BŠ

Bojan Štambuk

Klinički Bolnički Centar Split

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Miocardial revascularization without the use of extracorporeal circulation in coronary patients with diabetes mellitus

Bojan Štambuk Željko Sutlić Bojan Biočina Igor Rudež Davor Barić

Cilj: dokazati da je kardiokirurska operacija koja ne koristi izvantjelesnu cirkulaciju (OPCAB) dobra i preporucena operacija kod koronarnih bolesnika sa secernom bolesti, u usporedbi s onim dijabetickim bolesnicima podvrgnutim kardiokirurskoj operaciji koja koristi izvantjelesnu cirkulaciju (CABG), analizirajuci tridesetodnevno poslijeoperacijsko razdoblje Metode: prospektivna studija 273 dijabetickih bolesnika podvrgutih kardiokirurskoj operaciji u petogodisnjem razdoblju (prosinac 1997-prosinac 2002) dijabeticki bolesnici: 84 podvrgnutih OPCAB, 189 podvrgnutih CABG ; demografski podaci: dob i spol ; klinicki podaci: arterijska hipertenzija (sist. tlak>140 mmHg), hiperlipoproteinemija (kolesterol>5.5 mmol/L, LDL>3 mmol/L , LDL/HDL>2) preoperativni cimbenici rizika: prosirenost koronarne bolesti, stenoza debla lijeve koronarne arterije, nestabilna angina pektoris, prethodni infarkt miokarda, prethodni kardiokirurski zahvat ; uporaba arterijskih graftova: a. radialis, a. thoracica interna i v. saphena magma ; komplikacije: poslijeoperacijsko krvarenje, perioperativni infarkt miokarda, povrsinska i duboka infekcija rane, poslijeoperacijski cerebrovaskularni incident ; određivanje p vrijednosti pomocu c2 testa Rezultati: dijabeticki bolesnici podvrgnuti ACBP imaju statisticki znacajno ucestalije arterijsku hipertenziju (66% 52% p=0.047), trožilnu koronarnu bolest (76% 49% p<0.001) totalna arterijska revaskularizacija provedena je statisticki znacajno cesce kod bolesnika podvrgnutih OPCAB (55% 18% p<0.001) jedina statisticki znacajna razlika u postoperativnom morbiditetu nađena je kod pojave perioperativnog infarkta miokarda (ACBP 0% OPCAB 6% p=0.004) nije nađena statisticki znacajna razlika analizirajuci tridesetodnevni poslijeoperacijski mortalitet Zakljucak: OPCAB je zadovoljavajuca i sigurna operacija izbora kod koronarnih bolesnika sa secernom bolesti ; jedino je perioperativni infarkt miokarda cesce prisutan kod ove skupine bolesnika. Međutim, konacne zakljucke moguce je donijeti tek po analizi kasnih (petogodisnjih ili desetogodisnjih) poslijeoperacijskih rezultata

Extracorporeal circulation

Myocardial Revascularization

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Multiple arterial off-pump coronary artery bypass grafting: a 5-year experience with clinical results.

PubMed (2003)

Bojan Biočina Željko Sutlić Igor Rudež Davor Barić Daniel Unić

The use of arterial grafts combined with the off-pump coronary artery bypass (OPCAB) procedure offers many advantages, but most of them are still to be proven in long-term studies. We present our 5-year experience in combining these 2 strategies in coronary surgery.From February 1998 to December 2002 we operated on 155 patients (146 men and 9 women) for multiple arterial graft myocardial revascularization. All procedures were performed as OPCAB grafting using internal mammary and radial arteries. The mean +/- SD was 58 +/- 9 years for patient age, 57% +/- 11% for left ventricle ejection fraction, and 2.3 +/- 1.9 for the EuroSCORE. We reviewed perioperative and postoperative data and in-hospital mortality in our patients.A total of 356 distal anastomoses were created, an average of 2.3 per patient. The left internal mammary artery was used as a graft in 153 patients (98%), the right internal mammary artery was used in 13 patients (8%), and the radial artery was used in 146 patients (94%). No venous grafts were used. There were 4 reopenings (2.6%) because of mediastinal bleeding. Four patients (2.6%) experienced perioperative myocardial infarction, and 2 patients (1.3%) had permanent neurologic dysfunction. Five patients (3.2%) died in the hospital within 30 days of the operation.Our experience shows that arterial myocardial revascularization can be safely performed as an OPCAB procedure, even in the treatment of multiple-vessel coronary disease. The long-term benefit for patients is to be evaluated in the future.

EuroSCORE

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Citations (2)

[Use of non-steroidal antiinflammatory drugs in specialty polyclinic practice].

