During the last few years there has been a trend in myocardial revascularization of older patients, with more coexisting disease. Despite the fact that hospital mortality seems stable, there is an increase in major postoperative morbidity.
Peripheral vascular atherosclerosis, neurological pathology, aorta-pathology, the occurrence of a perioperative myocardial infarction and the time cohort 1993-1995 are identified as independent risk factors for neurological complications.
We present a patient with a solitary metastasis in the heart 8 years after treatment for Ewing's sarcoma. Exploratory thoracotomy was performed and biopsies were taken. Despite high dose ifosfamide, the patient died a few weeks after surgery.
Should patent vein grafts be replaced during reoperation?Rooperation for coronary artery disease has become a routine procedure; however, a second rooperation is exceptional. In this report we describe our experience with 16 patients undergoing a second rooperation for coronary atherosclerosis. The absence of operative mortality is certainly related to the patient selection. The number of patients is still too small to draw major conclusions. Striking, however, is that the first rooperation was usually done for angina because of progression of atherosclerosis in the native coronary system and the second rooperation was done because of graft failure. This experience supports the idea that the replacement of old, even patent, venous grafts and the choice of the best available conduits are of great importance at the first rooperation and may prevent a second rooperation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.