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  1. Article ; Online: Crystal Ball of Prognostication: Role of Biomarkers for Risk Stratification in Patient With Type A Acute Aortic Dissection.

    Raja, Shahzad G

    The American journal of cardiology

    2023  Volume 213, Page(s) 180–181

    MeSH term(s) Humans ; Aortic Dissection/diagnosis ; Biomarkers ; Risk Assessment ; Acute Disease ; Aortic Aneurysm, Thoracic/diagnosis
    Chemical Substances Biomarkers
    Language English
    Publishing date 2023-12-16
    Publishing country United States
    Document type Editorial
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2023.12.029
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  2. Article ; Online: Trainee Perceptions of Off-Pump Coronary Artery Bypass Grafting: United Kingdom Training Needs Survey.

    Comanici, Maria / Soni, Manish / Raja, Shahzad G

    The American journal of cardiology

    2024  Volume 220, Page(s) 47–48

    Language English
    Publishing date 2024-04-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2024.03.031
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  3. Article ; Online: Dual Antiplatelet Therapy in Percutaneous Coronary Intervention: Exploring the Role of Genotype-Guided Therapy in Reducing Readmission Rates.

    Comanici, Maria / Raja, Shahzad G

    The American journal of cardiology

    2023  Volume 203, Page(s) 507–508

    MeSH term(s) Humans ; Platelet Aggregation Inhibitors/therapeutic use ; Patient Readmission ; Clopidogrel/therapeutic use ; Percutaneous Coronary Intervention ; Genotype ; Acute Coronary Syndrome/drug therapy ; Treatment Outcome ; Cytochrome P-450 CYP2C19/genetics
    Chemical Substances Platelet Aggregation Inhibitors ; Clopidogrel (A74586SNO7) ; Cytochrome P-450 CYP2C19 (EC 1.14.14.1)
    Language English
    Publishing date 2023-07-26
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2023.07.043
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  4. Article ; Online: Dual-Antiplatelet Therapy After Coronary Artery Bypass Grafting: A Survey of UK Cardiac Surgeons.

    Comanici, Maria / Raja, Shahzad G

    Journal of cardiothoracic and vascular anesthesia

    2023  Volume 37, Issue 12, Page(s) 2517–2523

    Abstract: Objective: Antiplatelet therapy after coronary artery bypass grafting (CABG) is important in postoperative medical management. Although cardiac surgeons are well-versed in the guidelines regarding discontinuation of dual-antiplatelet therapy (DAPT; ... ...

    Abstract Objective: Antiplatelet therapy after coronary artery bypass grafting (CABG) is important in postoperative medical management. Although cardiac surgeons are well-versed in the guidelines regarding discontinuation of dual-antiplatelet therapy (DAPT; aspirin and a P2Y12 antagonist) before CABG to minimize bleeding risk, there is considerable variability in DAPT dosing after CABG. The objective of this study was to explore the current trends in DAPT after CABG in the UK to improve understanding of the existing practice.
    Design: This study used an online survey with 9 questions about the use of DAPT after CABG. An invitation to participate was sent to all adult cardiac surgeons currently in practice in the UK and the Republic of Ireland.
    Setting: The study was conducted in the UK and the Republic of Ireland.
    Participants: Participants in this study were adult cardiac surgeons currently in practice in the UK and the Republic of Ireland.
    Interventions: There were no interventions in this study.
    Measurements and main results: Responses were received from across the UK (85.4% UK; 4% each from Scotland and Northern Ireland, 1.3% from Wales) and 5.3% from the Republic of Ireland. Fifty-seven percent of the respondents performed between 50 and 100 CABGs per year. Ninety-one percent of the respondents prescribe DAPT postoperatively, but the choice of which patients receive it varied. Most responding surgeons used DAPT for selective patient cohorts, such as those with acute coronary syndrome (51%), diffuse coronary artery disease (42%), perioperative myocardial infarction (36%), coronary endarterectomy (31%), or when bypassing a stented coronary artery (23%). Thirty-eight percent of the respondents began all their patients with CABGs on DAPT. The most preferred P2Y12 antagonist was clopidogrel, used by 75% of respondents and introduced on day 1 after surgical revascularization (71%). The routine duration for DAPT is 12 months, which 78% of the respondents preferred. The main reason for not starting DAPT in those surveyed was the bleeding risk associated with DAPT (72%).
    Conclusions: The survey uncovered variation in the use of DAPT after CABG. However, DAPT remains the preferred strategy after CABG in the UK. The study highlighted the need to develop standardized protocols for DAPT after CABG.
    MeSH term(s) Adult ; Humans ; Platelet Aggregation Inhibitors ; Drug Therapy, Combination ; Coronary Artery Bypass/adverse effects ; Coronary Artery Bypass/methods ; Surgeons ; United Kingdom/epidemiology ; Treatment Outcome
    Chemical Substances Platelet Aggregation Inhibitors
    Language English
    Publishing date 2023-08-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2023.08.146
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    Zs.MO 31: Show issues

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  5. Article ; Online: Invited Commentary on "the translation of surgical animal models to human clinical research: A cross sectional study".

