Post-revascularization, the enlarged heart receives fresh coronary flow yet remains electrically unstable. Contractions are hard, weak, and poorly coordinated. Despite restored supply, the myocardium responds with fatigue and irritability.
#Arrhythmia #Cardiophilia #Cardiophile #Heart #Male #OPCAB

Old male OPCAB on an enlarged heart. Myocardium covered in fat; lungs diseased, right atrium and appendage grey, electrically unstable, producing ineffective bigeminy and frantic compensatory bursts. The exhausted heart visibly overexerting, incapable and failing.
#Cardiophilia #Heart #Male #OPCAB

Hemoglobin A1c and preoperative glycemia as a decision tool to help minimise sternal wound complications: a retrospective study in OPCAB patients - Journal of Cardiothoracic Surgery Background Poor glycemic control has been associated with an increased risk of wound complications after various types of operations. However, it remains unclear how hemoglobin A1c (HbA1c) and preoperative glycemia can be used in clinical decision-making to prevent sternal wound complications (SWC) following off-pump coronary artery bypass grafting (OPCAB). Methods We conducted a retrospective study of 1774 consecutive patients who underwent OPCAB surgery between January 2010 and November 2016. A new four-grade classification for SWC was used. The associations of HbA1c and preoperative glycemia with incidence and grade of SWC were analysed using logistic regression analysis and proportional odds models, respectively. Results During a median follow-up of 326 days (interquartile range (IQR) 21–1261 days), SWC occurred in 133/1316 (10%) of non-diabetes and 82/458 (18%) of diabetes patients (p < 0.001). Higher HbA1c was significantly associated with a higher incidence of SWC (odds ratio, OR 1.24 per 1% increase, 95% confidence interval, CI 1.04;1.48, p = 0.016) as well as a higher grade of SWC (OR 1.25, 95% CI 1.06;1.48, p = 0.010). There was no association between glycemia and incidence (p = 0.539) nor grade (p = 0.607) of SWC. Significant modifiers of these effects were found: HbA1c was associated with SWC in diabetes patients younger than 70 years (OR 1.41, 95% CI 1.17;1.71, p < 0.001), whereas it was not in those older than 70 years. Glycemia was associated with SWC in patients who underwent non-urgent surgery (OR 2.48, 95% CI 1.26;4.88, p = 0.009), in diabetes patients who received skeletonised grafts (OR 4.83, 95% CI 1.28;18.17, p = 0.020), and in diabetes patients with a BMI < 30 (OR 2.19, 95% CI 1.01;4.76, p = 0.047), whereas it was not in the counterparts of these groups. Conclusions Under certain conditions, HbA1c and glycemia are associated SWC following OPCAB. These findings are helpful in planning the procedure with minimal risk of SWC.

We investigated how hemoglobin A1c (#HbA1c) and preoperative #glycemia can be used to predict the risk of #sternal #wound #complications after #OPCAB and guide #decisionmaking

…rdiothoracicsurgery.biomedcentral.com/articles/10.11…

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We implemented a beating heart model at our center and developed a scoring chart to improve the evaluation of skills in #OPCAB and #MIDCAB during training. Check our results in #BMCSurgery!

ResearchGate:BMC Surgery:

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Read our new article about the efficacy of
#skeletonisation of the internal mammary artery in
#OPCAB surgery @JournalCTSurg

Available on our ResearchGate:Or directly via this link:

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