心拍動下冠動脈バイパス術
WordNet
- not performing or scheduled for duties; "Hes off every Tuesday"
- at a distance in space or time; "the boat was 5 miles off (or away)"; "the party is still 2 weeks off (or away)"; "away back in the 18th century" (同)away
- (of events) no longer planned or scheduled; "the wedding is definitely off" (同)cancelled
- in an unpalatable state; "sour milk" (同)sour, turned
- below a satisfactory level; "an off year for tennis"; "his performance was off"
- no longer on or in contact or attached; "clean off the dirt"; "he shaved off his mustache"
- not in operation or operational; "the oven is off"; "the lights are off"
- supply in great quantities; "Pump money into a project"
- a low-cut shoe without fastenings
- a mechanical device that moves fluid or gas by pressure or suction
- deliver forth; "pump bullets into the dummy"
- draw or pour with a pump
- flow intermittently
- move up and down; "The athlete pumps weights in the gym"
- operate like a pump; move up and down, like a handle or a pedal; "pump the gas pedal"
- question persistently; "She pumped the witnesses for information"
- raise (gases or fluids) with a pump
- (botany) the trumpet-shaped or cup-shaped outgrowth of the corolla of a daffodil or narcissus flower
- one or more circles of light seen around a luminous object
- a long cigar with blunt ends
- (anatomy) any structure that resembles a crown in shape
- a major thoroughfare that bears important traffic
- a blood vessel that carries blood from the heart to the body (同)arteria, arterial blood vessel
PrepTutorEJDIC
- 《分離》(接触しているところ)『から』,から離れて,からはずれて / 《位置》…『から離れたところで』(『に』) / (本来の状態など)からはずれて,…が狂って,がなくなって / (本道など)からそれて,から横道にはいったところに / 《eat, dineなどと共に》…からとって[食べる] / 《『from off』の形で》《話》…から / (ある値段)から割り引いて / 《話》…をやめて,慎んで《+『名』(do『ing』)》 / (仕事義務など)から離れて,を休んで / (人)をたよって,にやっかいになって / (1)《運動・移動を表す動詞と共に》『離れて』,向こうへ / 《状態の動詞と共に》『離れて』 / 《瞬間の動作を表す動詞と共に》『離して』 / 『去って』,出かけて / (電気・ガス・水道などが)『切れて』 / (本来の位置・状態などから)『はずれて』 / (仕事・勤務などを)『旧んで』 / (時間的・空間的に)『離れて』 / 《動作の完了》『すっかり』,完全に / 割り引いて / (中心・的などから)『それた』,『離れた』,はずれた / 『時期はずれの』,(時期などが)いつもほどよくない,シーズン外の / (状態が)水準以下の,いつも調子(状態)でない / 《補語にのみ用いて》(予定・用意されたことが)取りやめになって / 《補語にのみ用いて》(電気器具などが)電源が切れて;(ガス・水道が)切れて,止まって / (人が)…の暮らしぶりで / 勤務のない,休みの / 取れて,ぬげて,はずれて / (馬・車の1対のうち)右側の / 《補語にのみ用いて》(走者が)すでに走り出して / 《おもに英》《補語にのみ用いて》(食物などが)いたんで食べられない;飲めない / 《英》《補語にのみ用いて》(食堂などでメニューには載っているが料理が)もう品切れで / 《英》《補語にのみ用いて》(人の態度が)誠意のない,不親切な,ひどい / 《名詞の前にのみ用いて》《the ~》(クリケットで)打者の右前方の
- 『ポンプ』 / 《単数形で》ポンプで空気(ガス)を入れること / 《副詞[句]を伴って》〈気体・液体〉‘を'『ポンプで入れる』(『出す』) / …‘から'ポンプで水(など)を除く《+『out』+『名』,+『名』+『out』》 / …‘に'ポンプで空気(など)を満たす《+『up』+『名』,+『名』+『up』》 / (ポンプのハンドルのように)…‘を'上下(前後)に動かす / 《話》(…について)〈人〉‘を'あの手この手で問いただす(聞き出す)《+『名』+『for』(『about』)+『名』》 / 《話》(人に)〈知識など〉‘を'詰め込む《+『名』+『into』+『名』〈人〉》;(人から)〈情報など〉‘を'引き出す《+『名』+『out of』+『名』〈人〉》 / ポンプを使う / (ポンプのように)上下に動く,鼓動する / 〈水が〉噴出する
- パンプス(ひもや金具がなく,甲のあいた靴)
- 《所有・所属》…『の』,…のものである,…に属する・《材料・要素》…『でできた』,から成る・《部分》…『の』[『中の』] ・《数量・単位・種類を表す名詞に付いて》…の・《原因・動機》…『で』,のために(because of) ・《主格関係》…『の』,による,によって・《目的格関係》…『を』,の・《同格関係》…『という』・《関係・関連》…『についての』[『の』],の点で・《抽象名詞などと共に》…の[性質をもつ] ・《『It is』+『形』+『of』+『名』+『to』 doの形で,ofの後の名詞を意味上の主語として》・《分離》…『から』・《起原・出所》…『から』[『の』](out of) ・《『名』+『of』+『a』(『an』)+『名』の形で》…のような・《『名』+『of』+『mine』(『yours, his』など独立所有格)の形で》…の…・《時》(1)《副詞句を作って》…に《形容詞句を作って》…の・《時刻》《米》…前(to,《米》before)
- コロナ(皆既日食のときに見える光冠) / (太陽・月などの)かさ
- 動脈 / (道路・水路・鉄道などの)勘線,(通信の)主チャンネル
