Long-term survivors of RAAA enjoy a HRQOL that does not differ significantly from EAAA survivors. Scores for both groups compare favorably with population scores adjusted only for age.
The technique of composite grafting with remote popliteal arteriovenous fistula may be a useful alternative in infragenicular bypass when a satisfactory autogenous vein is not available.
In this article, we document flow disturbance due to internal thoracic artery spasm (ITA) in a patient undergoing minimally invasive coronary artery grafting. We used intraoperative duplex scanning. Application of systemic vasodilators resulted in rapid improvement of ITA flow, as demonstrated by serial duplex examinations.
The new england journal of medicine n engl j med 350;21 www.nejm.org may 20, 2004 2180 Acquired Arteriovenous FistulaMcGill University Health Center Montreal, QC H3A 1A1, Canada 35-year-old man presented with high-output congestive heart failure. Fourteen years earlier, he had received a shrapnel wound to the left thigh in a car-bomb attack in Lebanon. As a consequence, a progressively enlarging pulsatile mass had developed in the left side of the groin. Angiography showed a large arteriovenous fistula involving the deep femoral artery and vein (Panel A, arrow). A computed tomographic scan showed a large, thrombosed false aneurysm associated with the fistula (Panel B, arrow); a shrapnel fragment was also present (arrowhead). At surgery, all inflow and outflow vessels associated with the fistula were ligated. After surgery, the mass was no longer pulsatile, and the congestive heart failure resolved promptly.
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