Coronary artery stenosis bypass by using radial artery is good techniques which have longer outcomes. In coronary artery bypass grafting (CABG) the radial artery has several advantages. The radial artery has a thick muscular wall which is more susceptible to contraction from the competitive flow. As compared to the open harvesting technique endoscopic harvest of the radial artery has long lasting cosmetic results it also reduces the post-operative complications. The purpose of the study is to compare the two harvesting techniques and compare the short term and long term results related to intra-operative and post-operative outcomes Methods: This is retrospective study (In Queen Alia Heart Institute, Amman ,Jordan) to compare endoscopic radial artery technique versus open technique by reviewing patients files through a period between June 2013 and June 2018. Total 50 patients of CABG surgery was selected they were divided into two groups. Group A includes endoscopic radial harvest (n= 10) and Group B includes open harvest (n=40). Data was collected on predesigned Performa. Data were entered and analyze through IBM SPSS 22.0 Results: There was insignificant dissimilarity between the pre-operative outcomes between groups. The Post-operative outcomes were almost same in both groups except hand numbness (P-value<0.005). The comparison of intraoperative outcomes like harvest time between both groups indicate that the mean harvest time in group A was shorter than group B (39.20 + 3.73 Vs 51.90 + 2.09, P-value=0.000). The operative time in group A was higher than the group B (306.0 + 11.6 Vs 278 + 4.25 p-value=0.00). The hospital stays in both groups were insignificantly different (p = 0.09) Conclusions: Endoscopic radial artery harvest is best suited technique for CABG surgery as it significantly decreases the harvest time as well as hospital stay. It is also proven that it is safer, less painful and better wound appearance technique with exceptional outcomes based on positive surgical experience.
Background: Tricuspid insufficiency (TI) is a functional insufficiency in most of the cases and associated with the dilatation of the annulus and remolding. Pulmonary hypertension and right ventricular volume overload due to chronic aortic or / and mitral valve disease in most of the time causes the functional tricuspid insufficiency. Despite the different techniques used to repair the tricuspid valve, the recurrent TR is still occurring in 20- 30 % of the patients and the development of late TR is an important complication of left heart surgery. Our study aims to compare the long-term outcome of ring annuloplasty with De Vega annnuloplasty in patients with secondary tricuspid regurgitation (TR).Methods: A retrospective study of 320 patients who underwent tricuspid valve repair surgery for secondary tricuspid regurgitation from January 2002 to December 2010 at Queen Alia Heart Institute (QAHI). Patients were divided into two groups, in group (1) (n=180) patients had an annuloplasty ring. Group (2) (n=140) patients had De Vega procedure (no ring). The procedures were performed in association with mitral valve surgery in 78% of patients, aortic valve surgery in 15% and combined aortic and mitral valve surgery in 7% of patients. TR grade, NYHA functional class and Pulmonary artery pressure were nearly similar and no significant preoperative difference between the two groups.Results: Echocardiographic and clinical follow up were done for all patients. The duration of procedure for both De Vega and ring annuloplasty were nearly similar. The overall survival in ring group at 5year was 83.9% versus 77.9% in De Vega group. Freedom from residual and recurrent TR, event free survival and long-term survival were significantly better in the ring group and also the tricuspid valve reoperation were less in the ring group.Conclusions: The implantation of annuloplasty ring results in lower incidence of residual or recurrent of tricuspid regurgitation, improved the event-free survival and long-term survival when compared with the sewing techniques such as De Vega.
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