CABG Patients Research Articles

Effectiveness of the Individualized Self-Care Program Based on Orem’s Self-Care Theory: Impact on Learning Needs and Self-Care Behaviors Following Coronary Artery Bypass Surgery – A Randomized Controlled Trial

PurposeThis study aimed to investigate the specific learning needs of patients within the experimental group after receiving the Individualized Self-Care Program (ISCP) at two key time points: Time 2 (Day 2, Week 1) and Time 3 (Day 15, Week 3). Furthermore, it aimed to compare the effectiveness of the ISCP in improving self-care behavior between the experimental group and the control group, which received standard health education. MethodsThe study utilized a Randomized Controlled Trial (RCT) design and included a consecutive sample of 128 patients who had undergone their first CABG procedure. These patients were randomly divided into two groups: the experimental group (n = 64) and the control group (n = 64). The experimental group received an ISCP at Time 2 and Time 3 after being discharged, whereas the control group received standard health education. Statistical analyses included paired t-tests to assess differences in learning needs over time and Repeated Measures Analysis of Variance (ANOVA) to evaluate the effectiveness of the ISCP on self-care behavior. ResultsA paired t-test indicated a statistically significant difference in the total number of learning needs identified within the experimental group between Time 2 and Time 3 assessments. Patients in the experimental group initially identified more learning needs at Time 2 (4.3±1.5), but their knowledge significantly improved at Time 3, leading to fewer learning needs (2.6±1.1). Furthermore, an ANOVA comparing the experimental and control groups showed that the ISCP effectively improved self-care behavior in the experimental group, with significantly greater improvements compared to the control group, which received standard health education. ConclusionISCP delivered in early recovery enhances self-care behaviors and addresses postdischarge gaps. The study also revealed that patients' learning needs change over time during home recovery, emphasizing the importance of tailored self-care programs for CABG patients after discharge.

Optimizing Postoperative Glucose Management in CABG Patients: Exploring Early Transition to Subcutaneous Insulin

Optimizing Postoperative Glucose Management in CABG Patients: Exploring Early Transition to Subcutaneous Insulin

Body mass index and its impact on outcomes in CABG surgery: the paradox of obesity and underweight risks.

Objective: To explore the impact of BMI on the short-term mortality and morbidity of patients undergoing CABG. Study Design: Retrospective Cross Sectional study. Setting: Department of Cardiac Surgery Rehman Medical Institute, Peshawar, Pakistan. Period: 1st June 2017 to 31st December 2022. Methods: The data was collected from the data base of the cardiac surgery department. Results: Total of 2599 isolated CABG patients were included with mean age of 57.86±9.2 years. The majority was overweight (42%). Approximately 78.1% were male. Hypertension was our dominant co-morbidity (68.7%) followed by dyslipidemia (65.4%) & DM (50.1%). Majority of patients had NYHA-III symptoms (51.2%). A significant proportion of individuals who are classified as underweight are elderly. Generally, there is a significant increasing trend of DM & HTN incidence with increasing BMI. In terms of intra-operative parameters there is increasing trend of intra-operative transfusions and higher rate of IABP insertion in underweight patients. Generally the underweight patients has the higher trend of adverse outcomes (e.g., prolonged mechanical ventilation, blood product requirement, reopening & re-intubation), but not significant. However, they have significantly longer mechanical ventilation time compared to normal. On the other extreme, morbidly obese patients had the highest in-hospital mortality (11.3%) while overweight had the lowest (2.6%) with a P-value of 0.008. Multivariate regression analysis showed that mean age (P 0.034), cross-clamp time (P 0.018) & mechanical ventilation (P <0.001) were significantly associated with in-hospital mortality. Conclusion: Morbidly obese patients undergoing CABG surgery face significantly higher in-hospital mortality rate, conversely overweight patients exhibits the lowest mortality rates confirming a partial obesity paradox. However, underweight patients experience the worst outcomes, including increased requirements for postoperative blood transfusions, a higher incidence of surgical reopening, and significantly extended mechanical ventilation hours, which indicates either extreme of BMI group is associated with worst outcomes.

Long term follow-up of bilateral internal thoracic artery use in young coronary artery bypass grafting patients: 29 year single surgeon experience.

