Siven Seevanayagam

Learn More
OBJECTIVE To test whether perioperative sodium bicarbonate infusion can attenuate postoperative increases in serum creatinine in cardiac surgical patients. DESIGN Double-blind, randomized controlled trial. SETTING Operating rooms and intensive care unit at a tertiary hospital. PATIENTS Cohort of 100 cardiac surgical patients at increased risk of(More)
OBJECTIVE To compare the safety, availability, and long-term sequelae of percutaneous vs. surgical tracheostomy. DESIGN Prospective, randomized, controlled study. SETTING Combined medical/surgical intensive care unit in a tertiary referral hospital. PATIENTS Two hundred critically ill mechanically ventilated patients who required tracheostomy. (More)
BACKGROUND Reoperative coronary artery bypass grafting (redo CABG) shows improving outcomes, but with varying degrees of improvement. We assessed contemporary outcomes after redo CABG to determine if redo status is still a risk factor for early postoperative complications and midterm survival. METHODS Isolated CABG procedures (June 1, 2001 to May 31,(More)
BACKGROUND The purpose of this study was to find the preoperative and intraoperative factors that affect vein graft patency. METHODS A total of 3715 graft angiograms in 1607 patients were studied for recurrence of angina. The preoperative patient characteristics and intraoperative variables were prospectively collected from patients who had primary(More)
BACKGROUND Acute kidney injury (AKI) after cardiac surgery is a common and serious condition carrying significant costs. During cardiopulmonary bypass (CPB) surgery, modifiable factors may contribute to post-operative AKI. Their avoidance might be a potential target for nephroprotection. METHODS The objective of the present study was to identify and(More)
PURPOSE It is controversial whether all critically ill patients with risk, injury, failure, loss, and end-stage renal failure (RIFLE) F class acute kidney injury (AKI) should receive renal replacement therapy (RRT). We reviewed the outcome of open heart surgery patients with severe RIFLE-F AKI who did not receive RRT. MATERIALS AND METHODS We identified(More)
OBJECTIVE There is an important role for accurate risk prediction models in current cardiac surgical practice. Such models enable benchmarking and allow surgeons and institutions to compare outcomes in a meaningful way. They can also be useful in the areas of surgical decision-making, preoperative informed consent, quality assurance and healthcare(More)
Long-term patency of a bypass graft is an important determinant in reducing morbidity and increasing survival after coronary bypass surgery. The purpose of this review is to analyse factors contributing to improved outcomes of commonly used conduits. Progress has been limited by the lack of uniform definitions of graft failure and development of appropriate(More)
BACKGROUND Previous reports have supported the use of bilateral internal thoracic arteries to revascularize the left coronary circulation. If this becomes standardized practice, the optimal conduit for the right coronary system remains to be established. Our objective is to compare the performance of the radial artery versus the saphenous vein when used to(More)
OBJECTIVE The right internal thoracic artery is being used infrequently despite favorable observational angiographic data. Conversely, the radial artery utilization has increased with only limited data available. The purpose of this paper is to re-evaluate the roles of the right internal thoracic artery and the radial artery grafts. METHODS We reviewed(More)