The International journal of angiology : official publication of the International College of Angiology, Inc最新文献

{"title":"Low Incidence of Prosthesis-Patient Mismatch Following Extremely Small Transcatheter Aortic Valve Replacement with 20-mm Sapien 3.","authors":"Kazue Okajima,&nbsp;Ikki Komatsu,&nbsp;Todd B Seto","doi":"10.1055/s-0041-1732316","DOIUrl":"https://doi.org/10.1055/s-0041-1732316","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement has been developed as an emerging technique to treat patients with aortic valve disease. However, safety and outcome data on extremely small transcatheter heart valves (THV) is limited. We aimed to assess hemodynamic profiles and clinical outcome of very small balloon expandable THVs with 20-mm Sapien 3 (SP3). We examined data for all patients who received third-generation SP3 THV at a single hospital. Complications and clinical outcomes were defined based on the VARC-2 criteria. Postoperative prosthesis-patient mismatch (PPM) was defined as indexed effective orifice area (EOA) < 0.85 cm ² /m ² . We compared clinical characteristics and outcome between patients with 20-mm ( <i>n</i>  = 21), 23-mm ( <i>n</i>  = 67), and 26- or 29-mm ( <i>n</i>  = 113) sized valves. The 20-mm group included significantly higher number of Asian and female populations with lower body surface area. The baseline CT annular area in the 20-mm group was 316.5 ± 24.9 mm ² . There was no significant difference between groups in procedural mortality or early safety at 30 days. The higher procedural complication was observed in 20-mm group due to significant differences in minor vascular and bleeding complications. Despite higher post-THV gradients and smaller indexed EOA in 20-mm group, no PPM was observed in 20-mm group. The mortality at 30 days and 1 year in 20-mm group was 4.8% and 16.7%, respectively. The patients who received very small THVs with 20-mm SP3 did not result in PPM and experienced favorable early safety and midterm outcome in our cohort.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"120-125"},"PeriodicalIF":0.6,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272262/pdf/10-1055-s-0041-1732316.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40503606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vena Cava Atresia and Deep Vein Thrombosis: A Case Report and Systematic Review.","authors":"V Alende Castro,&nbsp;Jose Antonio Díaz-Peromingo","doi":"10.1055/s-0041-1732434","DOIUrl":"https://doi.org/10.1055/s-0041-1732434","url":null,"abstract":"<p><p>Congenital anomalies of the vena cava often go unnoticed, and their incidental finding is frequent in imaging tests performed for another cause in asymptomatic patients. However, an association with the development of thromboembolic disease has been described, mainly in young patients. We report the case of a young woman with deep vein thrombosis associated with vena cava atresia. We conducted a search of the PubMed/Medline database. The search identified 17 articles, of which 5 were selected for extraction and data analysis. Twelve studies were excluded because they failed to match the main criteria. We identified six new cases of deep vein thrombosis associated with vena cava abnormalities, with a mean age of 42.5 years; 83.3% were male. Regarding clinical manifestations, all patients presented as deep vein thrombosis, one case of recurrence, and another case associated with the kidney and inferior vena cava abnormalities with leg thrombosis syndrome. Only one patient had a target triggering factor (cholecystectomy postoperative). The thrombophilia study was negative in all cases and none of the patients died. Treatment included enoxaparin and vitamin K antagonists. This is the first study to report on a systematic review of vena cava atresia associated with deep vein thrombosis in Spain. It shows that in this region, the disease affects young population-even in the absence of risk factors-and is linked to a low mortality. The most frequent presentation form was deep vein thrombosis. Therefore, congenital abnormalities of the vena cava should be suspected in young patients with thromboembolic disease, due to their implications regarding to the duration of anticoagulant treatment, as well as their possible association with other prothrombotic factors.