MyMedR

Fulltext A Critical Evaluation of High Density Lipoprotein Cholesterol As An Index of Coronary Artery Disease Risk in Malaysians

Malays J Nutr, 1997;3(1):-.

MyJurnal

Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CAD), aged 35-75 years, who had undergone angioplasty (PTCA) / coronary artery bypass graft (CABG), and (b) 160 apparently healthy controls (106 males, 54 females, aged 30-75 years), were assessed for serum lipid profile. Both sex and ethnicity significantly influenced the levels of serum high density lipoprotein cholesterol (HDLC); in the controls, females had higher HDLC levels than males (46.7 mg/dl vs 38.5 mg/dl, p

Matched MeSH terms: Coronary Artery Bypass

A Flowmeter Technique to Exclude Internal Mammary Artery Anastomosis Error in an Arrested Heart

Hashim SA, Amin MA, Nair A, Raja Mokhtar RA, Krishnasamy S, Cheng K

Heart Lung Circ, 2018 May;27(5):e59-e63.

PMID: 29246681 DOI: 10.1016/j.hlc.2017.11.011

The revision of an internal mammary artery graft anastomosis because of a technical error can be time-consuming and complicated and may lead to complications. Here, we describe the technical details and our early experience of using a standard transit-time flowmeter to exclude technical errors and facilitate rapid decision making for anastomosis revision in an arrested heart during aortic cross-clamping in the absence of ultrasound guidance.

Matched MeSH terms: Coronary Artery Bypass/methods*

A Review of Coronary Artery Disease Research in Malaysia

Ang CS, Chan KM

Med J Malaysia, 2016 06;71(Suppl 1):42-57.

PMID: 27801387 MyJurnal

Coronary artery disease is the major cause of mortality and morbidity in Malaysia and worldwide. This paper reviews all research and publications on coronary artery disease in Malaysia published between 2000-2015. 508 papers were identified of which 146 papers were selected and reviewed on the basis of their relevance. The epidemiology, etiology, risk factors, prevention, assessment, treatment, and outcomes of coronary artery disease in the country are reviewed and summarized. The clinical relevance of the studies done in the country are discussed along with recommendations for future research.

Matched MeSH terms: Coronary Artery Bypass

Fulltext A descriptive analysis of exercise tolerance test at seremban hospital : an audit for the year 2001

Mohamed AL, Nee CC, Azzad A

Malays J Med Sci, 2004 Jul;11(2):59-64.

PMID: 22973128

Our purpose is to report on the epidemiological variables and their association with the results of the exercise tolerance test (ETT) in the series of patients referred for standard diagnostic ETT at Seremban Hospital during the year 2001. ETT is widely performed, but, in Malaysia, an analysis of the associations between the epidemiological data and the results of the ETT has not been presented. All patients referred for ETT at Seremban Hospital who underwent exercise treadmill tests for the year 2001 were taken as the study population. Demographic details and patients with established heart disease (i.e. prior coronary bypass surgery, myocardial infarction, or congestive heart failure) were noted. Clinical and ETT variables were collected retrospectively from the hospital records. Testing and data management were performed in a standardized fashion with a computer-assisted protocol. This study showed that there was no significant predictive epidemiological variable on the results of the ETT. However, it was found that there was statistically significant difference between the peak exercise time of males and females undergoing the ETT.

Matched MeSH terms: Coronary Artery Bypass

Fulltext A retrospective study on atrial fibrillation after coronary artery bypass grafting surgery at The National Heart Institute, Kuala Lumpur

Farouk Musa A, Quan CZ, Xin LZ, Soni T, Dillon J, Hay YK, et al.

F1000Res, 2018;7:164.

