Dr. Ramchandani
Heart Surgeon

Specializing in
Off-Pump Coronary Artery Bypass
Surgery

Houston, Texas
Tel. (713) 790-2822 Fax (713) 790-2859

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Article Category: Dr. Ramchandani''s Publications Dr. Ramchandani's Publications Off Pump Research

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Category: Off Pump Subcategory: OPCAB Surgery Abstracts

Reduced Hospital Length of Stay (LOS)
Author:


Several studies have shown that OPCAB reduces ICU time and total hospital length of stay.2,4,5,6,8 Decreases of approximately 50% in average ICU time for patients with OPCAB compared to CABG with CPB were reported by both Muneretto et al. (22 hours vs. 43 hours, p=.003)6 and Meharwal et al. (18 hours vs. 33 hours, p<.001).4 In addition, other studies, including two prospective randomized studies, have demonstrated significantly shorter hospital mean length of stay by 1 to 2 days for OPCAB patien

4-Feb-05 11:00 AM Click to read: Reduced Hospital Length of Stay...


Category: Off Pump Subcategory: OPCAB Surgery Abstracts

Complete Revascularization and Similar Graft Patency
Author:


The ability to achieve completeness of revascularization in OPCAB patients with multivessel disease without compromising graft patency has been directly assessed in recent studies by experienced OPCAB surgeons. Several studies comparing OPCAB and CABG with CPB have shown that complete revascularization with similar number of grafts can be effectively performed with OPCAB.1,2,3,4,5,6 In a prospective, randomized study of 200 unselected patients, Puskas et al. reported similar indices of completen

4-Feb-05 11:00 AM Click to read: Complete Revascularization and...


Category: Off Pump Subcategory: OPCAB Surgery Abstracts

Reduced Perioperative Morbidity and Complications
Author:


While many comparative studies support equivalent clinical outcomes between OPCAB and CABG with CPB, various studies have suggested that OPCAB may reduce perioperative morbidity and complications compared to CABG with CPB. In a large database review of 11,717 OPCAB patients and 106,423 conventional CABG patients, the risk-adjusted incidence of complications was significantly lower for the OPCAB group (10.62% OPCAB versus 14.15% CABG with CPB, p<.0001).9 An extensive meta-analysis of 53 studies s

4-Feb-05 11:00 AM Click to read: Reduced Perioperative Morbidity...


Category: Off Pump Subcategory: OPCAB Surgery Abstracts

Reduced Blood Loss and Fewer Transfusions
Author:


Clinical studies have consistently demonstrated that OPCAB is an effective technique for significantly reducing the blood loss and transfusion requirements often associated with CPB.1,3,4,5,12,15,18,21,22,23 In two prospective, randomized studies by Puskas et al. and Ascione et al., the number of OPCAB patients requiring transfusions was reduced by 41% and 56%, respectively,

4-Feb-05 11:00 AM Click to read: Reduced Blood Loss and Fewer...


Category: Off Pump Subcategory: OPCAB Surgery Abstracts

Reduced Neurocognitive Impairment and Stroke
Author:


Several randomized studies have found that OPCAB may avoid the neurocognitive impairment associated with CPB and the occurrence of intraoperative cerebral microemboli. In two separate studies measuring microemboli with transcranial doppler (TCD), OPCAB resulted in almost a 40-fold reduction in microemboli with improved performance in neurocognitive testing.14,15 Similar findings were reported by Zamvar et al. in another

4-Feb-05 10:45 AM Click to read: Reduced Neurocognitive...


Category: Off Pump Subcategory: OPCAB Surgery Abstracts

Similar or Reduced Mortality Risk
Author:


The ability to achieve completeness of revascularization in OPCAB patients with multivessel disease without compromising graft patency has been directly assessed in recent studies by experienced OPCAB surgeons. Several studies comparing OPCAB and CABG with CPB have shown that complete revascularization with similar number of grafts can be effectively performed with OPCAB.1,2,3,4,5,6 In a prospective, randomized study of 200 unselected patients, Puskas et al. reported similar indices of completen

4-Feb-05 10:00 AM Click to read: Similar or Reduced Mortality Risk


Category: Off Pump Subcategory: Article

Study Backs Bypass Operations Without Pumps
Author: Randy Dotinga


TUESDAY, April 20 (HealthDayNews) -- Since the advent of coronary bypass operations four decades ago, surgeons have temporarily stilled the hearts of their patients during surgery by hooking them up to heart-lung machines. Now, new research suggests patients do just as well -- and at a lower cost -- when cardiologists let the heart keep beating on its own during the procedure. According to an Emory University study, patients who had "off-pump" coronary artery operations were just as likely

17-Jun-04 10:00 AM Click to read: Study Backs Bypass Operations...


Category: Research Subcategory: Pub Med

Off-Pump Surgery with Epidural Analgesia reduced the incidence of postoperative atrial fibrillation.
Author: Athanasiou T, Aziz O, Mangoush O, Weerasinghe A, Al-Ruzzeh S, Purkayastha S, Pepper J, Amrani M, Gle


Atrial fibrillation is the most common postoperative complication in patients undergoing coronary artery bypass grafting (CABG) with advancing age having been shown to have a significant association with its incidence. This study aims to assess whether off-pump coronary artery bypass (OPCAB) reduces the incidence of atrial fibrillation in elderly patients.

10-May-04 1:00 PM Click to read: Off-Pump Surgery with Epidural...


Category: Dr. Ramchandani's Publications Subcategory: Coronary Artery

Diagnosis and operation for anomalous circumflex coronary artery.
Author: Mahesh Ramchandani


Background. Origin of the left circumflex coronary artery from the right sinus of Valsalva is the most common anatomic variation of the coronary artery circulation. However, there are few reports about the operative approach to this anomalous vessel.

1-Feb-97 11:00 AM Click to read: Diagnosis and operation for...


Category: Dr. Ramchandani's Publications Subcategory: Aneurysm

Right ventricular aneurysm associated with postinfarction ventricular septal defect.
Author: Nahas C, Jones JW, Lafuente J, Ramchandani M, Beall AC Jr.


Isolated right ventricular aneurysms are rare. Postinfarction right ventricular aneurysm associated with a ventricular septal defect is a very unusual complication. We present such a case that was successfully treated surgically.

1-Feb-96 11:00 AM Click to read: Right ventricular aneurysm...


Category: Dr. Ramchandani's Publications Subcategory: Trauma

Reoperation for bleeding in trauma.
Author: Hirshberg A, Wall MJ Jr, Ramchandani MK, Mattox KL


OBJECTIVE: Analysis of the causes and clinical patterns of postoperative bleeding requiring reoperation in trauma patients. DESIGN AND SETTING: A case series of 166 consecutive patients treated over 7 years at a level I trauma center. PATIENTS: 136 patients (82%) sustained penetrating trauma, primarily gunshot wounds (102 patients). On admission, 85 patients (51%) were hemodynamically unstable. INTERVENTION: 196 reoperative procedures were performed to control bleeding: 136 laparotomies, 49 thor

4-Oct-93 12:00 PM Click to read: Reoperation for bleeding in trauma.