6 and this improvement increased further by the Week 30 time-point (with many scores in the average range). This postoperative recovery suggests that the decline these patients exhibit preoperatively may be reversible and that rather than causing cognitive deficits, CABG surgery may ultimately improve both cardiac and cognitive health.
Psychologically, patients in the present sample reported the highest level of anxious and depressive symptoms, and the lowest quality of life, pre-surgically, but their psychological health gradually improved over the course of the postoperative period. Compared to other samples, however, the present sample were generally psychologically healthy.
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Adderley, Natasha Lorraine. "Intrathecal morphine for analgesia following coronary artery bypass graft surgery, a pilot study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0024/MQ36388.pdf.
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Wiggins, Matthew Corbin. "Bayesian based risk stratification of atrial fibrillation in coronary artery bypass graft patients." Diss., Atlanta, Ga. : Georgia Institute of Technology, 2007. http://hdl.handle.net/1853/24775.
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Thesis (Ph.D.)--Bioengineering, Georgia Institute of Technology, 2007.<br>Committee Co-Chair: Litt, Brian; Committee Co-Chair: Vachtsevanos, George; Committee Member: Butera, Robert; Committee Member: Frazier, Bruno; Committee Member: Gerstenfeld, Edward; Committee Member: Hunt, William.
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Lester, Arnette Sandland 1952. "Orthostatic blood pressure and heart rate responses after coronary artery bypass graft surgery." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277795.
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A quasi-experimental study was conducted to compare preoperative and postoperative postural responses to position change. A convenience sample of 30 men and women admitted for elective coronary artery bypass graft (CABG) surgery performed supine to sitting and supine to standing position changes prior to surgery and on postoperative day two or three. An ANOVA with repeated measures compared the responses of systolic blood pressure, diastolic blood pressure and heart rate. Systolic blood pressure exhibited a significant change from preoperative to postoperative measurements. Diastolic blood pressure remained the same; heart rate changed over time, but no significant preoperative to postoperative changes occurred. Comparison of normotensive and hypertensive subjects revealed reduced postoperative responsiveness in the hypertensive subjects for systolic blood pressure and heart rate. Nurses caring for postoperative CABG patients should anticipate a reduction in blood pressure and an increase in heart rate upon standing.
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Eriksson, Frida, and Jessica Kalmér. "Ett lagat hjärta : Ett spektrum av patientupplevelser tiden efter en Coronary artery bypass graft." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-32976.
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Coronary artery bypass graft (CABG) är en väl etablerad behandling för patienter med kranskärlssjukdom. Operationen är utmanande och påfrestande för patienten och upplevelserna efter genomgången operation är varierade. Att som sjuksköterska ha kännedom om patienters upplevelser tiden efter operationen är av betydelse för att möjliggöra god omvårdnad och återhämtning för patienten. Syftet var att belysa patienters upplevelser tiden efter en CABG. Studien grundades på 11 vetenskapliga artiklar och genomfördes som en litteraturstudie. Fyra teman framkom i resultatet; den relationella upplevelsen, den kroppsliga upplevelsen, den mentala skörheten och en ny syn på livet. Det framkom att patienterna upplevde stödet från omgivningen som det viktigaste för god återhämtning. Information från vårdpersonalen ansågs till viss del bristfällig av patienterna. Flera upplevde smärta efter operationen och hade delvis symtom kvar, men dessa avtog med tiden. Centralt efter operationen var även oro, men med tiden kom förbättrad livskvalitet och motivation. Det framkom att en CABG var en stor påfrestning för patienten och upplevelserna var både positiva och negativa. Kunskapsluckor avseende patientupplevelser efter operationen finns och ytterligare forskning bör fokusera på området för att ge sjuksköterskestudenter och sjuksköterskor ökad kunskap i mötet med denna patientgrupp.<br>Coronary artery bypass graft (CABG) is a well-established treatment for patients with coronary artery disease. The surgery is challenging and stressful for the patient and experiences varied after surgery. It’s important for the nurse to be aware of patients’ experiences after surgery to enable good care and recovery for the patient. The aim was to illuminate patients’ experiences during the time after a CABG. The study was based on 11 scientific articles and was conducted as a literature review. Four themes emerged; the relational experience, the bodily experience, the mental fragility and a new view on life. The result showed that patients' experienced the support from the surroundings as the most important for good recovery. Information given by caregivers were in some cases considered inadequate by the patients. Patients experienced pain after surgery and had partial symptoms left, which subsided with time. Concern was a central experience after surgery, but over time came improved quality of life and motivation. A CABG is a major strain for the patients and the experiences were both positive and negative. There are gaps in knowledge regarding patient experiences after the surgery and further research should focus on that area to give nursing students and nurses knowledge in the meeting with these patients.