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"88-91"},"PeriodicalIF":0.6,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272329/pdf/10-1055-s-0041-1732434.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40503609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Whole Blood Viscosity and Lesion Severity in Coronary Artery Disease.","authors":"Gökhan Ceyhun,&nbsp;Oğuzhan Birdal","doi":"10.1055/s-0040-1720968","DOIUrl":"https://doi.org/10.1055/s-0040-1720968","url":null,"abstract":"<p><p><b>Objective</b>  This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR. <b>Material and Method</b>  In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups. <b>Results</b>  In the group with FFR < 0.80 and significant coronary artery stenosis, WBV was significantly higher compared with the group with nonsignificant coronary artery stenosis in terms of both HSR (19.33 ± 0.84) and LSR (81.19 ± 14.20) ( <i>p</i>  < 0.001). In the multivariate logistic regression analysis, HSR and LSR were independent predictors of significant coronary artery stenosis (HSR: odds ratio: 1.67, 95% confidence interval: 1.17-2.64; LSR: odds ratio: 2.46, 95% confidence interval: 2.19-2.78). In the receiver operating characteristic (ROC) curve analysis, when the cutoff value of WBV at LSR was taken as 79.23, it had 58.42% sensitivity and 62.13% specificity for the prediction of significant coronary artery stenosis (area under the ROC curve: 0.628, <i>p</i>  < 0.001). <b>Conclusion</b>  WBV, an inexpensive biomarker that can be easily calculated prior to coronary angiography, was higher in patients with functionally severe coronary artery stenosis, and thus could be a useful marker in predicting the hemodynamic severity of coronary artery stenosis in patients with chronic coronary syndrome.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"117-121"},"PeriodicalIF":0.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1720968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39033692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"l -Arginine Can Enhance the Beneficial Effect of Losartan in Patients with Chronic Aortic Regurgitation and Isolated Systolic Hypertension.","authors":"Shoa-Lin Lin,&nbsp;Mike Lin,&nbsp;Kuei-Liang Wang,&nbsp;Hsien-Wen Kuo,&nbsp;Tahir Tak","doi":"10.1055/s-0041-1723948","DOIUrl":"https://doi.org/10.1055/s-0041-1723948","url":null,"abstract":"Abstract Information about the effects of angiotensin II receptor blocker (ARB) therapy on the hemodynamic and cardiac structure in patients with chronic aortic regurgitation (CAR) and isolated systolic hypertension (ISH) is limited. This study planned to test the hypothesis that l-arginine could further enhance the beneficial effect of an ARB, losartan, and provide a favorable effect on the natural history of CAR and ISH. Sixty patients with CAR and ISH were enrolled in a randomized, double-blind trial comparing hemodynamic and ultrasonic change in two treatment arms: losartan + l-arginine and losartan-only treated groups. Serial echocardiographic and hemodynamic studies were evaluated before and after treatment. Both groups had a significant reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP), left ventricular end-diastolic volume index (LVEDVI), LV end-systolic volume index (LVESVI), LV mass index (LVMI), and LV mean wall stress after 6- and 12-month treatment (p <0.01 in all comparisons). Both groups had a significant increase in LV ejection fraction and exercise duration after 6- and 12-month treatment (p < 0.01 in all comparisons). Using multivariate linear regression analysis, only losartan + l-arginine therapy achieved a significantly lower LVESVI (38.89 ± 0.23 mL/m2), LVEDVI (102.3 ± 0.3 mL/m2), LVMI (107.6 ± 0.3 g/m2), SBP (123.5 ± 1.0 mm Hg), and greater exercise duration (7.38 ± 0.02 minutes) than those of the losartan-only treated groups (p <0.01 in all comparisons). These findings suggest that early co-administrative strategy provides a beneficial approach to favorably influence the natural history of CAR.","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"122-131"},"PeriodicalIF":0.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159612/pdf/10-1055-s-0041-1723948.