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A study to examine the resulting outcome after the use of Aprotinin on patients having undergone coronary-artery bypass grafting surgery is conducted. Results indicate that those patients that were given Aprotinin had a higher mortality rate and increases in serum creatinine levels.

Inflammation and ischemia-reerfusion injury during coronary artery bypass graft (CABG) surgery requiring cardiopulmonary bypass are associated with post operative myocardial infraction (MI) and mortality. The efficacy and safety of pexelizumab, a C5 complement inhibitor, in reducing perioperative MI and mortality in CABG surgery is determined.

Many patients who have a coronary artery bypass may develop impaired mental function in the years following the operation. In a study of 261 patients who had a bypass, 53% were diagnosed with impaired mental function at discharge, 36% six weeks later, 24% six months later, and 42% five years after surgery.

Measuring the level of IgM antibodies against endotoxin may predict which patients will develop complications from heart surgery. Endotoxin is a component of bacteria and may initiate an inflammatory response in surgical patients. Researchers measured the levels of IgM and IgG antibodies to endotoxin (EndoCAb) in 301 patients before they had heart surgery. Following surgery, 11.3% of the patients developed a complication. Those with low IgM EndoCAb levels were more likely to develop a complication even after adjusting for other risk factors., Objective.--To test the hypothesis that low serum antiendotoxin core antibody (EndoCAb) level is an independent predictor of adverse outcome following cardiac surgery. Design,-- Prospective, blinded, cohort study. Setting.--Tertiary care medical center. Subjects.--A total of 301 patients undergoing coronary artery bypass graff surgery and/or valvular heart surgery. Design.--Preoperative serum was assayed for IgM EndoCAb, IgG EndoCAb, total IgM, and total IgG levels. Known preoperative risk factors were assessed, and patients were assigned a risk score using a validated method. Main Outcome Measure--A major complication, defined as either in-hospital death or postoperative length of stay greater than 10 days. Results.---Overall, a major complication occurred in 34 patients (11.3%). Lower IgM EndoCAb level independently predicted (P--.002) increased risk of major complication over and above the effects of preoperative risk score (P=.02), total IgG level (P--.07), and all other known perioperative risk factors. In contrast, IgG EndoCAb and total IgM concentrations did not predict outcome. No association existed between risk score and level of IgM EndoCAb. Conclusion.--There is marked preoperative variability in humoral immunity against endotoxin core, which is not accounted for by differences in known preoperative risk factors. In this study, low levels of IgMEndoCAb were an important independent predictor of adverse postoperative outcome, which supports the theory that endotoxemia is a cause of postoperative morbidity. JAMA. 1997;277:646-650

Changing the way coronary bypass operations are done may prevent the decline in intellectual function that often occurs in patients who have the operation. Research has shown that a heart-lung machine can cause air bubbles or clumps of matter to travel to the brain. This could damage the brain in the same way a stroke does.