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Hirschhorn, Andrew David. "Coronary Artery Bypass Graft Surgery: Exercise Testing and Prescription in the Acute Perioperative Phase." Thesis, Griffith University, 2011. http://hdl.handle.net/10072/367852.
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The general aim of the research presented in this thesis was to investigate the
impact of Phase I (in-hospital) physiotherapy intervention on the restoration of
functional capacity after coronary artery bypass graft surgery (CABG).<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School of Physiotherapy and Exercise Science<br>Griffith Health<br>Full Text
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Ghahramani, Melody. "Simultaneous modelling of long- and short-term survival after coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0018/MQ37536.pdf.
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Alhashemi, Jamal A. "Effect of subarachnoid morphine administration on extubation time following coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ39800.pdf.
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Chiang, Yin-Jung Helen. "The short-term effects of coronary artery bypass graft (CABG) surgery on cognitive performance." Master's thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/10246.
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Includes bibliographical references (leaves 63-74).<br>Considerable research evidence suggests that post-operative cognitive impairment is a common complication of coronary artery bypass graft (CABG) surgery. This study evaluated the short-term effects of CABG surgery on cognitive performance one to two days prior to surgery (baseline) and one-month post-surgery (follow up). 40 CABG surgical patients and 40 healthy, nonsurgical control participants were assessed with a standard neurocognitive battery that evaluated seven areas of cognitive functioning. Visioconstruction, visual memory, verbal memory, attention, psychomotor speed, executive functioning and language were measured. Additionally, the Beck Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI) were included to assess mood and anxiety states pre- and post-operatively. Demographic data pertaining to participants' general medical conditions were also collected. The repeated measures ANOV A with mixed designs procedure showed cognitive improvement on the domains of visioconstruction (p = 0.017), visual memory (p = 0.001), psychomotor speed (p = 0.001), executive functioning (p = 0.012) and language (p = 0.001). Significant cognitive decline on the domain of verbal memory (p = 0.026) was also found in both control and surgical groups. Furthermore, changes in mood and anxiety states did not influence post-operative changes in neurocognitive performance. The results yielded in the present study are mixed and confirm the multifactorial problem of studying cognitive functioning post-CABG surgery.
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Hong, Serena Sungyun. "Pain management after coronary artery bypass graft surgery, particularly in relation to physiotherapy interventions." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20257.
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The overall aim of the thesis was to evaluate physiotherapy and pain management in patients after coronary artery bypass graft (CABG) surgery and to determine the interaction between these. The thesis contains a literature review (Chapter 1), three research studies (Chapters 2-4), and a discussion (Chapter 5). The literature review provides an overview of CABG surgery, postoperative pain management and physiotherapy management. Chapter 2 reports the findings of a survey of centres in Australia and New Zealand that perform CABG surgery, to determine current physiotherapy mobility and walking management, expected clinical milestones and physiotherapists’ perception of pain severity in patients undergoing uncomplicated CABG surgery. Chapter 3 was a systematic review with meta-analyses designed to determine the effectiveness of continuous infusion of local anaesthetic (CLA) on pain and mobilisation post cardiac surgery. Chapter 4 was a prospective, multi-centre, randomised controlled trial (RCT) that evaluated the effect of continuous infusion of 0.5 % Ropivacaine via PainBuster, parasternally post CABG surgery compared to either a sham intervention of normal saline infusion via the PainBuster, or usual care. Overall, these studies have shown that a key role of physiotherapy after CABG surgery was patient mobilisation (based on the survey) and that continuous infusion of local anaesthetic agents around the wound sites after CABG surgery improved pain scores and reduced morphine requirements and time to first walk (based on the systematic review), however the randomised controlled trial of continuous infusion of local anaesthetics via PainBuster did not show a reduction of pain or an increased walking distance or shortened time to discharge from physiotherapy compared to patients who received a sham intervention or usual care. Chapter 5 summarises these main findings and discusses limitations, clinical practice implications, and suggestions for future research.
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Lindsay, Grace M. "The health and well-being of individuals before and after coronary artery bypass surgery." Thesis, University of Glasgow, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298692.