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39048389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Primary Angioplasty for STEMI during the COVID-19 Outbreak.","authors":"Surya Dharma,&nbsp;Iwan Dakota,&nbsp;Isman Firdaus,&nbsp;Siska Suridanda Danny,&nbsp;Dian Zamroni,&nbsp;Ardi Yudha,&nbsp;Agus Susanto,&nbsp;Bambang Budi Siswanto","doi":"10.1055/s-0041-1727133","DOIUrl":"https://doi.org/10.1055/s-0041-1727133","url":null,"abstract":"<p><p>There has been concern whether the declining cases of ST-segment elevation myocardial infarction (STEMI) during the coronavirus disease 2019 (COVID-19) outbreak associate with primary angioplasty performance. We assessed the performance of primary angioplasty in a tertiary care hospital in Jakarta, Indonesia, by comparing the door-to-device (DTD) time and thrombolysis in myocardial infarction (TIMI) flow after angioplasty between two periods of admission: during the outbreak of COVID-19 (March 1 to May 31, 2020) and before the outbreak (March 1, to May 31, 2019). Overall, there was a relative reduction of 44% for STEMI admission during the outbreak ( <i>n</i>  = 116) compared with before the outbreak ( <i>N</i>  = 208). Compared with before the outbreak period ( <i>n</i>  = 141), STEMI patients who admitted during the outbreak and received primary angioplasty ( <i>n</i>  = 70) had similar median symptom onset-to-angioplasty center admission (360 minutes for each group), similar to radial access uptake (90 vs. 89.4%, <i>p</i>  = 0.88) and left anterior descending infarct-related artery (54.3 vs. 58.9%, <i>p</i>  = 0.52). The median DTD time and total ischemia time were longer (104 vs. 81 minutes, <i>p</i>  < 0.001, and 475.5 vs. 449 minutes, <i>p</i>  = 0.43, respectively). However, the final achievement of TIMI 3 flow was similar (87.1 vs. 87.2%), and so was the in-hospital mortality (5.7 vs. 7.8%). During the COVID-19 outbreak, we found a longer DTD time for primary angioplasty, but the achievement of final TIMI 3 flow and in-hospital mortality were similar as compared with before the outbreak. Thus, primary angioplasty should remain the standard of care for STEMI during the COVID-19 outbreak.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"148-154"},"PeriodicalIF":0.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1727133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39048392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Delamination-A Possible Precursor of Impending Catastrophe.","authors":"Ayman Saeyeldin,&nbsp;Mohammad A Zafar,&nbsp;Lauren A Baldassarre,&nbsp;Hamid Mojibian,&nbsp;Bulat A Ziganshin,&nbsp;Sandip K Mukherjee,&nbsp;John A Elefteriades","doi":"10.1055/s-0040-1718546","DOIUrl":"https://doi.org/10.1055/s-0040-1718546","url":null,"abstract":"<p><p>Aortic diameter is a powerful predictor of adverse aortic events, such as aortic rupture or dissection, forming the basis of prophylactic surgical repair criteria. Limited evidence is available regarding the association of aortic wall thickness (AWT) with these adverse aortic events. We present the case and surgical video of a 73-year-old man with chest pain and an increased AWT, who underwent ascending aortic repair and deep hemiarch placement under deep hypothermic circulatory arrest. Surgical pathology demonstrated evidence of aortic delamination and medial separation, indicative of an impending dissection. The patient recovered uneventfully, and his chest pain ultimately resolved after open repair. In this patient, increased AWT was felt to be the precursor to a potential aortic catastrophe.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"160-164"},"PeriodicalIF":0.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159620/pdf/10-1055-s-0040-1718546.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39048394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free-Floating Thrombus in the Distal Internal Carotid Artery Causing a Stroke.","authors":"Spyros Papadoulas,&nbsp;Konstantinos Moulakakis,&nbsp;Natasa Kouri,&nbsp;Petros Zampakis,&nbsp;Stavros K Kakkos","doi":"10.1055/s-0040-1720973","DOIUrl":"https://doi.org/10.1055/s-0040-1720973","url":null,"abstract":"<p><p>We present a patient suffering from a stroke with a free-floating thrombus extending up to the distal internal carotid artery. The thrombus was totally resolved after a 2-week anticoagulation regimen without leaving behind any severe residual stenosis in the carotid bulb. The optimal treatment of this rare condition remains uncertain. We report some important treatment strategies that have been used in the literature, emphasizing the anticoagulation as the mainstay of therapy. Immediate surgical and interventional manipulations carry the risk of thrombus dislodgement and embolization and should be considered if there are recurrent symptoms despite medical management.