Improved long term survival has demonstrated by grafting left internal thoracic artery (LITA) to the left anterior descending artery (LAD). This study investigated the prognostic benefits of BITA versus single LITA with common anastomotic configurations of BITA. Elective patients age below 60years, undertaken by a single surgeon, between 1992 and 2014 were explored. Cox regression models were fitted to investigate prognostic benefits of BITA. Specific comparisons were made with BITA subgroups who received LITA to LAD or RITA to LAD to establish long-term prognostic difference with the use of the RITA to LAD as compared to the LITA to LAD anastomosis. Comparisons were made with other BITA configurations to establish long-term difference in survival as a result of the actual targets bypassed with BITA grafts. Both groups had similar baseline patient characteristics. Following risk adjustment, the use of a second ITA conferred a significant 48% reduction in long-term mortality to BITA group [HR 0.52 (95%CI: 0.36-0.74) p < .001]. The use of the RITA to LAD, instead of LITA, resulted in no difference in the long-term prognostic benefit. The targets grafted with second ITA conferred a significant prognostic benefit for common configurations it was used in for bypass surgery. The use of BITA confers long term prognostic benefit to patients. Grafting RITA to LAD instead of more common LITA to LAD made no difference in long term prognosis when compared to CABG patients with single ITA. The use of a second ITA conduit in common configurations for CABG confers prognostic benefits irrespective of distal target grafted.

The Role of Preoperative Breathing Exercises in Reducing Postoperative Respiratory Complications in Coronary Artery Bypass Grafting: A Comparative Review of On-Pump and Off-Pump Techniques

Objectives: This review aims to evaluate the efficacy of preoperative breathing exercises in reducing postoperative respiratory complications, particularly respiratory failure, in patients undergoing CABG surgery. The review also compares the outcomes of these interventions in patients undergoing on-pump (ONCAB) versus off-pump (OPCAB) procedures. Methodology: A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Cochrane Library, to identify studies that examined the impact of preoperative breathing exercises on respiratory outcomes in CABG patients. The review focused on randomized controlled trials (RCTs) that compared the effectiveness of these exercises in ONCAB and OPCAB settings. Results: The review identified several studies supporting the role of preoperative breathing exercises in reducing postoperative respiratory complications. These exercises, including diaphragmatic breathing, incentive spirometry, and deep breathing, were associated with improved pulmonary outcomes, such as reduced incidence of respiratory failure, shorter durations of mechanical ventilation, and decreased hospital length of stay. While the overall results were positive for both ONCAB and OPCAB patients, variations were observed based on the surgical technique and patient-specific factors. Conclusion: Preoperative breathing exercises are an effective intervention for reducing the risk of postoperative respiratory complications in CABG patients. The benefits were observed in both ONCAB and OPCAB procedures, with particular advantages noted in the ONCAB group due to the higher baseline risk. Further research is needed to optimize these interventions, considering the individualized nature of patient responses and the specific characteristics of each surgical technique.

The clinical applications of ensemble machine learning based on the Bagging strategy for in-hospital mortality of coronary artery bypass grafting surgery

BackgroundMachine learning (ML) has excelled after being introduced into the medical field. Ensemble ML models were able to integrate the advantages of several different ML models. This study compares the ensemble ML model's and EuroSCORE II's performance predicting in-hospital mortality in patients undergoing coronary artery bypass grafting surgery. MethodsThe study included 4,764 patients from three heart centers between January 2007 and December 2021. Of these, 3812 patients were assigned to the modeling group, and 952 patients were assigned to the internal test group. Patients from other two heart center (1733 and 415 cases, respectively) constituted the external test group. The modeling set data are trained using each of the three ML strategies (XGBoost, CatBoost, and LightGBM), and the new model (XCL model) is constructed by integrating these three models through an ensemble ML strategy. Performance of different models in the three test groups comparative assessments were performed by calibration, discriminant, decision curve analysis, net reclassification index (NRI), integrated discriminant improvement (IDI), and Bland-Altman analysis. ResultsIn terms of discrimination, the XCL model performed the best with an impressive AUC value of 0.9145 in the internal validation group. The XCL model continued to perform best in both external test groups. The NRI and IDI suggested that the ML model showed positive improvements in all three test groups compared to EuroSCORE II. ConclusionsML models, particularly the XCL model, outperformed EuroSCORE II in predicting in-hospital mortality for CABG patients, with better discrimination, calibration, and clinical utility.