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Palmatier, Andrew D. Nezu Christine M. "The functioning of patients and partners after the coronary artery bypass graft surgery process : examining the patient's psychosocial and physical adjustment /." Philadelphia, Pa. : Drexel University, 2008. http://hdl.handle.net/1860/2913.
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Dreifaldt, Mats. "Conduits in coronary artery bypass grafting surgery : Saphenous vein, radial and internal thoracic arteries." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-33265.
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A novel technique for saphenous vein (SV) graft harvesting, the No-touch technique (NT), has been developed at the Dept. of Cardiovascular surgery, Örebro University hospital. With NT the SV is harvested with a pedicle of surrounding tissue. This avoids graft spasm and eliminates the need for distension. The surrounding tissue acts as a structural support and is a rich source of vaso-dilating agents. A randomized controlled trial (RCT) has shown a significantly higher patency rate for NT SV grafts compared to SV grafts harvested with conventional technique (CT). This thesis evaluates some of the properties of the surrounding tissue and compares patency rates between NT SV and radial artery (RA) grafts and patency rates for internal thoracic artery (ITA) grafts harvested with and without surrounding tissue. Paper I investigated vasa vasorum (VV) in SV grafts and showed that the NT preserves an intact VV whereas CT does not. This could be one of the mechanisms underlying the improved patency for NT SV grafts. Paper II evaluated VV and associated nitric oxide (NO) in SV and arterial grafts. SV grafts showed a higher number and larger VV, which correlated with NO production, compared to arterial grafts. NT SV grafts showed higher activity for e-NOS compared to CT SV grafts. Paper III is a RCT comparing patency rates between NT SV and RA grafts, three years after surgery, showing a significantly higher patency rate for NT SV grafts. Paper IV is a RCT comparing patency rates for ITA graft harvested with and without surrounding tissue and did not show any difference between graft preparations. In conclusion, the NT for SV graft harvesting preserves an intact vasa vasorum and associated NO production. NT SV grafts show a higher patency rate than RA grafts. Harvesting of ITA with or without surrounding tissue does not affect patency rate.
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Parry, Monica J. E. "Physiologic and psychological responses of men and women waiting for coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ55925.pdf.
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Brown, C. Ann. "Autonomic modulation of heart rate in men and women following coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape2/PQDD_0034/NQ59518.pdf.
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Swenne, Christine Leo. "Wound Infection Following Coronary Artery Bypass Graft Surgery : Risk Factors and the Experiences of Patients." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7168.
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Engel, Amy M. "The Impact of Body Mass Index on Hospital Outcomes following Coronary Artery Bypass Graft Surgery." University of Cincinnati / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1240590704.
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Nishiyama, Kei. "Temporal Pattern of Strokes after On-Pump and Off-Pump Coronary Artery Bypass Graft Surgery." Kyoto University, 2010. http://hdl.handle.net/2433/120611.
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Potgieter, Helena Davina. "Inflammatory marker comparison between patients with acute coronary syndrome undergoing on-pump versus off-pump coronary artery bypass graft surgery." Thesis, Bloemfontein : Central University of Technology, Free State, 2010. http://hdl.handle.net/11462/126.
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Thesis (M. Tech. (Biomed. Tech.)) -- Central University of Technology, Free State, 2010<br>The World Health Organization (WHO) has warned in 2005 that: “Coronary heart disease is now one of the leading causes of death worldwide. It is on the rise and has become a true pandemic that respects no borders” (WHO, 2005). The Heart and Stroke Foundation of South Africa more specifically estimates that approximately 33 (thirty‐three) people per day will die of a heart attack in South Africa. Despite the already high death toll resulting from AIDS in South Africa, death from a chronic disease, also including heart disease, will increase from 565 deaths per day in the year 2000, to 666 deaths per day by 2010 (Steyn, 2007).
