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Emergency off-pump coronary artery surgery

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Chinese Medical Journal 2004年第6期117卷 823-827页

作者： shahzad g raja Zulfiqar Haider Haider Zaman Department of Cardiac Surgery Alder Hey HospitalDepartment of Cardiovascular SurgeryMayo HospitalDepartment of Cardiovascular SurgeryMayo Hospital Liverpool L12 2APUnited KingdomLahorePakistanLahorePakistan

Background Off-pump coronary artery bypass grafting is fast-becoming a procedure of choice for elective revascularization in high-risk patients with multi-vessel coronary artery disease. However,the role of off-pump coronary artery bypass grafting for patients with acute coronary syndromes requiring emergency revascularization still requires validation. We present our experience to show the feasibility of off-pump coronary artery surgery as an emergency revascularization technique. Methods From April 2001 to September 2003,emergency (operation within 24 hours after hospitalization) coronary artery bypass grafting without cardiopulmonary bypass (CPB) was performed in 66 patients with a mean age of (66.9±5.4) years (range 49-72 years). They presented acute coronary syndromes with 38 patients on platelet glycoprotein Ⅱb/Ⅲa receptor antagonists. All patients underwent off-pump coronary artery bypass surgery via sternotomy with the intention of complete coronary *** An average of 2.9 grafts per patient were performed and the posterior descending artery and marginal branches of the circumflex artery were grafted in 83.3% of the patients. There were 4 events of intraoperative cardiac instability, precipitated by occlusion of right coronary artery or positioning of a cardiomegaly heart,leading to immediate conversion to CPB. The mortality rate was 3% (2/66). Two patients suffered postoperative stroke while three needed hemofiltration for acute renal failure. Post surgery elective coronary angiography (n=46) showed no significant *** Emergency off-pump coronary artery surgery with complete revascularization is feasible in patients with acute coronary syndrome with low morbidity and mortality and excellent early results.

关键词： coronary artery bypass·myocardial revascularization·off-pump coronary artery bypass grafting

Off-pump and on-pump coronary artery bypass surgery:time to move on

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Chinese Medical Journal 2004年第6期117卷 959-959页

作者： shahzad g raja Department of Cardiac Surgery Alder Hey Hospital

To the editor: Chen and colleagues,1 and the editorial staff of the Chinese Medical Journal, deserve much credit for carrying out and publishing a prospective comparative study of on-pump and off-pump coronary artery bypass (OPCAB) surgery in 300 patients with triple-vessel coronary artery disease. Although this study is limited by non-randomization and selection bias yet contrary to the previously published prospective, randomized studies by Van Dijk et al,2 and Ascione et al,3 the patient population of this study is more representative of current coronary artery surgery practices. Even more important is the conclusion that OPCAB can be applied to patients with triple-vessel coronary artery disease and 'in experienced hands' can achieve similar completeness of revascularization and similar early surgical results.

关键词： Cardiopulmonary Bypass Coronary Artery Bypass Humans

Off-pump coronary artery bypass grafting: Misperceptions and misconceptions

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World Journal of Methodology 2014年第1期4卷 6-10页

作者： shahzad g raja Umberto Benedetto Department of Cardiac Surgery Harefield Hospital Middlesex UB9 6JH United Kingdom

Coronary artery bypass grafting(CABg) continues to be one of the most commonly performed cardiac surgical procedures worldwide. Conventional CABg performed on cardiopulmonary bypass termed on-pump CABg is regarded as the gold standard. However, on-pump CABg results in several physiologic derangements including but not limited to thrombocytopenia, activation of complement factors, immune suppression, and inflammatory responses leading to organ ***, manipulating an atherosclerotic ascending aorta during cannulation and cross-clamping can predispose to embolization and stroke risk. Recognition of these detrimental effects of on-pump CABg resulted in resurgence of off-pump CABg nearly two decades ***-pump CABg since its resurgence has been a subject of intensive scrutiny and speculation. Despite numerous retrospective nonrandomized studies, prospective randomized trials, and meta-analyses validating the safety and efficacy of off-pump CABg, opponents of the technique have persistently demanded abandonment of off-pump CABg. Several misconceptions and misperceptions are used as an excuse for such demands. This review article examines published scientific evidence to evaluate these misperceptions and misconceptions about off-pump CABg.