Early Experiences of Serbian Surgeons Using No-Touch Technique for Vein Conduits in CABG Patients: A Follow-Up Study with Multi-Slice CT Angiography.

Background and Objectives: The saphenous vein graft (SVG) remains the most frequently used conduit worldwide, despite its common disadvantage of early graft failure. To solve the problem and reduce the SVG damage, Souza implemented a new technique where a vein is harvested with surrounding fascia and fat tissue (the so-called no-touch technique). Materials and Methods. A prospective study conducted from February 2019 to June 2024 included 23 patients who underwent myocardial revascularization using a no-touch vein, with follow-up control examinations using computed tomographic angiography to detect graft stenosis or occlusion. Results. Of the entire patient group, 17 (73.9%) were male, with a mean age of 67.39 ± 7.71 years. The mean follow-up period was 25 months. There were no major adverse cardiovascular or cerebrovascular events (MACCEs) during hospitalization, although one patient died in the hospital. Another patient died due to malignancy, but no MACCEs occurred during the follow-up period. According to multi-slice CT coronary angiography, the results were impeccable, with an astonishing 100% patency observed in all 20 IMA grafts and 58 no-touch SVGs examined. Conclusions. The excellent patency rate during the early follow-up period confirmed that the no-touch technique is a good option for surgical revascularization.

Effect of Regional Anaesthesia on Cognitive Function in CABG Patients

Effect of Regional Anaesthesia on Cognitive Function in CABG Patients

The impact of pre-operative uric acid levels on post-operative renal outcomes in off-pump coronary artery bypass grafting patients

Background: Elevated pre-operative uric acid levels significantly impact post-operative renal outcomes in off-pump CABG patients, increasing the risk of acute kidney injury, as evidenced by higher serum creatinine and reduced urine output. Methods: This cross-sectional study was conducted in Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh from January 2021 to December 2022. Total 160 patients undergoing off pump CABG were divided into two groups, group A and group B, each containing 80 patients. In group A, uric acid level was &lt;7 mg/dl for male and &lt;6 mg/dl for female and in group B, it was &gt;7 mg/dl and &gt;6 mg/dL for female. Results: The demographic characteristics, pre-operative serum UA levels and serum creatinine levels between the two groups was not statistically significant. Group A had shorter operative times (mean 265.21±53.33 minutes) compared to Group B (mean 327.04±44.32 minutes), with more patients in Group-B undergoing longer surgeries (&gt;360 minutes). Group-B also had more grafts (mean 4.4 vs 3.6), higher serum creatinine (1.91 vs 1.17 mg/dl), bilirubin (0.8 vs 0.7 mg/dl), and lower urine output (mean 47.52 vs 95.37 ml/hour), all statistically significant (p&lt;0.001). Conclusions: This study concludes that there is significant impact of pre-operative uric acid levels on post-operative renal outcomes in off-pump CABG patients.

Minimally Invasive Coronary Artery Bypass Grafting in a Low-Risk Asian Cohort: A Propensity-Score Matched Study.

Minimally invasive coronary artery bypass grafting (MICS CABG) offers a new paradigm in coronary revascularization. This study aims to compare the outcomes of MICS CABG with those of conventional median sternotomy CABG (MS CABG) within a growing minimally invasive cardiac surgical program in Singapore. Propensity matching produced 111 patient pairs who underwent MICS CABG or MS CABG between January 2009 and February 2020 at the National University Heart Centre, Singapore. Minimally invasive direct coronary artery bypass surgery patients were matched to single- or double-graft MS CABG patients (Group 1). Multivessel MICS CABG patients were matched to MS CABG patients with equal number of grafts (Group 2). Overall, MICS CABG patients experienced shorter postoperative length of stay (P<0.071). In Group 2, procedural duration (P<0.001) was longer among MICS CABG patients, but it did not translate to adverse postoperative events. Postoperative outcomes, including 30-day mortality, reopening for bleeding, new onset atrial fibrillation as well as neurological, pulmonary, renal, and infectious complications were comparable between MICS and MS CABG groups. MICS CABG is a safe and effective approach for surgical revascularization of coronary artery disease and trends toward a reduction in hospital stay.

