Coronary Artery Bypass Graft (CABG)

Researchers are evaluating an AI-assisted digital health tool called the "Smart family doctor" to improve control of hypertension, diabetes, and dyslipidemia in adults who have undergone coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). This study uses a randomized controlled design involving about 536 participants across 5-10 hospitals. Participants must be adults aged 18 or older with a history of CABG or PCI and the specified conditions. Participants in the experimental group will use the AI-assisted "Smart family doctor" app that provides personalized health education, targeted guidance on managing blood pressure, blood sugar, medication adherence, exercise, and smoking cessation. They will also receive tailored reminders and can report self-measured health data for feedback. Both groups receive weekly 3-hour health management guidance from health managers, and participants will wear a smart band daily for health data collection during the 6-month study period. Throughout the study, participants will be assessed for control rates of hypertension, diabetes, and hyperlipidemia at 6 months. Additional measures include blood pressure, cholesterol levels, blood glucose, physical activity, quality of life, psychological status, and cognitive function. The study monitors health data continuously via smart bands and collects self-reports and clinical assessments to evaluate the intervention's impact over the 6 months.

Researchers are evaluating a predictive tool called the Multifactorial Dynamic Perfusion Index (MDPI) to estimate the risk of acute kidney injury after cardiac surgery involving cardiopulmonary bypass (CPB). This observational study involves adults and infants undergoing cardiac surgery, aiming to validate the MDPI in adults, develop a version for infants under 20 kg, and explore if the MDPI can predict other complications including mortality. The MDPI combines seven variables measured during CPB, many of which can be modified by the surgical team to potentially improve patient outcomes. The study is divided into three parts: first, validating the MDPI in 800 adult cardiac surgery patients from two centers using existing CPB monitors that collect data such as hematocrit, oxygen delivery, arterial pressure, and transfusions; second, developing a modified MDPI for 200 infants under 20 kg undergoing congenital heart surgery with additional infant-specific variables; and third, investigating whether the MDPI can predict other postoperative issues like low cardiac output, longer ICU stays, bleeding complications, and 30-day mortality. Data collection includes parameters recorded during surgery and postoperative creatinine values. Participants will undergo cardiac surgery with CPB, during which relevant physiological data will be continuously recorded by specialized monitors. After surgery, kidney function and other outcomes will be monitored for up to 48 hours, with extended follow-up for complications and mortality over 30 days. Researchers will analyze how well the MDPI predicts acute kidney injury and other clinical outcomes, aiming to incorporate the MDPI into real-time monitoring devices to guide therapeutic decisions during surgery.

Researchers are evaluating the safety and effectiveness of a human umbilical cord mesenchymal stem cell injection called B2278 in combination with coronary artery bypass grafting (CABG) surgery for treating chronic heart failure caused by chronic ischemic cardiomyopathy. This multi-center Phase I/II clinical trial aims to find the best dose and treatment schedule for injecting B2278 directly into the heart muscle during surgery. Preliminary studies suggest B2278 may help repair the heart by reducing inflammation, promoting blood vessel growth, and regulating immune responses. Participants will undergo CABG surgery combined with different doses of B2278 injected into the epicardium, including low, medium, and high doses, or CABG surgery alone without B2278. The trial compares these four groups to explore the safety, tolerance, and heart function effects of adding B2278 to surgery. This approach focuses on direct heart treatment during CABG to address chronic heart failure caused by ischemic damage. During the study, participants will be monitored through various heart function tests such as cardiac magnetic resonance imaging and echocardiography at scheduled intervals up to six months after treatment. Researchers will assess safety events, heart pumping efficiency, heart size, walking ability, quality of life, and heart failure symptoms. Follow-up visits will include questionnaires, imaging, and blood tests to track changes and ensure participant safety throughout the trial period.

