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Complete revascularization was more frequently accomplished by bypass surgery than by stent implantation. One year after bypass, there was no significant difference in event-free survival between surgically treated patients with complete revascularization and those with incomplete revascularization, but patients randomized to stenting with incomplete revascularization had a greater need for subsequent bypass surgery.

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Neovascularization is an integral process of inflammatory reactions and subsequent repair cascades in tissue injury. Monocytes/macrophages play a key role in the inflammatory process including angiogenesis as well as the defence mechanisms by exerting microbicidal and immunomodulatory activity. Current studies have demonstrated that recruited monocytes/macrophages aid in regulating angiogenesis in ischemic tissue, tumours and chronic inflammation. In terms of neovascularization followed by tissue regeneration, monocytes/macrophages should be highly attractive for cell-based therapy compared to any other stem cells due to their considerable advantages: non-oncogenic, non-teratogenic, multiple secretary functions including pro-angiogenic and growth factors, straightforward cell harvesting procedure and non-existent ethical controversy. In addition to adult origins such as bone marrow or peripheral blood, umbilical cord blood (UCB) can be a potential source for autologous or allogeneic monocytes/macrophages. Especially, UCB monocytes should be considered as the first candidate owing to their feasibility, low immune rejection and multiple characteristic advantages such as their anti-inflammatory properties by virtue of their unique immune and inflammatory immaturity, and their pro-angiogenic ability. In this review, we present general characteristics and potential of monocytes/macrophages for cell-based therapy, especially focusing on neovascularization and UCB-derived monocytes.

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Objective: To analyze pulmonary functional changes and pain in patients undergoing off-pump coronary artery bypass grafting utilizing a left internal thoracic artery graft, comparing pleural drain insertion through the intercostal space and the subxyphoid approach.Methods: Twenty-eight patients (mean age 57.4 ± ± ± ± ± 8.4 years) were divided into two groups, according to the pleural drain site. Group LI (n=15) had the pleural drain inserted through the sixth left intercostal space at the mid-axillary line and in the MI group (n=13) the drain was placed through the subxyphoid region. All the patients underwent pre-and postoperative evaluations of pulmonary function tests as well as arterial blood gas analysis. Forced vital capacity (FVC) and forced expiratory volume over one second (FEV 1 ) were recorded in the preoperative period, and on the first, third and fifth postoperative days. The pain sensation was evaluated using a standard score from 0 to 10. Results:In both groups, falls in the FVC and FEV 1 were noted, up to the fifth postoperative day (P<0.001). However the decrease was higher in the LI group, when compared to the MI group (p<0.05). Also arterial blood gas analysis showed a decline of the partial oxygen pressure in both groups on the first postoperative day, but more significantly in the LI group (p=0.021). The pain sensation was higher in the LI group (p=0.002).Conclusion: Off-pump coronary artery bypass grafting using the left internal thoracic artery, disregarding the pleural drain site, leads to a significant decrease of postoperative pulmonary function. However, the subxyphoid technique of drain insertion has shown a better preservation of the lung function when compared to the intercostal drain site.Descriptors: Coronary artery bypass surgery. Pleural drain. Pulmonary function. 48GUIZILINI, S ET AL -Effects of the pleural drain site on the pulmonary function after coronary artery bypass grafting Bras Cir Cardiovasc 2004; 19(1): 47-54 Rev