Comparison of the effect of telephone follow-up with social network follow-up program on self-efficacy and depression in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial

IntroductionCoronary artery bypass graft (CABG) surgery is a common procedure to improve blood flow to the heart muscles, but patients often face challenges during the recovery period. Self-efficacy and depression play crucial roles in patient outcomes. Telephone follow-up and social network follow-up have been introduced as interventions to enhance self-efficacy. This study aims to compare the effectiveness of telephone follow-up and social network follow-up on self-efficacy and depression in CABG patients. MethodThe study is a single-blinded, randomized controlled trial conducted at Shahid Rajaee Heart Hospital in Tehran, Iran. The sample size was determined to be 99 patients who met the inclusion criteria. Data were collected using a demographic questionnaire, Sullivan's cardiac self-efficacy questionnaire, and the Beck Depression Inventory (BDI). Participants were assigned to three groups: control, telephone follow-up, and WhatsApp follow-up using randomization. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). ResultsThe results revealed significant improvements in self-efficacy and reductions in depression scores for both the telephone and WhatsApp follow-up groups compared to the control group following the intervention (p < 0.001). Additionally, the mean self-efficacy score was higher and the mean depression score was lower in the WhatsApp follow-up group than in the telephone follow-up group after the intervention (p < 0.001). DiscussionThe findings provide valuable insights for healthcare professionals in choosing appropriate interventions to enhance patients' self-efficacy levels and improve mental health outcomes. Both telephone follow-up and social network follow-up interventions have their own advantages and can be effective in supporting patients' recovery after CABG surgery.

Relationships between Interleukin 18 -607 C/A and -137 G/C, Osteopontin -9250 C/T Genetic Polymorphisms and Systemic Inflammatory Response Syndrome in Coronary Artery Bypass Graft Surgery.

Background and Objectives: Systemic inflammatory response syndrome (SIRS) is one of the most significant complications after on-pump heart surgery procedures. High cytokine levels have been shown after open-heart surgeries and a genetic predisposition seems to be an important underlying modulatory characteristic for SIRS. To investigate the association between interleukin 18 -607 C/A, interleukin 18 -137 G/C and osteopontin 9250 C/T genetic polymorphisms and SIRS in on-pump CABG patients. Materials and Methods: Two hundred consecutive elective on-pump CABG patients were recruited prospectively to the study. Genomic DNA was extracted from whole blood and genotyping was determined by sequence specific PCR or PCR-RFLP methods for related polymorphisms. Results: SIRS incidence was 60.2%, 38.1%, 18.9% on postoperative day 1, 2 and 3, respectively, in the whole study population. The SIRS rate on the second postoperative day was 13% and 43.4%, respectively, in osteopontin 9250 C/T T allele non-carriers and carriers (p = 0.004). WBC (White Blood Cell) counts were higher on day 2 and 3 in osteopontin 9250 C/T T allele carriers compared to non-carriers (day 2; 12.7 ± 4 vs. 10.5 ± 2.4 (p = 0.015), day 3; 11.8 ± 4 vs. 9.1 ± 4.7 (p = 0.035)). The average ICU stay was 3.1 ± 7.4, 1.28 ± 0.97 for IL 18-137 G/C C allele carriers and non-carriers, respectively (p = 0.003), and in the IL 18-137 G/C C allele carriers, SIRS developed in 42.2% by the second postoperative day whereas the rate was 57.8% in non-carriers (p = 0.025). Conclusions: The current research revealed a possible link between osteopontin 9250 C/T and IL18-137 G/C genetic polymorphism and SIRS and morbidity in on-pump CABG patients.

Exploring the Impact of Cardiac Rehabilitation Programs on Health-Related Quality of Life and Physiological Outcomes in Patients Post Coronary Artery Bypass Grafts: A Systematic Review.