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/04/30 19:48:34」(JST)
[Wiki en表示]
| Template:Off-pump coronary artery bypass (OPCAB) |
| Intervention |
| MeSH |
D047549 |
Off-pump coronary artery bypass or "beating heart" surgery is a form of coronary artery bypass graft (CABG) surgery performed without cardiopulmonary bypass (heart-lung machine) as a treatment for coronary heart disease. During most bypass surgeries, the heart is stopped and a heart-lung machine takes over the work of the heart and lungs. When a cardiac surgeon chooses to perform the CABG procedure off-pump, also known as OPCAB (Off-pump Coronary Artery Bypass), the heart is still beating while the graft attachments are made to bypass a blockage.
Off-pump coronary artery bypass was developed partly to avoid the complications of cardiopulmonary bypass during cardiac surgery. The medical community believes cardiopulmonary bypass causes a post-operative cognitive decline known as postperfusion syndrome (informally called "pumphead"), but research has shown no long-term difference between on and off pump coronary artery bypass[1] in patients of lower risk. This is probably because the pump is not the main cause of brain damage at all, rather it is the embolic process described below.
Sometimes the fatty type materials that collects to form a blockage or lining on the walls of the artery may break loose during CABG procedure manipulation. This debris can result in clots, or “emboli”, that may interrupt the flow of blood to the brain, causing neurological damage or even stroke. Data analysis from beating heart surgery patients shows a significant reduction in the release of this debris with correspondingly lower stroke rates.
The fatty emboli which cause brain damage are generated when the large artery from the heart (aorta) is manipulated and although these are reduced in most off-pump coronary bypass surgeries they are not eliminated because the aorta is still used as a site to attach some of the grafts. A growing number of OPCAB surgeons, however, are avoiding the aorta completely, known as "anaortic" coronary bypass surgery, by taking all their grafts from sites other than the aorta (e.g. the internal mammary arteries.).[2] This results in a very low risk of stroke, actually less than occurs during percutaneous coronary intervention [3]
In addition to off-pump surgery being associated with the clinical benefits of a reduced risk of stroke or memory problems, patients also typically have a faster recovery and shorter hospital stay, fewer blood transfusions, and fewer unwanted inflammatory/immune response issues.
Off-pump surgery can be more technically challenging. The technique has a steep learning curve, but with adequate training and experience, the quality of the anastomoses has been shown to be similar to on-pump results in surgeons with comparable experience but when aortic manipulation is avoided the results are better because nearly all strokes are avoided
See also
- Cardiac surgeon
- Coronary artery bypass surgery (CABG)
- Minimally invasive direct coronary artery bypass surgery (MIDCAB)
- Percutaneous coronary intervention (PCI), a.k.a. angioplasty
References
- ^ Postperfusion syndrome
- ^ Ross, Donald (Summer 2012). "Anaortic Coronary Bypass Surgery". Seminars in Thoracic and Cardiovascular Surgery 24 (2): 90–92.