PMID: 30254739 DOI: 10.12688/f1000research.13244.2

Background: Atrial fibrillation (AF) is common after cardiac surgery and has been associated with poor outcome and increased resource utilization. The main objective of this study is to determine the incidence of POAF in Malaysia and identify the predictors of developing POAF. The secondary outcome of this study would be to investigate the difference in mortality and morbidity rates and the duration of intensive care unit (ICU), high dependency unit (HDU) and hospital stay between the two. Methods: This is a retrospective single-center, cross sectional study conducted at the National Heart Institute, Malaysia. Medical records of 637 who underwent coronary artery bypass grafting (CABG) surgery in 2015 were accrued. Pre-operative, operative and post-operative information were subsequently collected on a pre-formulated data collection sheet. Data were then analyzed using IBM SPSS v23. Results: The incidence of POAF in our study stands at 28.7% with a mean onset of 45±33 hours post operatively. Variables with independent association with POAF include advancing age, Indian population, history of chronic kidney disease, left ventricular ejection fraction and beta-blocker treatment. The mortality rate is significantly higher statistically ( p < 0.05), and similarly the incidence of stroke. The incidence of other post-operative complications was also significantly higher statistically. The duration of ICU, HDU and hospital stays were statistically longer ( p < 0.001) with higher rates of ICU readmissions and reintubations seen. Conclusion: We conclude that the incidence of POAF in Malaysia is comparable to the figures in Western countries, making POAF one of the most commonly encountered condition after CABG with similar higher rates of mortality, poor outcomes and longer duration of stay, and therefore increased cost of care. Strategies to reduce the incidence of AF after cardiac surgery should favorably affect surgical outcomes and reduce utilization of resources and thus lower cost of care.

Matched MeSH terms: Coronary Artery Bypass/adverse effects*

Fulltext A young patient with history of Kawasaki disease presenting with triple vessel disease

Lim AL, Lam HY, Kareem BA, Kamarulzaman MH

Med J Malaysia, 2012 Apr;67(2):219-21.

PMID: 22822650 MyJurnal

Kawasaki disease is primarily a condition that affects young children and it is associated with cardiac morbidity and mortality. This disease has been known to cause coronary artery aneurysms which occurs as a sequelae of vasculitis. The progression of triple vessel disease in adult which results from cardiac complications from Kawasaki disease is rare. We report a case of a young man with history of Kawasaki disease at infancy presenting with triple vessel disease requiring cardiac bypass surgery at the age of 20 years old.

Matched MeSH terms: Coronary Artery Bypass*

Fulltext Acute kidney injury following coronary artery bypass graft surgery in a tertiary public hospital in Malaysia: an analysis of 1228 consecutive cases

Hiew KC, Sachithanandan A, Muhammad Nor MA, Badmanaban B, Jasid AM, Ismail F, et al.

Med J Malaysia, 2016 Jun;71(3):126-30.

PMID: 27495886 MyJurnal

Acute kidney injury (AKI) following cardiac surgery is well established but the reported incidence is variable due to varying definitions and criteria. Furthermore there is a paucity of such data from Southeast Asia.

Matched MeSH terms: Coronary Artery Bypass*

An incidental finding of thymic carcinoid during urgent CABG operation

Abdullah F, Loon LG

Heart Surg Forum, 2002;5(4):E35-6.

PMID: 12538128

We present a case report of a 60-year-old Malay man who was undergoing an urgent coronary artery bypass graft (CABG) operation when a well encapsulated thymoma-like tumor was found incidentally. Total thymectomy was performed together with the CABG. Histopathological report of the tumor, however, confirmed a rare thymic carcinoid. The clinical features, management, and outcome of surgery are discussed.

Matched MeSH terms: Coronary Artery Bypass*

Anomalous aortic origin of a coronary artery (AAOCA): A case report

Anwar A, Chan KMJ, Awang Y, Ping DC

Med J Malaysia, 2019 Oct;74(5):436-438.

PMID: 31649223

Anomalous Aortic Origin of a Coronary Artery (AAOCA) is a rare anomaly of the coronary artery with a considerable risk of sudden cardiac death due to ischaemia of the heart. Symptoms may include chest pain on exertion, breathlessness or dizziness. We encountered a case of a 46- year-old female who complained of exertional chest pain with a positive-stress test and subsequently diagnosed with AAOCA through CT angiography (CTA). She successfully underwent a coronary artery bypass graft (CABG) surgery using a saphenous vein graft with uneventful recovery. Right internal mammary artery (RIMA) was not used as it was flimsy and the flow was very poor.

Matched MeSH terms: Coronary Artery Bypass

Carotid revascularization in patient with asymptomatic unilateral carotid stenosis undergoing coronary bypass--a futile effort!

Chai FY, Ishamuddin IM, Hairulfaizi H, Joanna SM, Ramzisham AR

Clin Ter, 2012;163(2):125-7.

PMID: 22555827

The best management of asymptomatic carotid artery disease in patient who needs coronary bypass remains controversial. We report the neurological outcome of four patients with asymptomatic unilateral significant carotid artery disease who underwent conventional coronary bypass without carotid revascularization. Our review highlighted the risk of perioperative stroke is not increased despite carotid revascularization was not performed. Asymptomatic carotid artery disease is not the cause for cerebral infarct but soft aortic atheroma encountered during surgery is the main culprit.