This systematic review explores the impact of cardiac rehabilitation programs (CRPs) on health-related quality of life (HRQoL) and physiological outcomes post-coronary artery bypass graft (CABG) surgery. Acknowledging the increasing importance of CRPs in post-CABG care, the study emphasizes the need for a comprehensive evaluation of their effectiveness. The primary objective is to investigate how CRPs influence HRQoL and physiological outcomes in post-CABG patients, offering insights into the multifaceted impact of these rehabilitation programs. A systematic literature review approach was employed to identify relevant studies published between 2013 and 2023. Inclusion criteria encompassed clinical randomized trials and quasi-experimental studies, with a focus on CRP interventions and their impact on HRQoL and physiological parameters. The review reveals a diverse array of CRP approaches, including exercise training, home-based programs, and telemonitored interventions. Despite methodological variations, a consistent positive impact on HRQoL and physiological outcomes is observed across studies. Noteworthy interventions, such as those incorporating family caregivers, demonstrate holistic benefits. However, limitations include methodological variability and the exclusion of qualitative studies. This systematic review underscores the substantial positive impact of CRPs on HRQoL and physiological outcomes in post-CABG patients. The diverse approaches and consistent improvements across studies provide a robust foundation for healthcare practitioners and researchers. Future efforts should focus on standardizing CRP interventions and conducting well-designed trials to further enhance the evidence base, facilitating more targeted and effective rehabilitation strategies for CABG patients.

Efficacy of Erector Spinae Plane Block for Postoperative Pain Management in Adult Cardiac Surgery Among CABG Patients.

Efficacy of Erector Spinae Plane Block for Postoperative Pain Management in Adult Cardiac Surgery Among CABG Patients.

Remote ischemic preconditioning and cognitive dysfunction following coronary artery bypass grafting: A systematic review and meta-analysis of randomized controlled trials.

Postoperative cognitive dysfunction (POCD) is a common neurological issue following cardiopulmonary bypass (CPB)-assisted heart surgery. Remote ischemic preconditioning (RIPC) increases the tolerance of vital organs to ischemia/reperfusion injury, leading to reduced brain injury biomarkers and improved cognitive control. However, the exact mechanisms underlying RIPC's neuroprotective effects remain unclear. This systematic review aimed to explore the hypothesis that RIPC lowers neurocognitive dysfunction in patients undergoing CPB surgery. All relevant studies were searched in PubMed, ScienceDirect, EBSCOhost, Google Scholar, Semantic Scholar, Scopus, and Cochrane Library database. Assessment of study quality was carried out by two independent reviewers individually using the Cochrane Risk of Bias (RoB-2) tool. Meta-analysis was performed using a fixed-effect model due to low heterogeneity among studies, except for those with substantial heterogeneity. A total of five studies with 1,843 participants were included in the meta-analysis. RIPC was not associated with reduced incidence of postoperative cognitive dysfunction (five RCTs, odds ratio [OR:] 0.79, 95% confidence interval [CI]: 0.56-1.11) nor its improvement (three RCTs, OR: 0.80, 95% CI: 0.50-1.27). In addition, the analysis of the effect of RIPC on specific cognitive function tests found that pooled SMD for RAVLT 1-3 and RAVLT LT were -0.07 (95% CI: -0.25,012) and -0.04 (95% CI: -0.25-0.12), respectively, and for VFT semantic and phonetic were -0.15 (95% CI: -0.33-0.04) and 0.11 (95% CI: -0.40-0.62), respectively. The effect of RIPC on cognitive performance in CABG patients remained insignificant. Results from previous studies were unable to justify the use of RIPC as a neuroprotective agent in CABG patients.

Prevalence of Adhesive Capsulitis and its associated risk factors in post CABG patients-An Analytical Cross-Sectional study

Objectives: To discern the prevalence of Adhesive Capsulitis (AC) and its associated risk factors in post CABG patients. Methodology: This analytical cross sectional study was conducted in Imran Idrees Teaching Hospital, Pervaiz Ellahi Institute of Cardiology, Allama Iqbal Teaching Hospital and Islam Teaching Hospital from February 2023 to May 2023. Data was collected from 124 participants both female and male with ages above forty; that underwent CABG three months before, and were coming for follow up. Data was collected using a Structured Questionnaire regarding associated factors, SPADI Questionnaire to measure disability and Apley’s scratch test to reconfirm diagnosis. Data was analyzed using SPSS version 22.Chi square-test was used to find association and then results were presented in form of frequencies and crosstabs. Results: Results showed that mean age of participants was 54.78±7.61, mean of SPADI was 29.94±20.53 and prevalence of Frozen Shoulder among post-CABG patient was 23.4%. The results also showed that age, female gender, Hypertension, Diabetes Mellitus, shoulder immobility after surgery, lack of physical activity, lack of physical therapy follow-up and SPADI were significantly related to the development of AC in post-CABG patients. Conclusion: The conclusion of the study showed an increased prevalence of AC among post-CABG patients and risk factors such as hypertension, female gender, age, increased duration of shoulder immobility, physical inactivity before surgery, diabetes, and no physiotherapy follow-up significantly contribute to its increased prevalence.

