Anesthesia Medical News about Coronary Artery Bypass Coronary Artery Bypass, Off-Pump

Become a Member Today!
Register

Most Viewed Abstracts

1. Report Shows Shift in Starting Salaries for Physicians

2. 2008 Exclusive Survey—Earnings: Good news for primary care income

3. Medicare pay-for-reporting effort draws fire from frustrated doctors

4. Debunking Myths in the US Healthcare System

5. Doctors and the DEA Free full text

Your Article Summary

See Latest Articles

(Click the title below to leave the MDLinx Network and go to the Journal's Website)

A Randomized Clinical Trial Investigating the Relationship Between Aprotinin and Hypercoagulability in Off-Pump Coronary Surgery
Anesthesia & Analgesia, 10/21/09

Desai PH et al. – This study demonstrates that aprotinin protects patients undergoing OPCAB surgery from a hypercoagulable state by diminishing thrombin–induced platelet activation and thrombin generation within saphenous vein grafts, while maintaining systemic hemostatic and antifibrinolytic benefits. These results support further investigation of aprotinin and other PAR–1 antagonists in OPCAB surgery.

Exclusive Author Commentary
Robert S. Poston, 10/21/09

There has been little clinical investigation on the quesiton of how the mechanisms for hemostasis differ than for thrombosis. A series of observations from this paper provides preliminary support for the idea that PAR-1 may be responsible for thrombosis but have less effect on hemostasis: 1) Aprotinin has a potent inhibitory effect on the platelet thrombin receptor, PAR-1, a pathway that is critical for thrombosis. 2) Based on the effects of direct thrombin inhibitors on bleeding after CABG, it is clear that thrombin is required for adequate hemostasis through a variety of different mechanisms. 3) Although the clinical effect of aprotinin remains in debate (safe hemostatic vs. procoagulant agent), it certainly does not cause bleeding after cardiac surgery. A reasonable conclusion based on these observations is that the activation of PAR-1 via thrombin must be relatively unimportant for hemostasis. If so, this would be an ideal target for prevention of thrombosis after surgical procedures.

<< Previous
Lower Bispectral Index Values in Children Who Are Intellectually...

Next >>
The Effect of Perioperative Intravenous Lidocaine on...

Survival of patients on dialysis having off-pump versus on-pump coronary artery bypass surgery in the United States
The Journal of Thoracic and Cardiovascular Surgery, 10/27/09 Relevance Score: 99%

Abdominal perfusion pressure and coronary arterial perfusion pressure in patients undergoing coronary artery bypass graft surgery
Experimental and Clinical Cardiology, 11/18/09 Relevance Score: 98%

Predictors of Improvement of Unrepaired Moderate Ischemic Mitral Regurgitation in Patients Undergoing Elective Isolated Coronary Artery Bypass Graft Surgery
Circulation, 10/07/09 Relevance Score: 98%

Reduced expression of systemic proinflammatory and myocardial biomarkers after off-pump versus on-pump coronary artery bypass surgery: A prospective randomized study
Journal of Critical Care, 10/02/09 Relevance Score: 98%

Off-pump coronary bypass grafting is safe and efficient in patients with left main disease and higher EuroScore
European Journal of Cardio-Thoracic Surgery, 10/01/09 Relevance Score: 98%