Predominant Use of Bilateral Internal Mammary Arteries in Off-Pump Coronary Artery Bypass Surgery (2024)

CABG SurgeryBilateral internal mammary artery (BIMA) in coronary artery bypass grafting (CABG) has been shown to provide long-term clinical benefits over single internal mammary artery (SIMA) grafting. Nevertheless, the perceived technical complexity of the procedure and concerns about potential early postoperative complications, particularly, sternal wound infections, have led to a utilization rate of BIMA grafting of less than 5% in the United States. We systematically compared early (30-day) postoperative outcomes between the BIMA and SIMA cohorts in patients with similar baseline characteristics. A retrospective single-center study was conducted on matched patients, using stabilized inverse probability treatment weighting to mitigate bias between the 2 study cohorts.

 From 546 patients who underwent off-pump CABG initially identified, we examined 328 BIMA and 213 SIMA grafts from the matched samples. Despite using 60.4% BIMA grafts, we observed similar rates of 30-day overall and cardiac mortality between the BIMA and SIMA groups. The rates of 30-day postoperative complications, including superficial and deep sternal wound infections, stroke, sepsis, acute kidney injury, and cardiac arrest, were similar between the 2 groups.

Molecular Modeling, Synthesis, and Antihyperglycemic Activity of the New Benzimidazole Derivatives - Imidazoline Receptor Agonists (2024)

The paper presents the results of a study on the first synthesized benzimidazole derivatives obtained from labile nature carboxylic acids. The synthesis conditions of these substances were studied, their structure was proved, and some components were found to have sugar-reducing activity.Diabetes and Hypertension Research

Effect of F11 Receptor/Junctional Adhesion Molecule-A derived Peptide on Neointimal Hyperplasia in a Murine Intimal Hyperplasia Model (2024)

To determine whether inhibition of the F11 receptor/JAM-A (F11R) using F11R-specific antagonist peptide 4D results in inhibition of smooth muscle cell (SMC) proliferation and migration in vivo, known as neointimal hyperplasia (NIH) model.

Is Off-Pump Coronary Bypass Surgery the Savior of Low EF Coronary Artery Disease Patients? (2023)

Coronary artery disease (CAD) with EF less than 35% prompts the patients to higher complication rates and death. On-pump CABG (ONCAB) should intuitively have higher complication rates than Off-pump (OPCAB) given the usually compromised status of other end organs. We studied in-hospital and 7-year follow-up outcomes between the two procedures in our CABG patients with an EF ≤ 35%.

The use of simple ultrafiltration technology as a fluid management strategy for high-risk coronary artery bypass grafting surgery (2022)

The use of simple ultrafiltration technology as a fluid management strategy for high-risk coronary artery bypass grafting surgeryThe use of simple ultrafiltration technology as a fluid management strategy for high-risk coronary artery bypass grafting surgery

Off-pump myocardial revascularization with Impella 5.5-assisted for cardiogenic shock (2021)

We report a case of Impella 5.5-assisted off-pump coronary artery bypass grafting for acute myocardial infarction with cardiogenic shock. The Impella 5.5 was placed in the left ventricle during the emergent procedure, and an off-pump coronary artery bypass grafting was successfully performed with exposure of all three walls of the heart. Our findings demonstrated the feasibility of off-pump coronary revascularization in three-vessel disease in a patient assisted with an Impella 5.5 percutaneous left ventricular assist device without displacement of the device during the entire perioperative period.CABG with Impella

LOW ADHERENCE TO DISCHARGE MEDICATIONS PREDICTS RISK OF CARDIAC EVENTS MIDTERM AFTER CARDIAC SURGERY: A PILOT STUDY AMONG PREDOMINANTLY BLACK INNER-CITY PATIENTS (2018)

Outcomes after heart surgery are relatively poor among Black patients (pts). Impact of nonadherence to medications on outcome needs definition in these pts. Post-hospital medication adherence may predict midterm outcomes after cardiac surgery.

Hexim1 heterozygosity stabilizes atherosclerotic plaque and decreased steatosis in ApoE null mice fed atherogenic diet. (2017)

Athersclerosis Research:

Hexim-1 is an inhibitor of RNA polymerase II transcription elongation. Decreased Hexim-1 expression in animal models of chronic diseases such as left ventricular hypertrophy, obesity and cancer triggered significant changes in adaptation and remodeling. The main aim of this study was to evaluate the role of Hexim 1 in lipid metabolism focused in the progression of atherosclerosis and steatosis.

Intraoperative Epicardial Sonography as a Useful Adjunct to Repair of Coronary Artery Dissection (2013)

  Coronary artery dissection are rare but potentially life threatening. They can occur either spontaneously or as a complication of percutaneous coronary interventions. Management can be either catheter based or surgical and is determined by the extent of the dissection, hemodynamic status and the number and extent of the vessels involved.

Partial transplant cardiectomy mitral exposure (2013)

Although a traditional groove of Sondergaard left atriotomy incision gives adequate mitral valve exposure in most instances, for difficult cases alternative approaches can be helpful. Radical approaches to the difficult mitral valve through sternotomy have beed described and this paper describes another surgical technique.

The Journal of Thoracic and Cardiovascular Surgery, May 2013

Anomalous right coronary artery from the left sinus: a minimally invasive approach (2012)

Abstract : Anomalous right coronary artery arising from the left sinus (ARCA) is a known cause of sudden cardiac death, particularly in young athletes. Surgery is recommended for all adult patients who are symptomatic or who have evidence of exercise-induced myocardial ischemia. Surgical options include coronary artery bypass grafting (CABG) and anatomic correction by unroofing the ostium or by reimplanting the ostium into the right sinus of Valsalva. We describe the rationale and technique of a minimally invasive right thoracotomy approach for correction of ARCA.