Researchers are evaluating a wearable device designed to continuously monitor lactate levels in the body for patients undergoing planned coronary artery bypass graft (CABG) and/or valve replacement surgery. The goal is to compare the device's readings with standard blood tests to verify accuracy. If successful, this device could reduce the need for frequent blood tests during surgery recovery and may also help in emergency rooms, especially for patients with chest pain. The study is conducted at Barts Hospital and sponsored by Queen Mary University of London. Participants will have two lactate sensors placed on their upper arm up to five days before surgery, with a 24-hour warm-up period before continuous measurement begins. During and after surgery, the sensors will monitor lactate levels for up to 48 hours. Hourly blood samples will be taken for up to 14 hours during surgery to compare with the sensor readings, including measurements of arterial and venous lactate, as well as venous troponin. Vital signs such as blood pressure, heart rate, and respiratory rate will be monitored regularly, and any medication changes will be recorded. Participants will undergo assessments including ECGs, blood pressure, heart rate, respiratory rate, and blood tests both before and after surgery. The sensors will be removed within 48 hours post-surgery, and the skin will be checked for any reactions. Follow-up monitoring will continue for up to 24 hours after sensor removal or until hospital discharge. Researchers will evaluate the device's accuracy, functionality, and safety through continuous lactate sensor measurements compared to standard blood tests over 14 to 48 hours, and safety monitoring up to 8 days.

Researchers are evaluating how artificial intelligence (AI) can analyze and assess the skills and techniques of surgeons performing vascular connections during coronary artery bypass grafting (CABG) procedures. The study focuses on comparing AI evaluation scores with those given by human experts specifically during the left anterior descending (LAD) artery anastomosis. The goal is to determine how consistent the AI assessments are with traditional expert evaluations. This observational study involves surgeons performing internal mammary artery-to-LAD artery bypass grafting on patients undergoing their first isolated CABG surgery. While there is no experimental treatment, the AI system will observe and evaluate the surgeon's motions and technique during the procedure. Measurements such as graft flow and flow resistance will also be recorded during surgery to provide detailed data on surgical performance. Participants in the trial are adult patients aged 18 and older who have agreed to participate and are scheduled for the specified CABG surgery. Researchers will collect data on the surgical procedure, including motion tracking of the surgeon and intraoperative measurements. The primary outcome is the consistency between the AI evaluation scores and human expert scores at the end of enrollment. Additional assessments include surgeon motion characteristics and further consistency evaluations. The study is expected to continue until July 2027.

Coronary artery bypass grafting surgery (CABG) is a common major surgery performed on older patients, involving significant surgical stress and immune responses. This stress can trigger inflammation and systemic effects, sometimes leading to complications like multiple organ dysfunction. Aging also changes immune function, causing increased inflammation and reduced ability to respond to stress, which may affect recovery from surgery. This study evaluates alpha-ketoglutarate (AKG), a dietary supplement thought to protect against aging-related immune changes and improve surgical resilience in patients undergoing CABG. Participants will be randomly assigned to receive either AKG tablets or placebo tablets once daily. The trial is double-blind and placebo-controlled, assessing the impact of AKG on inflammation and recovery after surgery. Participants will be monitored from surgery through 90 days afterward, with assessments including immune and inflammatory markers, muscle mass and strength, infection rates, frailty, pain, disability, quality of life, fatigue, depression, and patient satisfaction. Researchers will also track hospital resource use and long-term outcomes. The primary measurement is a combined assessment of systemic inflammatory response syndrome and organ dysfunction within 90 days after surgery.

Researchers are investigating the best way to monitor anticoagulation in patients receiving unfractionated heparin (UFH) after major heart and vascular surgeries. The study aims to compare different anticoagulation monitoring methods such as activated clotting time (ACT), activated partial thromboplastin time (aPTT), viscoelastic tests (ROTEM), and anti-factor Xa levels. It also explores the relationship between inflammation, anticoagulation levels, adverse events like bleeding or thrombosis, and the occurrence of delirium after these surgeries. Patients undergoing heart surgery require full heparinization before using the heart-lung machine, with monitoring done during and after surgery using ACT and other tests. Those undergoing vascular surgery receive UFH intraoperatively and sometimes continuous infusion postoperatively. The study evaluates various monitoring tools in real-time to assess anticoagulation levels, inflammation markers, and related complications. Some patients receiving extracorporeal membrane oxygenation (ECMO) support are also included, with close monitoring of their anticoagulation needs. Participants will be followed for up to 30 days after surgery to track adverse events such as bleeding, thrombosis, inflammation, delirium, and the need for additional treatments like protamine. The study collects data from blood tests, coagulation monitoring tools, and clinical assessments to understand the links between anticoagulation, inflammation, and patient outcomes. This observational study does not involve experimental treatments but gathers detailed information to improve monitoring approaches.