Matched MeSH terms: Coronary Artery Bypass*

Chest tube entrapment: a simple solution for technical error

Haron H, Baharudin MN, Ismail I, Zainuddin K, Abdul Rahman MR

Ann Thorac Surg, 2014 Jun;97(6):2166-7.

PMID: 24882295 DOI: 10.1016/j.athoracsur.2013.07.129

Unrecognized chest tube entrapment by surgical closure is a technical error. We present a rare case of chest tube entrapment that was successfully treated with a simple and safe solution in an elderly man after coronary artery bypass grafting (CABG). We visualized the suture using a small endoscope through the chest tube and incised it with the help of thoracoscopic scissors. The tube was then removed without the need for surgical exploration.

Matched MeSH terms: Coronary Artery Bypass*

Fulltext Combined repair of aortic arch aneurysm and coronary artery bypass grafting via a modified clamshell incision

Eng JB

Med J Malaysia, 2007 Jun;62(2):177-8.

PMID: 18705461 MyJurnal

A 58 year-old man presented with a large aneurysm of the aortic arch and severe coronary artery disease. He underwent combined repair of the aortic arch aneurysm and coronary artery bypass grafting via a modified clamshell incision using deep hypothermic circulatory arrest and retrograde cerebral perfusion. He made an uncomplicated postoperative recovery. The operative techniques are discussed with a review of the relevant literature.

Matched MeSH terms: Coronary Artery Bypass/methods*

Fulltext Continuing challenges in haemodialysis treatment

Morad Z

Med J Malaysia, 2012 Apr;67(2):145-6.

PMID: 22822631

Matched MeSH terms: Coronary Artery Bypass*

Conventional versus Minimally Invasive Vein Harvesting: A Clinical Audit of Wound Dehiscence Complications

Shiang SW, Vendargon SJ, Hamid SRBGS

J Coll Physicians Surg Pak, 2019 Apr;29(4):371-374.

PMID: 30925964 DOI: 10.29271/jcpsp.2019.04.371

OBJECTIVE: To determine the wound complications post coronary artery bypass graft surgery (CABG) by conventional vein harvest technique (CVH) and minimally invasive vein harvest technique (MIVH) in Hospital Sultanah Aminah Johor Bahru, Malaysia.

STUDY DESIGN: Clinical audit report.

PLACE AND DURATION OF STUDY: Hospital Sultanah Aminah Johor Bahru, Malaysia, from March 2016 to May 2017.

METHODOLOGY: Data were collected retrospectively from all 127 patients who underwent CABG with saphenous vein grafts, either with CVH technique (n=68), or MIVH technique (n=59) performed with Vasoview system. The rate of wound dehiscence was evaluated. Patients with severe wound dehiscence that required readmission and surgical intervention were identified for further evaluation.

RESULTS: There was total 26.8% of wound dehiscence in our study, which was not appreciably different between two groups (p=0.092). Patient with severe wound breakdown that required surgical intervention was significantly less in MIVH group (1/59, 1.7%) compared to CVH group (8/68, 11.8%, p=0.037). There was no significant difference in readmission rate between MIVH and CVH group (p=0.574).

CONCLUSION: There is significant reduction in severity of wound dehiscence post-saphenous vein harvesting among CABG patients with MIVH technique. However, there is no statistical difference in wound dehiscence and readmission rate between MIVH and CVH technique.

Matched MeSH terms: Coronary Artery Bypass/adverse effects*

Fulltext Coronary Artery Bypass Graft in a Young Adult, An Emerging Phenomenon: A Case Report.

Ramzisham, A.R.M., Joanna, O.S.M., Talal, A.R., Shahrulakmal, S., Maskon, O., Noorfaizan, S., et al.

International Medical Journal Malaysia, 2010;9(1):47-49.

MyJurnal

A 29-year-old, smoker, diabetic, hypertensive and hypercholesterolemic man was diagnosed of having severe coronary artery disease with a critical left main stem stenosis. On-pump coronary artery bypass graft surgery (CABG) was performed using conduits from the left internal mammary artery as well as the left radial artery and right saphenous vein which were both harvested endoscopically. He was discharged after a week of uneventful recovery. This case emphasizes on the best possible management of conduits selection, intraoperative myocardial protection and the risk factors modifi cation in achieving a long term graft patency and avoiding premature cardiac related death.

Matched MeSH terms: Coronary Artery Bypass

Fulltext Coronary artery bypass graft (CABG) surgery: current University Hospital (K.L.) experience

Ghani SA

Med J Malaysia, 1991 Mar;46(1):21-7.