Acute coronary syndrome (ACS) is an ‘umbrella term’ describing a heterogeneous spectrum of clinical symptoms compatible with acute myocardial ischaemia (Monaco, Mathur, Martin, 2005; ACC/AHA, 2007) and an ongoing inflammatory process resulting from atherosclerosis. ACS can either be treated medically (pharmacological treatment), by percutaneous coronary intervention (PCI), or by performing coronary artery bypass graft (CABG) surgery either through on‐pump or offpump CABG surgery. By treating the ACS patient by means of CABG surgery, an inflammatory response is further triggered on top of the already existing inflammation resulting from atherosclerosis. This leads to a systemic inflammatory response (SIR), which may eventually lead to systemic inflammatory response syndrome (SIRS). This study focuses on the inflammatory response initiated by the CABG technique applied during the revascularisation of the ACS patient. Many past studies compared on‐pump and off‐pump CABG surgery, arguing not only the advantages and disadvantages of these surgeries, but also the outcomes regarding SIRS. Both types of surgery are associated with an inflammatory response resulting from tissue trauma and the use of the extracorporeal circulation (EC) in CABG surgery (Quaniers, Leruth, Albert, Limet, Defraigne, 2006).
This non‐randomised, observational study primarily aimed to assess and compare the pre‐ and the post‐operative inflammatory markers between (n=60) patients with ACS undergoing either on‐pump CABG (n=30) or off‐pump CABG surgery (n=30). A secondary objective was to ascertain whether a correlation exists between the pre‐operative risk factors, the surgical procedure and the pre‐ and post‐operative inflammatory markers. Three inflammatory markers ‐ full blood count (FBC), procalcitonin (PCT) and C‐reactive protein (CRP) ‐ were analysed employing normal routine laboratory analysis. Interleukin‐6 (IL‐6) and tumour necrosis factor alpha (TNF‐α) were analysed using an enzyme amplified sensitivity immunoassay (EASI) method. The inflammatory markers were analysed pre‐operatively (baseline) and post‐operatively and at different time intervals (24, 48, 72, 96 and 120 hours post‐operatively).
Pre‐operatively, all the leucocytes were already elevated in both CABG groups, as could be expected in patients with ACS resulting from the already existing atherosclerotic process and the consequent pre‐operative existing inflammatory response. A significant pre‐operative difference was moreover detected in respect of the lymphocytes between the two CABG groups (p=0.03024). A significant post‐operative difference was also detected between the two CABG groups. The following significantly elevated levels were detected in the on‐pump CABG surgical group: for WCC at 24 hours (p=0.00761), 48 hours (p=0.01520) and 72 hours (p=0.00004); for neutrophils at 24 hours (p=0.17422), 96 hours (p=0.18611) and 120 hours (p=0.12872); for lymphocytes at 48 hours (p=0.04829) and at 96 hours (p=0.01982); and, for PCT at 24 hours (p=0.00811), 48 hours (p=0.00966) and 72 hours (p=0.01823) . However, measurable values of IL‐6 levels were found to be higher in the off‐pump CABG surgical group, with significant differences manifesting between the two CABG groups at 96 hours (p=0.05352) and 120 hours (p=0.09729). No differences between the two groups could be demonstrated for eosinophils, basophils, monocytes, CRP and TNF‐α.
In conclusion: despite the demonstrable inflammatory responses in both CABG groups, no difference in clinical outcomes was observed. The inflammatory responses evoked by on‐pump and off‐pump CABG procedures will, for some time to come, remain an area of interest for future research, but they are certainly not the only factors to have a bearing on surgical outcomes. The impact of intraoperative events needs to be elucidated further ‐ and in more detail ‐ in order to attempt to determine the relationship of these events on the extent of inflammatory responses and clinical outcomes, irrespective of whether the procedure is performed with or without cardiopulmonary bypass.
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Lau, Suet-Yim Diana. "A quality study of coronary artery bypass graft (CABG) surgery in Asians in California, 2003--2005." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3390054.
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Al-Shanafey, Saud. "Nodal vessels disease as a risk factor for atrial fibrillation after coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0020/MQ49304.pdf.
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Filion, Kristian B. 1980. "Use and effectiveness of perioperative cardiac medical therapy among patients undergoing coronary artery bypass graft surgery." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97952.
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The perioperative use of cardiac medical therapy (aspirin, angiotensin-converting-enzyme (ACE) inhibitors, lipid lowering agents (including statins), and beta-blockers) holds the potential to improve clinical outcomes among patients undergoing coronary artery bypass graft surgery (CABG). These medications have been shown to be efficacious in reducing adverse events in a small number of trials involving non-cardiac surgery patients. However, their use has not been closely examined among CABG patients. We performed a systematic review of the literature in which we identified all studies that examined the perioperative use of cardiac medical therapy among CABG patients. We also examined the use and effectiveness of these medications using a cohort of 2,389 consecutive CABG patients. We found that in-hospital medication use was low for all 4 medication classes. We also found a trend indicating an association between perioperative beta-blocker and statin use and a decrease in in-hospital mortality or non-fatal cardiac complications. Increasing perioperative cardiac medical therapy use may therefore lead to improved clinical outcomes among patients undergoing CABG.