PubMed (1989)

Bojan Štambuk T Dürrigl N Zenić K Stambuk

A retrospective investigation of the prescription of nonsteroidal antiinflammatory drugs (NSA) was performed in the Rheumatologic out-patient-institute in Zagreb, including 1000 patients of both sexes, aged 20-70 years. 500 outpatients were treated by NSA during 1987 and 1989 respectively for lumbosacral syndrome, rheumatoid arthritis, ankylosing spondylitis and coxarthrosis. The kind of NSA as well as the registered side-effects were analysed from case histories. During 1987, NSA were applied to 365 (73%) and during 1989 to 390 (78%) of the 500 patients. In both groups a phenyl-acetic acid derivative (diclophenac) was most often applied, followed by propionic acid derivatives and oxycams. The most rarely applied drugs were indol-acetic acid derivatives. Pyrazolones were given only to 2 patients with an acute flare of ankylosing spondylitis in 1987. A gastro-duodenal ulcer was the absolute counterindication for this kind of treatment. The number of side-effects in this investigation was relatively small (6.5% in 1987 and 5% in 1989), probably because this investigation was a retrospective one. The most common among them appeared in the gastro-intestinal tract.

Sulfasalazine

Pyrazolones

Oxyphenbutazone

Niflumic acid

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[Comparative study of the effects of auranofin and aurothiomalate on laboratory and clinical indicators in patients with rheumatoid arthritis].

PubMed (1998)

Tonko Vlak Bojan Štambuk

Is there any significant difference in the effect and tolerance of the gold salts applied peroral and intramuscular in patients with rheumatoid arthritis (RA)? 97 patients with RA have been included in the research. Group used auranofin perorally comprised 30 patients with RA, 25 women and 5 men. Their average age was 53.4 years, the average disease course was 9.06 years. Group used aurothiomalate parenterally comprised 30 patients with RA, 23 women and 7 men. Their average age was 52.5 years, the average duration of their illness being 10.87 years. Control group comprised 37 patients with RA, 27 women and 10 men. Their average age was 58.2 years, the average disease course was 8.3 years. They did not use any "second line drug" or corticosteroids. During a six-month (26 week) continuous application of the gold salts (perorally and parenterally) the following parameters were observed in regular intervals: the erythrocyte sedimentation rate, the hemoglobin level in the serum, the C-reactive protein. Ritchie index, the PIP extent of the fist joints and the morning stiffness span of the small fist joints. The tolerance of the gold salts has also been controlled. The results have shown that there is no any significant difference between two forms of the gold salts in patients with RA. The statistical processing of data indicated that auranofin and aurothiomalate have significant effect on all controlled parameters. As regard of the side effects, patients accepted aurothiomalate better than auranofin.

Auranofin

Erythrocyte sedimentation rate

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[Comparative double-blind trial of diclophenac-sodium and naproxen in hip arthrosis].

PubMed (1981)

Bojan Štambuk N Zenić

Naproxen Sodium

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Arterijska revaskularizacija miokarda kod bolesnika sa šećernom bolesti

Bojan Štambuk Željko Sutlić Bojan Biočina Igor Rudež Davor Barić

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Clinical guidelines for diagnosis, treatment and monitoring of patients with invasive breast cancer – Croatian Oncology Society (BC-3 COS)

Liječnički vjesnik (2022)

Ingrid Belac-Lovasić Martina Bašić Koretić Paula Podolski Natalija Dedić Plavetić Tajana Silovski

SAŽETAK.Rak dojke je najčešći zloćudni tumor u žena koji se može probirom, redovitim kontrolama i zdravstvenim odgojem otkriti

Croatian

Clinical Oncology

10.26800/lv-144-9-10-2

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Total arterial revascularization in diabetic versus non-diabetic patients

Bojan Štambuk Željko Sutlić Bojan Biočina Davor Barić Daniel Unić

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[Advanced myocardial ischemia in patients with diabetes mellitus--early results of surgical treatment].

PubMed (2005)

Bojan Štambuk Željko Sutlić Bojan Biočina Igor Rudež Davor Barić

In this restrospetive study, data on 272 coronary artery disease patients with concomitant diabetes mellitus treated between 12/1997 and 12/2002 were analyzed. Eighty patients inderwent complete arterial revascularization (DM-ART), whereas 192 patients underwent coronary revascularization using arterial-venous grafts (DN-NEART). The following preoperative data and risk factors were analyzed: arterial hypertension, hyperlipoproteinemia, number of vessels involved, left coronary artery stenosis, unstable angina, previous myocardial infarction (MI), previous cardiac surgery, EuroScore. During a 30-day postoperative period, the following complications were analyzed: bleeding, perioperative MI, wound infection, sternal dehiscence, neurologic dysfunction, mortality. DM-ART patients had a higher rate of hyperlipoproteinemia (p=0.004). Difference was only found for the occurrence of perioperative MI in DM-NEART group (p<0.001). Total arterial revascularization without cardiopulmonary bypass is a reliable and safe choice in patients with concomitant diabetes mellitus irrespective of its type. Definitive conclusions can only be made after five- or ten-year evaluation of postoperative mirbidity and mortality.

Concomitant

Unstable angina

EuroSCORE

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