Optimal antiplatelet strategy following coronary artery bypass grafting: a meta-analysis

ObjectiveCoronary artery bypass grafting (CABG) is an established revascularisation strategy for multivessel and left main coronary artery disease. Although aspirin is routinely recommended for patients with CABG, the optimal antiplatelet...

Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery

We investigated the impact of distance covered in the six-minute walk test (6mWT) before being discharged from the hospital after cardiac surgery on the risk of all-cause mortality. Our study included 1127 patients who underwent cardiac surgery and then took part in a standardised physiotherapist-supervised inpatient rehabilitation programme during 2007–2017. The percentage of the predicted 6mWT distance, and the lower limit of normal distance was calculated based on individual patients’ age, sex, and body mass index. We used Cox regression with adjustment for confounders to determine multivariable-adjusted hazard ratios (HRs) for mortality. Over a median follow-up period of 6.4 (IQR: 3.5–9.2) years, 15% (n = 169) patients died. We observed a strong and independent inverse association between 6mWT distance and mortality, with every 10 m increase in distance associated to a 4% reduction in mortality (HR: 0.96, 95% CI 0.94–0.98, P < 0.001). Those in the top tertile for predicted 6mWT performance had a 49% reduced risk of mortality (HR: 0.51, 95% CI 0.33–0.79) compared to those in the bottom tertile. Patients who met or exceeded the minimum normal 6mWT distance had 36% lower mortality risk (HR: 0.64, 95% CI 0.45–0.92) compared to those who did not meet this benchmark. Subgroup analysis showed that combined CABG and valve surgery patients walked less in the 6mWT compared to those undergoing isolated CABG or valve surgeries, with a significant association between 6mWT and mortality observed in the isolated procedure groups only. In conclusion, the longer the distance covered in the 6mWT before leaving the hospital, the lower the risk of mortality.

Koroner Arter Bypass Greft Cerrahisi Sonrası Fiziksel Aktivite Danışmanlığının Erken Dönem Sonuçlarının İncelenmesi

Objective: Physical inactivity, an important risk factor for coronary artery disease, should be increased after coronary artery bypass graft (CABG) surgery. The aim of this study was to examine the effects of early physical acitivity (PA) counseling in CABG patients. &#x0D; Material and Method: Thirty male patients included in the study were randomly divided into two groups. Fifteen patients received PA counseling and routine physiotherapy, while the others received only standard physiotherapy. PA, exercise capacity, daily living activities, sleep quality, depression, and anxiety were assessed before and two weeks after surgery. All patients received an activity monitor (MF-SenseWear Armband) upon discharge for PA and energy expenditure evaluation. Energy expenditure, average MET, PA duration, laying and sleeping time, and daily steps were monitored for seven days after discharge. &#x0D; Results: The 6-minute walking distance decreased from 507.87±77.70 m to 470.46±69.83 m in the PA group (p=0.001) and from 499.80±82.93 m to 448.00±64.25 m in the control group (p=0.002), but the difference was not significant (p=0.610). PA counseling did not significantly affect total energy expenditure (8516.10±1489.75 vs. 8568.75±999.68 joules, p=0.910), active energy expenditure (307.43 joules (min 13.57- max 3300.57) vs. 303.68 joules (min 30.71-max 11.68), p=0.412), mean metabolic equivalent (1.30±0.16 vs 1.17±0.17, p=0.057), PA duration (16.57 minutes (min 0.71-max 180) vs 16.85 minutes (min 3.57-max 58.71), p=0.367), the number of steps (723.86 steps (min 198.57-max 5944.14) vs 796.28 (min73.86-max 4217.86), p=1.000). &#x0D; Conclusion: Our PA counseling did not improve PA and clinical outcomes after CABG surgery more than conventional treatment. Longer follow-ups are needed to demonstrate efficacy.

Importance of the Internal Thoracic Artery as the Source of Collateral Circulation in CABG Patients with Leriche Syndrome

Importance of the Internal Thoracic Artery as the Source of Collateral Circulation in CABG Patients with Leriche Syndrome