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"170-172"},"PeriodicalIF":0.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159588/pdf/10-1055-s-0040-1720973.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39048396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endarterectomy for Iliac Occlusive Disease during Kidney Transplantation: A Multicenter Experience.","authors":"William S Sorrells,&nbsp;Shennen A Mao,&nbsp;Timucin Taner,&nbsp;Caroline C Jadlowiec,&nbsp;Houssam Farres,&nbsp;Victor Davila,&nbsp;Samuel R Money,&nbsp;William M Stone,&nbsp;Mohammad Al-Khasawneh,&nbsp;Joao A Da Rocha Da Rocha-Franco,&nbsp;Warner A Oldenburg,&nbsp;Gustavo S Oderich,&nbsp;C Burcin Taner,&nbsp;Albert G Hakaim,&nbsp;Young Erben","doi":"10.1055/s-0040-1714752","DOIUrl":"https://doi.org/10.1055/s-0040-1714752","url":null,"abstract":"<p><p>Little is known about the surgical challenges and outcomes of kidney transplantation (KT) in the face of severe iliac occlusive disease (IOD). We aim to examine our institution's experience and outcomes compared with all KT patients. Retrospective review of our multi-institutional transplant database identified patients with IOD requiring vascular surgery involvement for iliac artery endarterectomy at time of KT from 2000 to 2018. Clinical data, imaging studies, and surgical outcomes of 22 consecutive patients were reviewed. Our primary end-point was allograft survival. Secondary end-points included mortality and perioperative complications. A total of 6,757 KT were performed at our three sites (Florida, Arizona, and Minnesota); there were 22 (0.32%) patients receiving a KT with concomitant IOD requiring iliac artery endarterectomy. Mean patient age was 61.45 ± 7 years. There were 13 (59.1%) male patients. The most common etiology of renal failure was diabetic nephropathy in 10 patients (45.5%) followed by a combination of hypertensive/diabetic nephropathy in five patients (22.7%), and hypertensive nephrosclerosis in three patients (13.6%). The majority ( <i>n</i>  = 16, 72.7%) of patients received renal allografts from deceased donors and six (27.3%) were recipients from living donors. Mean time from dialysis to transplantation was 2.9 ± 2.9 years. Mean follow-up was 3.5 ± 2.5 years. Mean length of hospital stay was 6.3 ± 4.3 days (range: 3-18 days). Graft loss within 90 days occurred in two (9.1%) patients, one due to renal vein thrombosis and another due to acute tubular necrosis. Overall allograft survival was 90.1% at 1-year and 86.4% at 3-year follow-up. Overall mortality occurred in 6 (27.3%) patients. Perioperative complications (Clavien-Dindo Grade 2-4) occurred in 13 (59.1%) patients, including 10 (45.5%) with acute blood loss anemia requiring transfusion, 2 (9.1%) reoperations for hematoma evacuation, 1 (4.5%) ischemic colitis requiring total abdominal colectomy, and 1 (4.5%) renal vein thrombosis requiring nephrectomy. IOD patients selected for KT are not common and although challenging, they have similar outcomes to our standard KT patients. The 1- and 3-year allograft survivals were 90.1 and 86.4% versus 96.0 and 90.3% in the general KT patient population. With these excellent outcomes, we recommend expanding the criteria for KT to include patients with IOD with prior vascular surgery consultation to prevent progression of IOD or prevention of wait list removal in select patients who are otherwise good candidates for KT.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"91-97"},"PeriodicalIF":0.