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Musa, Ahmad Salem. "Spiritual nursing care and spiritual well-being of hospitalized patients following coronary artery bypass graft surgery." Thesis, University of Essex, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442518.
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Liebenberg, Liebenberg. "Evaluation of near-infrared spectroscopy in patients with acute coronary syndrome undergoing on and off-pump coronary artery bypass graft surgery." Thesis, Bloemfontein : Central University of Technology, Free State, 2012. http://hdl.handle.net/11462/161.
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Thesis (M. Tech. (Clinical technology)) - Central University of technology, Free State, 2012<br>The objective of this study was to investigate whether intra-operative regional cerebral tissue oxygen saturation (NIRS) and hemodynamic monitoring in patients with Acute Coronary syndrome (ACS) during coronary bypass graft surgery (CABG on-pump vs. off-pump) can predict clinical outcomes and complications.
Data from 60 CABG patients (30 on-pump and 30 off-pump) were analyzed. The regional cerebral tissue oxygen saturation was monitored by using near-infrared spectroscopy (NIRS). The sensors were positioned in the middle of the patient's forehead and the cables were connected to the sensors and to the INVOS 5100C® Oximeter. According to NIRS values obtained, patients were subdivided into two groups. Patients in Group 1 had absolute NIRS values more than 50 or less than a 20% drop from the baseline value. Patients in Group 2 had absolute NIRS values of less than 50 or a drop of more than 20% from the baseline value. The lowest value recorded during the procedure was recorded for this purpose, irrespective of the time this value was obtained. Intra-operative hemodynamic monitoring was captured by a computer software program (Supplier Datex Ohmeda, South Africa).
In order to describe surgical outcomes several parameters were analysed and compared. This included a Pre- and Post-operative Mini-Mental state examination that was performed to identify neurological outcomes or impairment. The NIRS values and trends in relation to renal function (U&E and creatinine, urine output, and urine electrolytes), as well as clinical outcomes were analyzed post-operatively for the different groups. Clinical outcomes were described using the Society of Thoracic Surgeons Database (STS database) data fields, and specifically the recording of complications.
The overall clinical outcomes were analysed between the on-pump and off-pump groups as well as the NIRS results between the two groups.
In order to elucidate the predictive role of NIRS the patients were divided into groups with either impaired /reduced NIRS values or acceptable NIRS values according to published results where a reduction of more than 20% from baseline or absolute values of less than 50 were associated with inferior outcomes.
Finally, the predictive value of NIRS was evaluated within the on- and then the off-pump groups. In this analysis the outcomes of patients with reduced NIRS values was compared to those of patients with acceptable NIRS values.
The study demonstrated that by far the majority of patients with reduced cerebral flow/oxygen delivery as reflected in cerebral NIRS, had on-pump CABG procedures (84% fell in risk group 2). It also showed that a NIRS reduction of more than 20 % from baseline and values of less than 50, has an impact on post–operative renal function.
Monitoring of cerebral oximetry intra-operatively by using near-infrared spectroscopy during cardiac surgery (especially in on-pump cardiac surgery patients) allows the perfusionist and anaesthesiologist to detect cerebral desaturation and to intervene as necessary. This study also showed a tendency towards less renal function impairment in patients with absolute NIRS values > 50 or where there was < 20% drop from baseline.
It is probably important to consider studying the time spend below 50 or a drop of more than 20% from baseline NIRS values, or the “area under the curve” as a specific factor contributing to the increased risk for post-operative complications applied on an increased study population.
The study supports the routine use of NIRS as a non-invasive trend monitor of cerebral saturation and certainly initiated interventions by both anaesthetic and perfusion staff which contributed to excellent clinical outcomes in this research study.
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Manie, Shamila. "The profile and selected outcomes of Coronary Artery Bypass Graft (CABG) patients in the Cape Metropolitan Area : a baseline study /." Thesis, Link to the online version, 2007. http://hdl.handle.net/10019/1100.
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Cozac, JoAnn Lee. "Spouses’ experiences of having a mate in the Intensive Care Unit following coronary artery bypass graft surgery." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24413.