    Raja, Shahzad G

    International journal of surgery (London, England)

    2020  Volume 78, Page(s) 7–8

    MeSH term(s) Animals ; Biomedical Research ; Cross-Sectional Studies ; Humans ; Models, Anatomic ; Models, Animal ; Translations
    Language English
    Publishing date 2020-04-15
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2020.04.002
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  6. Article ; Online: Invited commentary on "Use of the eLogbook in surgical training in the United Kingdom: A nationwide survey and consensus recommendations from the Association of Surgeons in Training".

    Raja, Shahzad G

    International journal of surgery (London, England)

    2020  Volume 77, Page(s) 111

    MeSH term(s) Consensus ; Humans ; Surgeons ; Surveys and Questionnaires ; United Kingdom
    Language English
    Publishing date 2020-03-28
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2020.03.041
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  7. Article ; Online: Invited Commentary on "Diagnostic dilemma of perioperative myocardial infarction after coronary artery bypass grafting: A review".

    Raja, Shahzad G

    International journal of surgery (London, England)

    2020  Volume 79, Page(s) 323

    MeSH term(s) Coronary Artery Bypass ; Humans ; Myocardial Infarction
    Language English
    Publishing date 2020-06-07
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2020.05.089
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  8. Article ; Online: Total arterial off-pump coronary revascularization: The Holy Grail?

    Raja, Shahzad G

    Current opinion in cardiology

    2019  Volume 34, Issue 5, Page(s) 552–556

    Abstract: Purpose of review: Coronary artery bypass grafting (CABG) remains the standard of care for patients with complex multivessel coronary artery disease. However, conventional CABG utilizing left internal mammary artery and supplemental vein grafts ... ...

    Abstract Purpose of review: Coronary artery bypass grafting (CABG) remains the standard of care for patients with complex multivessel coronary artery disease. However, conventional CABG utilizing left internal mammary artery and supplemental vein grafts performed on cardiopulmonary bypass is marred by questionable long-term patency of vein grafts and risk of neurological injury. Total arterial off-pump CABG is a strategy associated with avoidance of neurological injury and vein graft failure. The aim of this review is to summarize recent evidence on safety and effectiveness of total arterial off-pump CABG.
    Recent findings: Two key studies have been published recently. One describes a dual inflow technique that achieves anaortic, off-pump complete revascularization using arterial grafts only. The other is single centre study that reports 10-year survival of 89.33%, rate of freedom from repeat revascularization of 91.33% and early stroke rate of 0.9% after total arterial off-pump CABG.
    Summary: Total arterial off-pump CABG with its advantages of improved survival, enhanced freedom from repeat revascularization and low stroke rate can be regarded as the Holy Grail of myocardial revascularization. However, the results of a large, multicenter, prospective trial are required to substantiate this status.
    MeSH term(s) Coronary Artery Bypass/adverse effects ; Coronary Artery Bypass/methods ; Coronary Artery Bypass/mortality ; Coronary Artery Bypass, Off-Pump/adverse effects ; Coronary Artery Bypass, Off-Pump/methods ; Coronary Artery Bypass, Off-Pump/mortality ; Coronary Artery Disease/surgery ; Humans
    Language English
    Publishing date 2019-05-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645186-x
    ISSN 1531-7080 ; 0268-4705
    ISSN (online) 1531-7080
    ISSN 0268-4705
    DOI 10.1097/HCO.0000000000000645
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    Zs.A 2556: Show issues Location:
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  9. Article: Cannulation strategies for aortic surgery: which is the best one?

    Raja, Shahzad G

    Journal of thoracic disease

    2017  Volume 9, Issue Suppl 6, Page(s) S428–S429

    Language English
    Publishing date 2017-06-12
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd.2017.03.99
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  10. Article ; Online: Emergency cardiac surgery for patients on NOACs in the NOAC era - Perspective.

    Alwis, Shehani / Raja, Shahzad G

    International journal of surgery (London, England)

    2021  Volume 87, Page(s) 105893

    Abstract: Excessive bleeding is an important cause of morbidity and mortality after cardiac surgery. Bleeding after cardiac surgery is multifactorial. Adherence to the proverbial 6 Ps remains the cornerstone of any strategy for management of postoperative bleeding ...

    Abstract Excessive bleeding is an important cause of morbidity and mortality after cardiac surgery. Bleeding after cardiac surgery is multifactorial. Adherence to the proverbial 6 Ps remains the cornerstone of any strategy for management of postoperative bleeding after cardiac surgery. Recent years have seen a surge in the number of patients who have been prescribed novel oral anticoagulants (NOACs) for the prevention and treatment of thromboembolic events. This phenomenon has significant repercussions particularly for patients presenting for emergency cardiac surgery. The published evidence guiding management of such patients is limited and in the form of expert consensus. Plasma levels of NOAC >30 ng/ml necessitate specific therapeutic interventions to tackle excessive bleeding attributed to NOAC intake. Current recommendation is to consider using specific reversal agent if available. Otherwise, use of prothrombin complex concentrates is recommended.
    MeSH term(s) Administration, Oral ; Anticoagulants/adverse effects ; Cardiac Surgical Procedures/adverse effects ; Emergency Service, Hospital ; Humans ; Postoperative Hemorrhage/chemically induced
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2021-02-09
    Publishing country England
    Document type Editorial
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2021.02.004
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