Comparison of post-operative neurological complications between on-pump and off-pump coronary artery bypass surgery

To assess neurological impairment after the off-pump and On-pump techniques in patients with first-time isolated coronary artery bypass graft surgery. One hundred twenty patients undergoing first-time isolated coronary artery bypass graft surgery prospectively at Baqiatallah University Hospital, Tehran, Iran were randomised to the off-pump or on-pump technique. Change in NIHSS score was measured at 30 days postoperatively. The on-pump group showed a significantly greater deterioration in scores than the off-pump group. The incidence of TIA at 30 days postoperatively was 15.3% [9 out of 60] in the on-pump group and 5% [3 out of 60] in the off-pump group. [P=0.05]. The incidence of Stroke at 30 days postoperatively was 3.4% [2 out of 60] in the off-pump group, while no one from off-pump group suffered from stroke. [P=0.05] Off-pump coronary artery bypass graft surgery results in less neurological impairment than the on-pump technique

Clinical outcomes of patients with isolated atherosclerotic lesion of proximal left anterior descending coronary artery who underwent coronary angioplasty with stenting

The atherosclerosis of left anterior descending [LAD] coronary artery because of subtending more than 50% of left ventricular myocardial mass, has long been the focus of concern regarding appropriate treatment. This study aimed to evaluate efficacy of Percutaneous Transluminal Coronary Angioplasty [PTCA] with stenting for treatment of proximal LAD disease. In this descriptive study, 75 patients with isolated proximal LAD atherosclerotic lesion treated with PTCA and stenting were followed up for 9 months. The stenosis of all patients was documented by coronary angiography prior to enrollment. Exercise tolerance testing [ETT] by Bruce protocol was performed before angioplasty and at the end of follow up period as well. There were 44 [58.7%] males, and 31 [41.3%] females. The mean age of patients was 59.4 [range, 39 to 83 yrs]. Clinical outcomes of 73 [97.3%] patients were satisfactory. Only two patients developed re-stenosis during the follow up period. The first patient developed myocardial infarction at the 3rd day of her admission, and the second one had an abnormal ETT after 9 months. Percutaneous coronary revascularization with stenting was performed, and both of them were discharged without any problem. This study demostrated that the nine months prognosis of patients with isolated stenosis of proximal LAD coronary artery that treated by PTCA and stenting was acceptable. This treatment improves clinical status and results in lower hospital adverse event rates and in appropriate clinical outcome