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It is generally recognized that a serious illness with concurrent hospitalization in an ICU will have an impact on family members. Few researchers, however, have described the ways in which spouses are affected when their mates are hospitalized in an ICU. Therefore, this study aimed to describe and explain the spouses' experiences of having a mate in an ICU following coronary artery bypass graft surgery.
Kleinman's conceptual framework guided the development of the research question and provided the focus for data collection and analysis. Kleinman proposes that an understanding of the client's perspective is necessary for the provision of effective health care.
A qualitative research method based on the theoretical perspective of phenomenology was used to answer the research question. The spouses' viewpoints were elicited through unstructured interviews. The sample consisted of seven spouses, four women and three men. The spouses were interviewed on two occasions, once while their mate was still in the ICU and once shortly following their mate's discharge from the ICU. A total of 13 in-depth interviews were conducted over a 3 month period.
Data were analyzed simultaneously with and following data collection. Responses that were similar were grouped together into categories. After the data were examined and sorted into categories, the researcher defined the theme that dominated each category. The themes that emerged from the data were clarified, validated, and/or rejected by the participants during subsequent interviews. As relationships between the categories were identified, the important aspects of the spouses' experiences became apparent.
The findings revealed that the spouses located the ICU experience within the context of their experience with their mate's coronary artery bypass graft surgery. The spouses understood and made sense of the ICU experience by attaching meaning to specific events that related to the entire surgical experience. They perceived the surgical experience as consisting of three distinct but interrelated phases: pre-surgery; waiting during surgery; and post-surgery. During each phase, the spouses described and explained how they reacted to and coped with each new situation. These two themes, "reaction to the situation" and "coping with the situation," appeared as threads throughout the entire surgical experience. By organizing the data in relation to phases and themes, the researcher was able to meaningfully understand and communicate the spouses' entire surgical experience.
In view of the study findings, implications for nursing practice, education and research are delineated.<br>Applied Science, Faculty of<br>Nursing, School of<br>Graduate
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Valge, Evelyn Lana. "Women's experiences of in-home recovery following a myocardial infarction and/or coronary artery bypass graft surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq20814.pdf.
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Moye, Dana Lynn. "Self-Rated Sleep Quality, Functional Capacity, and Physical Activity Status Three Months After Coronary Artery Bypass Graft Surgery." Thesis, Virginia Tech, 1998. http://hdl.handle.net/10919/36675.
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It is widely accepted that sleep disturbances occur in patients recovering from coronary artery bypass graft (CABG) surgery. This sleep disturbance, at least in theory, might retard or limit the return of functionality and exacerbate psychological states known to increase use of health care services and adversely affect prognosis. This study explored possible relations between sleep, self-rated aerobic physical capacity and physical activity in a sample of patients who underwent CABG surgery. Secondary analysis investigated the possible concurrent influences of post-CABG health complaints and depression on sleep function. Measures included the Pittsburgh Sleep Quality Questionnaire; the Veterans Specific Activity Questionnaire; the Paffenbarger Physical Activity Questionnaire; the Health Complaint Scale and the Beck Depression Inventory, Version II. The physical measure of body composition was also used. Fifty-five subjects completed baseline questionnaires for all measures just prior to surgery, excluding the Paffenbarger Physical Activity Questionnaire. Follow-up evaluations were repeated at 3 mo post-CABG for the same measures and the patients were also asked to report their patterns of post-surgical physical activity involvement. Correlation coefficients were calculated to determine whether a correlation existed between the measures. Significant correlations were found between pre-surgical and post-surgical sleep score, sleep subscales, functional capacity, depression and health complaints (p < 0.05). Post-CABG sleep and physical activity did not exhibit a significant correlation. A number of secondary analyses were performed in an effort to isolate possible influences of confounding factors, such as depression, body mass index > 27, and a ventricular ejection fraction (EF) < 30. In the low EF subgroup, overall sleep score and self-rated functional capacity were strongly correlated before surgery was performed (r = -0.85; p < 0.01). Stepwise regression equations were constructed to predict sleep outcome before and after surgery. Somatic health complaints, depression, and skinfold measures were found to be predictors for pre-surgical sleep (R2 = 0.52), as well as post-surgical sleep (R2 = 0.78). Fitness measures of functional capacity and physical activity were not a significant predictor of sleep. The findings of this study suggest that a modest correlation exists between functional capacity and sleep in CABG patients; however, predictors including health complaints, depression and skinfold measures serve as better indicators for sleep outcome before and after CABG surgery.<br>Master of Science