PMID: 1836034

A personal series of 163 patients who underwent coronary artery bypass surgery (CABG) in the University Hospital, Kuala Lumpur between March 1988 and December 1990 were reviewed retrospectively to determine factors affecting hospital morbidity and mortality. One hundred and thirty eight were elective cases while 25 patients underwent emergency CABG surgery. Of these, 15 patients had recent myocardial infarction, with unstable haemodynamics or post infarct angina; six had failed angioplasty procedures and four patients immediately following coronary angiogram. The elective hospital mortality rate was 2.2% (three cases) and there were two deaths in the emergency group. Pre-operatively 20 patients (13%) had very poor left ventricular function of less than 30% ejection fraction. Significant improvement in ejection fraction was observed following surgery. The follow-up periods were between three months to three years. Ninety eight percent of patients showed improvement in their functional status (NYHA classification) in relation to angina and exercise performance.

Matched MeSH terms: Coronary Artery Bypass/mortality*

Coronary artery bypass graft surgery in a young female with systemic lupus erythematosus and its operative challenges: A case report

Gurpreet S, Vendargon SJ, Syed Rasul SH

Med J Malaysia, 2019 12;74(6):549-550.

PMID: 31929487

We understand that autoimmune disorders such as Systemic Lupus Erythematosus increases the likelihood of developing coronary heart disease. However, its implications on patients undergoing cardiac surgery is not well understood. Here we present a female patient with SLE who developed coronary artery disease at a young age and underwent coronary artery bypass graft surgery. As SLE is associated with vasculitis, we wanted to understand regarding the choice of conduit as well as its long term patency. Also whether percutaneous angioplasty has a role to play in patients with SLE.

Matched MeSH terms: Coronary Artery Bypass/methods*

Fulltext Coronary artery bypass surgery in a patient with asymptomatic brugada syndrome

Raj JM, Kanagaratnam K, Mohammad NM, Abdul Rahman Z, Badmanaban B, Chong YS, et al.

Med J Malaysia, 2013 Apr;68(2):171-2.

PMID: 23629569 MyJurnal

Matched MeSH terms: Coronary Artery Bypass*

Cryopreserved mesenchymal stromal cell treatment is safe and feasible for severe dilated ischemic cardiomyopathy

Chin SP, Poey AC, Wong CY, Chang SK, Teh W, Mohr TJ, et al.

Cytotherapy, 2010;12(1):31-7.

PMID: 19878080 DOI: 10.3109/14653240903313966

Bone marrow (BM) mesenchymal stromal cells (MSC) represent a novel therapy for severe heart failure with extensive myocardial scarring, especially when performed concurrently with conventional revascularization. However, stem cells are difficult to transport in culture media without risk of contamination, infection and reduced viability. We tested the feasibility and safety of off-site MSC culture and expansion with freeze-controlled cryopreservation and subsequent rapid thawing of cells immediately prior to implantation to treat severe dilated ischemic cardiomyopathy.

Matched MeSH terms: Coronary Artery Bypass/methods

Fulltext Current trends in the surgical management of coronary artery disease

Saw Huat Seong

Med J Malaysia, 1987 Dec;42(4):252-63.

PMID: 3331407

Coronary artery surgery as we know it today, has undergone rapid evolution since its introduction in the late 1960's, resulting, not surprisingly, in much confusion. In an attempt to present the state of the art, a collective review of the literature, coupled with the experiences with 118 patients is presented and discussed. The modern surgical management of patients with obliterative coronary artery disease is designed to relieve symptoms, prolong life and identify patients at high risk of premature death or myocardial infarction if they were to continue with medical management. Though the most common indication for surgery is persistent limitation of life style by severe symptoms, management is influenced by the strong association between such symptoms and increased mortality. During the short history of coronary bypass surgery, other indications for operation have been influenced by a combination of lessons from the past and hopes for the future. In addition, advances in technology have produced an enormous impetus for improvements in patient evaluation, surgical technique and postoperative care. As these advances continue and as more and more late results of surgery become available, answers to questions about surgery may increasingly be deduced from lessons rather than from hopes. As a result of these changes, an aura of confusion has gradually crept into the scene. It is hoped that this collective review, together with experiences gained from a personal series of 118 patients over a 3 year period from 1984 to 1986, will put into proper perspective, the state of the art of surgical management of coronary artery disease today.

Matched MeSH terms: Coronary Artery Bypass/trends*

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