关键词： Coronary artery bypass grafting Cardiopulmonary bypass Off-pump coronary artery bypass grafting Surgical myocardial revascularization Coronary artery surgery

内窥镜获取大隐静脉:技术、预后、思考与争议

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中国胸心血管外科临床杂志 2015年第3期22卷 245-251页

作者： shahzad g.raja Zubair Sarang 朱贤 Department of Cardiac Surgery Harefield Hospital London UK Department of Transplantation & Simulation Fellow Harefield Hospital London UK 不详

移植血管的选择对冠状动脉旁路移植术(CABg)短期及远期预后有着重要意义。患者术后的平稳恢复,长期生活质量的改善以及避免二次干预都和冠状动脉血管桥的通畅密不可分。考虑到桥血管远期通畅率以及术后生存率,乳内动脉是CABg患者桥血管... 详细信息

移植血管的选择对冠状动脉旁路移植术(CABg)短期及远期预后有着重要意义。患者术后的平稳恢复,长期生活质量的改善以及避免二次干预都和冠状动脉血管桥的通畅密不可分。考虑到桥血管远期通畅率以及术后生存率,乳内动脉是CABg患者桥血管的首选。但是,当患者存在多根冠状动脉需要搭桥时,大隐静脉仍然被广泛应用。大隐静脉获取的传统方法是采用自脚踝至腹股沟开放切口,称为开放性大隐静脉获取术(OVH)。但是这样的取桥方法会引起腿部手术切口疼痛以及感染。此外,如此长的伤口会让患者感觉极不美观。切口相关并发症以及患者对美观的需求促使内窥镜大隐静脉获取术(EVH)的产生。对于OVH和EVH两种术式,既往的文献表明EVH可以减少切口相关并发症,满足患者的美观需求,缩短住院时间,并减轻术后切口的疼痛。尽管EVH具有上述已知的优点,但是也有报道认为内窥镜技术存在损伤静脉的风险,同时在静脉桥的通畅度以及临床预后等方面存在潜在的不利因素,这些都限制了EVH的广泛应用。本综述将对EVH的技术、预后、思考以及争议等方面进行详细的剖析。

关键词：内窥镜下获取大隐静脉术(EVH) 移植血管冠状动脉旁路移植术(CABg) 长的大隐静脉(LSV) 开放式大隐静脉获取(OVH)

Reduced bit low power VLSI architectures for motion estimation

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Journal of Systems Engineering and Electronics 2013年第3期24卷 382-399页

作者： Shahrukh Agha Shahid Khan shahzad Malik raja Riaz Department of Electrical Engineering COMSATS Institute of Information Technology

Low power and real time very large scale integration （VLSI） architectures of motion estimation （ME） algorithms for mobile devices and applications are presented. The power reduction is achieved by devising a novel correction recovery mechanism based on algorithms which allow the use of reduced bit sum of absolute difference （RBSAD） metric for calculating matching error and conversion to full resolution sum of absolute difference （SAD） metric whenever necessary. Parallel and pipelined architectures for high throughput of full search ME corresponding to both the full resolution SAD and the generalized RBSAD algorithm are synthe- sized using Xilinx Synthesis Tools （XST）, where the ME designs based on reduced bit （RB） algorithms demonstrate the reduction in power consumption up to 45% and/or the reduction in area up to 38%.

关键词： motion estimation (ME) very large scale integration (VLSI) reduced bit sum of absolute difference (RBSAD).

Improved binary similarity measures for software modularization

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Frontiers of Information Technology & Electronic Engineering 2017年第8期18卷 1082-1107页

作者： Rashid NASEEM Mustafa Bin Mat DERIS Onaiza MAQBOOL Jing-peng LI Sara shahzad Habib SHAH Faculty of Computer Science and Information Technology Universiti Tun Hussein Onn Malaysia Parit Raja 86500 Malaysia Dcpartment of Computer Science Quaid-i-Azam University Islamabad45320 Pakistan Division of Computer Science and Mathematics University of Stirling Stirling FK9 4LA UI Department of Computer Science University of Peshawar Peshawar 25120 Pakistan SFaculty of Computer and Information Systems Islamic University Madina Madina POBox 170 KSA

目的:各种各样的二元相似度测量在聚类方法中被用来确定数据中的相似实体的同类组。这些相似度测量大多数仅基于特征的存在或缺失。二元相似度测量在软件模块化中亦能与不同的聚类方法一起用于提高软件系统的可理解性与可管理性。每种... 详细信息

目的:各种各样的二元相似度测量在聚类方法中被用来确定数据中的相似实体的同类组。这些相似度测量大多数仅基于特征的存在或缺失。二元相似度测量在软件模块化中亦能与不同的聚类方法一起用于提高软件系统的可理解性与可管理性。每种相似度测量都有其优势与不足,分别能使聚类结果优化或恶化。创新点:本文强调了软件模块化中一些已有的著名的二元相似度测量的优势。此外,基于这些已有的相似度测量,新提出了几种改进的相似度测量。方法:首先,介绍了一些软件模块化中已有的著名的二元相似度测量的优势。接着,提出了几种改进的新的相似度测量。结合具体例子,说明这些新方法整合了JCJNM和RR这几种已有的二元相似度测量的优势。最后,通过实验比较新方法与已有方法的结果,验证所提新方法的有效性。结论:实验结果表明相较于已有的相似度测量,本文所提出的新的二元相似度测量结果的可信度更高。这些新方法能减少任意决策的数量,增加聚类过程中聚类的数量。尽管这些新方法仅基于数据的二元特征向量表达,它们能被用来测试任何编程语言编写的软件系统。

关键词：二元相似度测量二元特征测量组合软件模块化