Researchers are evaluating surgical approaches to reduce brain-related complications during coronary artery bypass grafting (CABG) in patients with coronary artery disease. This multicenter, randomized controlled trial aims to improve outcomes and quality of life by comparing a new aortic no-touch technique with the conventional partial clamping method. The study focuses on lowering silent brain infarction and other neurological risks during surgery. The trial compares two surgical methods for off-pump CABG: one uses a partial clamp on the ascending aorta to connect the saphenous vein graft, while the other avoids any aortic manipulation by attaching the vein graft to the right internal mammary artery as a composite graft. These two approaches will be assessed for safety and effectiveness in preventing brain injury and other cardiovascular events. Participants will undergo surgery followed by detailed assessments including neurocognitive tests and MRI scans within the first week after surgery to detect brain infarcts or strokes. Researchers will monitor outcomes such as graft blockage, cognitive function, delirium, and major cardiac or cerebrovascular events for up to one year. Safety and quality of life measures will be evaluated throughout the study period to understand the impact of each surgical strategy.

Patients with ischemic heart disease who are scheduled for elective coronary artery bypass graft (CABG) surgery often face challenges such as advanced age, frailty, other health conditions, and physical inactivity. These factors, along with the physical and psychological stress of surgery, can affect recovery after the operation. Traditionally, efforts to improve surgical outcomes focus on care during and after surgery, but the waiting period before surgery may offer a valuable opportunity for prehabilitation to boost patients' ability to recover. The study evaluates the feasibility of a home-based multimodal prehabilitation program for patients awaiting elective CABG surgery. This program combines web-based supervised exercise sessions, nutritional guidance, psychological support, and advice on smoking and alcohol cessation. Patients in the intervention group receive these additional preoperative supports alongside usual care, while the control group receives usual care alone. The intervention includes three exercise sessions per week via a tablet and weekly phone consultations with a specialized nurse. Participants will be involved from enrollment until 30 days after surgery. Researchers will monitor recruitment, retention, adherence to the prehabilitation program, and safety throughout the preoperative period. Various assessments will occur at baseline, the day before surgery, and 30 days post-surgery, including exercise capacity, muscle strength, nutritional status, quality of life, anxiety, depression, and lifestyle factors such as tobacco and alcohol use. The study aims to inform a larger future trial and improve patient outcomes using the pre-surgery period.

The RECOVER study is an observational research project focused on patients undergoing cardiac rehabilitation at Hochgebirgsklinik Davos. It aims to understand patient characteristics, rehabilitation methods, recovery predictors, and clinical outcomes in heart disease patients, including those who have had cardiac procedures or surgeries. The study is sponsored by Medicine Campus Davos AG and the Kühne Foundation, with a goal to identify factors that influence long-term recovery and improve individualized therapy. Participants will be patients referred for cardiac rehabilitation who provide informed consent. The study will create a detailed database and biobank for comprehensive patient profiling, including genetics, plasma, digital and clinical biomarkers, and comorbidities. It will follow patients over time to observe how these factors relate to their recovery and health outcomes. During the study, patients will undergo extensive clinical assessments and long-term follow-up at 1, 5, and 10 years after inclusion. Researchers will monitor cardiovascular events, hospitalizations, quality of life, cognitive function, and functional capacity. The study seeks to provide insights into modifiable risk factors and support better targeted rehabilitation approaches over a prolonged period.