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1714752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39033690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curcumin's Effect on Inflammatory Response following Percutaneous Coronary Intervention in Adult Patients with Stable Coronary Heart Disease.","authors":"Todung Silalahi,&nbsp;Idrus Alwi,&nbsp;Frans Suyatna,&nbsp;Katarina D Sartika","doi":"10.1055/s-0040-1720969","DOIUrl":"https://doi.org/10.1055/s-0040-1720969","url":null,"abstract":"<p><p>Cardiovascular diseases play major roles in the health problems worldwide especially in Indonesia. Percutaneous coronary intervention (PCI) is a minimally invasive procedure with relatively low complications. However, high inflammatory response post-PCI has showed adverse events even after administration of standard medication. Previous studies showed that curcumin was able to reduce inflammatory response in adult patients with stable coronary heart disease (CHD). This article determines the efficacy of oral administration of curcumin in reducing inflammatory response post-PCI with stable CHD. A double-blind randomized controlled trial on 50 adult patients comparing curcumin and placebo was performed in Cipto Mangunkusumo General Hospital and Jakarta Heart Center within April and June 2015. Either curcumin (45 mg/day) or placebo was given 7 days prior to PCI until 2 days after PCI. Inflammatory markers (high-sensitivity C-reactive protein [hsCRP] and soluble CD40 ligand [sCD40L]) were measured in three phases (7 days prior PCI, 24 hours post-PCI, and 48 hours post-PCI). There were no significant differences in the reduction of hsCRP and sCD40L between curcumin and placebo groups in three phases of measurement. Curcumin significantly reduce the serum hsCRP ( <i>p</i>  = 0.006) and sCD40L ( <i>p</i>  = 0.002) 7 days before PCI to 48 hours post-PCI. The decrement of hsCRP (-14.2% vs. -7.4%) and sCD40L (-24.3% vs. -13.2%) from 24 to 48 hours post-PCI was higher in the curcumin group than placebo group. The administration of curcumin 45 mg dose daily for 7 days prior PCI until 48 hours post-PCI is useful in reducing inflammatory response post-PCI with stable CHD.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"132-138"},"PeriodicalIF":0.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159605/pdf/10-1055-s-0040-1720969.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39048390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney-Pancreas Transplant Recipients Experience Higher Risk of Complications Compared to the General Population after Undergoing Coronary Artery Bypass Grafting.","authors":"Jordyn M Perdue,&nbsp;Alejandro C Ortiz,&nbsp;Afshin Parsikia,&nbsp;Jorge Ortiz","doi":"10.1055/s-0040-1721680","DOIUrl":"https://doi.org/10.1055/s-0040-1721680","url":null,"abstract":"<p><p>This retrospective analysis aims to identify differences in surgical outcomes between pancreas and/or kidney transplant recipients compared with the general population undergoing coronary artery bypass grafting (CABG). Using Nationwide Inpatient Sample (NIS) data from 2005 to 2014, patients who underwent CABG were stratified by either no history of transplant, or history of pancreas and/or kidney transplant. Multivariate analysis was used to calculate odds ratio (OR) to evaluate in-hospital mortality, morbidity, length of stay (LOS), and total hospital charge in all centers. The analysis was performed for both nonemergency and emergency CABG. Overall, 2,678 KTx (kidney transplant alone), 184 PTx (pancreas transplant alone), 254 KPTx (kidney-pancreas transplant recipients), and 1,796,186 Non-Tx (nontransplant) met inclusion criteria. KPTx experienced higher complication rates compared with Non-Tx (78.3 vs. 47.8%, <i>p</i>  < 0.01). Those with PTx incurred greater total hospital charge and LOS. On weighted multivariate analysis, KPTx was associated with an increased risk for developing any complication following CABG (OR 3.512, <i>p</i>  < 0.01) and emergency CABG (3.707, <i>p</i>  < 0.01). This risk was even higher at transplant centers (CABG OR 4.302, <i>p</i>  < 0.01; emergency CABG OR 10.072, <i>p</i>  < 0.001). KTx was associated with increased in-hospital mortality following emergency CABG, while PTx and KPTx had no mortality to analyze. KPTx experienced a significantly higher risk of complications compared with the general population after undergoing CABG, in both transplant and nontransplant centers. These outcomes should be considered when providing perioperative care.</p>","PeriodicalId":520798,"journal":{"name":"The International journal of angiology : official publication of the International College of Angiology, Inc","volume":" ","pages":"107-116"},"PeriodicalIF":0.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159610/pdf/10-1055-s-0040-1721680.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39033691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}