- ^ Misfeld, Martin; Brereton JL,et al (August 2011). "Neurological complications after off-pump coronary artery grafting with and without aortic manipulation". J. Thorac. Cardiovasc. Surg. 142 (2): e11–e17.
External links
- Myocardial Revascularization without Cardiopulmonary Bypass chapter by Todd M. Dewey and Michael J. Mack in Cardiac Surgey in the Adult
- Canadian study to test value of heart-lung machine during cardiac surgery
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Healthcare science – Medicine / Surgery / Cardiac procedures (ICD-9-CM V3 35–37+89.4+99.6, ICD-10-PCS 02)
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| Surgery and IC |
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Heart valves
and septa
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- Valve repair
- Valvulotomy
- Mitral valve repair
- Valvuloplasty
- Valve replacement
- Aortic valve replacement
- Ross procedure
- Percutaneous aortic valve replacement
- Mitral valve replacement
- production of septal defect in heart
- enlargement of existing septal defect
- Atrial septostomy
- Balloon septostomy
- creation of septal defect in heart
- Blalock–Hanlon procedure
- shunt from heart chamber to blood vessel
- atrium to pulmonary artery
- Fontan procedure
- left ventricle to aorta
- Rastelli procedure
- right ventricle to pulmonary artery
- Sano shunt
- compound procedures
- for transposition of great vessels
- Jatene procedure
- Mustard procedure
- for univentricular defect
- Norwood procedure
- Kawashima procedure
- shunt from blood vessel to blood vessel
- systemic circulation to pulmonary artery shunt
- Blalock–Taussig shunt
- SVC to the right PA
- Glenn procedure
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Cardiac vessels
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- CHD
- Angioplasty
- Bypass/Coronary artery bypass
- MIDCAB
- Off-pump CAB
- TECAB
- Coronary stent
- Bare-metal stent
- Drug-eluting stent
- Bentall procedure
- Valve-sparing aortic root replacement
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Other
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- Pericardium
- Pericardiocentesis
- Pericardial window
- Pericardiectomy
- Myocardium
- Cardiomyoplasty
- Dor procedure
- Septal myectomy
- Ventricular reduction
- Alcohol septal ablation
- Conduction system
- Maze procedure
- Cox maze and minimaze
- Catheter ablation
- Cryoablation
- Radiofrequency ablation
- Pacemaker insertion
- Left atrial appendage occlusion
- Cardiotomy
- Heart transplantation
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Diagnostic
tests and
procedures |
- Electrophysiology
- Electrocardiography
- Vectorcardiography
- Holter monitor
- Implantable loop recorder
- Cardiac stress test
- Bruce protocol
- Electrophysiology study
- Cardiac imaging
- Angiocardiography
- Echocardiography
- TTE
- TEE
- Myocardial perfusion imaging
- Cardiovascular MRI
- Ventriculography
- Radionuclide ventriculography
- Cardiac catheterization/Coronary catheterization
- Cardiac CT
- Cardiac PET
- sound
- Phonocardiogram
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| Function tests |
- Impedance cardiography
- Ballistocardiography
- Cardiotocography
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| Pacing |
- Cardioversion
- Transcutaneous pacing
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noco/cong/tumr, sysi/epon, injr
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proc, drug (C1A/1B/1C/1D), blte
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UpToDate Contents
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English Journal
- Pain and inflammatory response following off-pump coronary artery bypass grafting.
- Sondekoppam RV, Arellano R, Ganapathy S, Cheng D.Author information Department of Anesthesiology and Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.AbstractPURPOSE OF REVIEW: Inflammation and pain are two common clinical issues following cardiac surgery, which are important to patient outcomes. This article reviews the literature regarding inflammation and pain following cardiac surgery with special emphasis on off-pump cardiac surgery.
- Current opinion in anaesthesiology.Curr Opin Anaesthesiol.2014 Feb;27(1):106-15. doi: 10.1097/ACO.0000000000000036.
