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2014, Number 1

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Rev Cubana Cardiol Cir Cardiovasc 2014; 20 (1)

Myocardial revascularization using combined arterial implants

Mojena MG, Estévez ÁN, Paredes CÁ, Rivero MN, Céspedes AG, Milán GE, Casas GJJ, Calzada FA, Núñez FR

Language: Spanish
References: 28
Page:
PDF size: 693.14 Kb.


ABSTRACT

Introduction: The Myocardial revascularization surgery constitutes a key therapeutic alternative in the modern world, resulting in the need of getting a higher number of more complex patients. This tendency justifies the use of alternatives such as the myocardial revascularization using combined arterial implants.
Objective: To characterize the results of the myocardial revascularization using combined arterial implants.
Method: Descriptive, analytical, longitudinal and prospective study. Out of a universe of 297 cases, a sample of 151 patients was taken, who received myocardial revascularization using combined arterial implants surgical treatment between January 2011 and December 2012.
Results: The clinical characteristics during the post operation period were related to a prevalence of male sex and the classical coronary risk factors. The most used way of doing the vascular implants was the inner left mammalian artery with the inner right mammalian artery in Y; the higher numbers of cases were done with extracorporeal circulation. The most revascularized coronary artery was the anterior descending, followed by the first marginal obtuse and the first diagonal, with a higher average of bridges by patients in lateral term way. During the post operation period most of the patients had an improvement in their functional class as well as in the ejection fraction of the left ventricle. The most common post operatory complications were excessive post surgical bleeding, surface infection of the surgical wound and renal dysfunction. Mortality was low and the main cause of death was renal dysfunction.
Conclusions: The myocardial revascularization using combined arterial implants constitutes an alternative techniquewhich may bring good results in our patients.


REFERENCES

  1. Ministerio de Salud Pública: Anuario Estadístico de Salud 2012. ISSN: 1561-4425, La Habana, abril 2013.

  2. Carrel A. VIII. On the Experimental Surgery of the Thorac-ic Aorta and Heart. Ann Surg 1910; 52:83-95.

  3. Stephenson LW. History of cardiac surgery. In: Cohn LH, editor. Cardiac surgery in the adult. 3rd ed. New York: McGraw-Hill; 2008. p. 3-28

  4. Estévez Álvarez N., et al. Ética e investigación científica en salud. Una aproximación al tema. Rev Cubana Car-diolCirCardiovasc 2013; 19(3-4).

  5. Tatoulis J. Total arterial coronary revascularization patient election, stenoses, conduits, targets. Ann Cardiotho-racSurg 2013;2(4)499-506.

  6. Glineur D. La elección del segundo injerto. RevEspCar-diol. 2013;66(6):427-431.

  7. Stamou SC, Nussbaum M, Stiegel RM, Reames MK, Skipper ER, Robicsek F, et al. Effect of Body Mass Index on Outcomes After Cardiac Surgery: Is There an Obesity Paradox? Ann ThoracSurg 2011; 91:42-47.

  8. Lips de Oliveira TM, Moraes de Oliveira GM, Klein CH, de Souza e Silva NA, Godoy PH.ArqBrasCardiol 2012; 95:345-52.

  9. Gillum MF, Mussolino RE, Madans JH. Diabetes mellitus, coronary Herat disease incidence and death from all causes in African American and European American women: the NHANES 1 epidemiologic follow-up study. J ClinEpidemiol 2010; 53:511.

  10. Argenziano M, Spotnitz HM, Whang W, Bigger JT Jr, Parides M, Rose EA.Risk stratification for coronary by-pass surgery in patients with left ventricular dysfunction: analysis of the coronary artery bypass grafting patch trial database. Circulation 1999; 100:119-24.

  11. Delcan JL. Cardiopatía Isquémica. Servicio de Cardiolo-gía del Hospital Gregorio Marañón. Madrid, 1999; 369-449.

  12. Guo-Wei He (Ed.) Arterial Grafts for Coronary Bypass Surgery. Springer-Verlag Berlin Heidelberg. 2006, p.279-283.

  13. Paterson HS, Naidoo R, Byth K, Chen C, Denniss AR. Full myocardial revascularization with bilateral internal mam-mary artery Y grafts. Ann CardiothoracSurg 2013; 2(4):444-452.

  14. Glineur D. Importance of the third arterial graft in multiple arterial graft in gstrategies. Ann CardiothoracSurg 2013;2(4):475-480.

  15. Buxton BF, Hayward PA. The art of arterial revasculariza-tion – total arterial revascularization in patients with triple vessel coronary artery disease. Ann CardiothoracSurg 2013;2(4):543-551.

  16. Fernández García RA.Factores asociados al infarto agudo del miocardio perioperatorio en la Cirugía Cardíaca. Tesis de terminación de residencia de Cirugía Cardiovascular. ICCCV-HHA. Ciudad de la Habana. 2011.

  17. Taggart DP. Current status of arterial grafts for coronary artery bypasses grafting. Ann CardiothoracSurg 2013;2(4):427-430.

  18. Valley MP, Edelman JJ, Wilson MK. Bilateral internal mammary arteries: evidence and technical consideration. Ann CradiothoracSurg 2013;2(4):570-577.

  19. Lytle BW. Bilateral internal thoracic artery grafting. Ann CardiothoracSurg 2013; 2(4): 485-492.

  20. SolimanHamad MA, van Straten AH M, Schonberger JPAM, Woorst JF, de Wolf AM, Martens EJ, et al. Pre-operative ejection fraction as a predictor of survival after coronary artery bypass grafting: comparison with a matched general population. Journal of Cardiothoracic Surgery2010; 5:29.

  21. Christensen MC, Krapf S, Kempel A, von Heymann Ch. Costs of excessive postoperative hemorrhage in cardiac surgery. J ThoracCardiovascSurg 2009; 138:687-93.

  22. Khalpey ZI, Ganim RB, Rawn JD. Postoperative care of cardiac surgery patients. In: Cohn LH, editor. Cardiac surgery in the adult. 3rd ed. New York: McGraw-Hill; 2008. p. 465-86.

  23. Arribas LP, Aguado JM. Infecciones en el postoperatorio de cirugía cardiaca. En: Perales N, editor. Control post-operatorio de la cirugía cardiaca. 2da ed. Barcelona: EdikaMed; 2005. p. 109-21.

  24. Morlans K, Santos Gracia J, González CM, Rodríguez Salgueiro F, García Mendive B, Sainz H. Disfunción neu-rológica en la cirugía cardiovascular. Acercamiento al te-ma. RevCubCardiolCirCardiovasc. 1998; 12(1): 20-8.

  25. Estévez Álvarez N. Revascularización miocárdica em-pleando injertos arteriales combinados. Trabajo de Ter-minación de Residencia Cirugía Cardiovascular. ICCCV, 2013.

  26. DiGiammarco G, Pano M, Cirmeni S, Pelini P, Vitolla G, DiMarco M. Predictive value of intraoperative transit-time

  27. flow measurement for short-term graft patency in coronary surgery. J ThoracCardiovascSurg 2006; 132:468-74.

  28. Hol PK, Lingaas PS, Lundbland R, Rein KA, Vatne K, Smith HJ, et al. Intraoperative angiography leads to graft revision in coronary artery bypass surgery. Ann ThoracSurg 2004; 78:502-05.




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