A Pulmonary Artery “Chimney” Relieves Right Ventricular Assist Device Anxiety (2012)

Patients with biventricular failure undergoing implantation of a long-term left ventricular assist device (LVAD) occasionally need right ventricular assist device (RVAD) support, often urgently. At this point, the patient's condition is unstable and the patient has a swollen right ventricular outflow tract, and placing a side-biting clamp on the pulmonary artery for off-pump RVAD is difficult at best. The alternative, returning to cardiopulmonary bypass to place the RVAD, is also undesirable. Depending on timing, this may require recannulation, possibly with a new cardiopulmonary bypass tubing pack, and the second pump run will certainly worsen coagulopathy.  To avoid this situation, we have routinely placed a “chimney” on the pulmonary artery of such high-risk patients during LVAD implant.

A Simple Technique to Preserve the LSVC during Reoperative Orthotopic Heart Transplant (2012)

Increasingly, patients undergo heart transplant after previous heart surgery. In patients with a persistent left superior vena cava (LSVC), the preferred technique, preservation of drainage via the native coronary sinus, can be difficult in reoperative cases due to adhesions. We report a technique simplifying this operation in such a patient. (J Card Surg 2012;27:767-768)

Genes and Cardiovascular Function. CLP-1-Mediated Transcriptional Control of Hypertrophic Gene Programs Underlying Cardiac Hypertrophy (2011)

Cardiac hypertrophy is the heart’s response to increased work, pressure, or volume overload. It begins with a compensatory phase that allows the heart to meet imposed demand through rapid expression of stress response genes. A decompensatory phase follows marked by additional adaptive stress response gene expression that with prolonged stress progressively turns maladaptive, leading the heart into failure. The transition from compensatory to decompensatory hypertrophy is likely to reflect changes in the transcription factors and regulatory molecules that control these programs in response to changes in stress stimuli and the status of cardiomyocytes throughout the hypertrophic process. Our laboratory has been studying the role of one such transcriptional regulatory molecule, CLP-1 (cardiac lineage protein-1), in the cellular response to hypertrophic stimuli.

Transplantation of High Panel-Reactive Antibody Left Ventricular Assist Device Patients Without Crossmatch Using On-Bypass Pheresis and Alemtuzumab (2011)

Abstract: Highly sensitized (HS) left ventricular assist device (LVAD) patients with high panel-reactive antibody (PRA) levels present a challenge. Alemtuzumab, a potent depleting agent for T and B lymphocytes (months to years), and plasmapheresis, offer an opportunity for heart transplantation to these patients who might die of VAD complications on the transplant waiting list. This study compared rates of acute rejection and survival of a HS LVAD cohort with a contemporaneous control group after heart transplant.

Heart Failure (2011)

CLP-1-Mediated Transcriptional Control of Hypertrophic Gene Programs Underlying Cardiac Hypertrophy

pages 199-211

Enhanced hypertrophy in ob/ob mice due to an impairment in expression of atrial natriuretic peptide (2009)

We investigated the molecular mechanism(s) that play a role in leptin signaling during the development of left ventricular hypertrophy (LVH) due to pressure overload. To this end, ob/ob leptin-deficient and C57BL/6J control mice were subjected to transverse aortic constriction (TAC).

The Physiologic Basis of Surgery. Chapter 15: The Cardiovascular System (2008)

The Cardiovascular System chapter was written for the 4th Edition of The Physiologic Basis of Surgery Textbook and was designed to be a review of the basic science, anatomy and pathophysiology of the cardiovascular system written for general surgery residents.

Thoracoscopic management of empyema thoracis (2007)

Abstract:

Appropriate management of empyema thoracis is dependent upon a secure diagnosis of the etiology of empyema and the phase of development. Minimal access surgery using video-assisted thoracoscopy (VATS) is one of many useful techniques in treating empyema. Complex empyema requires adjunctive treatment in addition to VATS.

Inhibition of Jak2 phosphorylation attenuates pressure overload cardiac hypertrophy (2006)



We examined the role of Jak2 kinase phosphorylation in the development of pressure overload hypertrophy in mice subjected to transverse aortic constriction (TAC) and treated with tyrphostin AG490, a pharmacological inhibitor of Jak2.

VITAMIN C INHIBITS HYPOXIA-INDUCED DAMAGE AND APOPTOTIC SIGNALING PATHWAYS IN CARDIOMYOCYTES AND ISCHEMIC HEARTS (2004)

Myocardial ischemic injury is mediated in part by reactive oxygen species (ROS) produced during the ischemic process and exacerbated by reperfusion. ROS generated from metabolic processes are normally quenched by antioxidants that are part of physiological cellular defense mechanisms. In disease states such as sudden hypoxia, however, overproduction of ROS and consumption of antioxidants result in oxidative cellular damage. Rapid restoration of blood flow increases the level of tissue oxygenation, but there is a second burst of ROS generation that leads to the syndrome of reperfusion injury. 

Free Radical Biology & Medicine, Vol. 37, No. 9, pp. 1419–1429, 2004

Fluorescent Chemosensors for Ion and Molecule Recognition (1993)

Chapter: Intrinsic Chromophores and Fluorophores in Synthetic Molecular Receptors