- PURPOSE OF REVIEW: Inflammation and pain are two common clinical issues following cardiac surgery, which are important to patient outcomes. This article reviews the literature regarding inflammation and pain following cardiac surgery with special emphasis on off-pump cardiac surgery.RECENT FINDINGS:
- PMID 24322210
- Operative mortality and stroke after on-pump vs off-pump surgery in high-risk patients: an analysis of 83 914 coronary bypass operations.
- Cavallaro P, Itagaki S, Seigerman M, Chikwe J.Author information The Mount Sinai School of Medicine, New York, NY, USA.AbstractOBJECTIVES: The objective of this study was to compare the early outcomes of off-pump and on-pump surgeries in high-risk patient groups.
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2014 Jan;45(1):159-64. doi: 10.1093/ejcts/ezt221. Epub 2013 May 12.
- OBJECTIVES: The objective of this study was to compare the early outcomes of off-pump and on-pump surgeries in high-risk patient groups.METHODS: The outcomes of 83 914 high-risk patients undergoing off-pump or on-pump isolated coronary bypass surgery identified from the Nationwide Inpatient Sample f
- PMID 23671201
- Outcomes following cardiac surgery in patients with preoperative renal dialysis.
- Vohra HA, Armstrong LA, Modi A, Barlow CW.Author information Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, UK.AbstractA best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was that whether patients who are dependent on chronic dialysis have higher morbidity and mortality rates than the general population when undergoing cardiac surgery. These patients often require surgery in view of their heightened risk of cardiac disease. Altogether 278 relevant papers were identified using the below mentioned search, 16 papers represented the best evidence to answer the question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses were tabulated. Dialysis-dependent (DD) patients undergoing coronary artery bypass grafting (CABG) or valve replacement have higher morbidity but acceptable outcomes. There is some evidence to show that outcomes after off-pump coronary artery bypass grafting (OPCAB) are better than after on-pump coronary artery bypass grafting (ONCAB) and that results are worse in DD patients with diabetic nephropathy. Patients undergoing combined procedures have a higher mortality.
- Interactive cardiovascular and thoracic surgery.Interact Cardiovasc Thorac Surg.2014 Jan;18(1):103-11. doi: 10.1093/icvts/ivt407. Epub 2013 Sep 20.
- A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was that whether patients who are dependent on chronic dialysis have higher morbidity and mortality rates than the general population when undergoing cardiac surgery. These patients often
- PMID 24057861
Japanese Journal
- Impact of Preoperative Fibrinogen Concentration on Postoperative Outcome in Patients Who Received Dual Antiplatelet Therapy in Proximity to Off-Pump Coronary Bypass Surgery
- Kim Na Young,Shim Jae-Kwang,Song Jong Wook [他]
- Circulation journal : official journal of the Japanese Circulation Society 78(7), 1661-1666, 2014-07
- NAID 40020098994
- EDITORIAL : Preoperative Fibrinogen and Morbidity in Patients With Residual Platelet Inhibition Undergoing Off-Pump Coronary Artery Bypass Grafting : Cause or Effect?
- Capodanno Davide
- Circulation journal : official journal of the Japanese Circulation Society 78(7), 1571-1573, 2014-07
- NAID 40020098820
- 症例 悪性症候群から冠状動脈攣縮が誘発されたOPCABの1例
- 盛 彬子,山谷 一広,新田 能郎 [他]
- 胸部外科 = The Japanese journal of thoracic surgery 67(3), 247-250, 2014-03
- NAID 40019987753
Related Links
- 59 years old male, submitted to the Cardiology department with acute inferior myocardial infarction. Angiography revealed the total occlusion of circumflex branch, and PTCA+Stenting was performed. There ...
- Original Article Off-Pump versus On-Pump Coronary-Artery Bypass Grafting in Elderly Patients Anno Diegeler, M.D., Ph.D., Jochen Börgermann, M.D., Ph.D., Utz Kappert, M.D., Ph.D., Martin Breuer, M.D., Andreas ...
★リンクテーブル★
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心拍動下冠動脈バイパス術, off-pump coronary artery bypass
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心拍動下冠動脈バイパス術, off-pump coronary artery bypass
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off-pump coronary artery bypass
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off-pump coronary artery bypass
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心拍動下冠動脈バイパス術
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off-pump coronary artery bypass
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- 関
- pumping
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- 関
- coronary artery、coronary vessel
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- 関
- pump
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コロナ帯