Seguimento clínico a médio prazo com uso exclusivo de enxertos arteriais na revascularização completa do miocárdio em pacientes com doença coronária triarterial

Lisboa, Luiz Augusto Ferreira; Dallan, Luís Alberto; Puig, Luiz Bóro; Filho, Carlos Abreu; Leca, Ricardo Cerquinho; Dallan, Luís Augusto Palma; Oliveira, Sérgio Almeida de

doi:10.1590/s0102-76382004000100004

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…One of the biggest advances in CABG was the use of the internal thoracic artery (ITA) anastomosed to the left anterior descending branch (AD) of the left coronary artery [2,3], proven in the 80s, as the gold standard in CABG because of its higher patency in the medium and long term compared to the saphenous vein (SV). Consequently, these studies have led surgeons to search for new arterial grafts [4], such as right internal thoracic artery, radial, gastroepiploic [5] and inferior epigastric [6].…”

Section: Introductionmentioning

confidence: 99%

Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas

Hortmann¹,

Oliveira

Rabello³

et al. 2010

Rev Bras Cir Cardiovasc

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Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomasComparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting post operative with return of the symptoms 219HORTMANN, HC ET AL -Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting post operative with return of the symptoms Bras Cir Cardiovasc 2010; 25(2): 218-223 Rev

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Section: Introductionmentioning

confidence: 99%

Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas

Hortmann¹,

Oliveira

Rabello³

et al. 2010

Rev Bras Cir Cardiovasc

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“…There is no increase in the operative time, there is no more bleeding, low output or mortality by its utilization as has already been demonstrated [13,17].…”

Section: Commentsmentioning

confidence: 67%

“…The utilization of the left internal thoracic artery to the anterior intraventricular branch (with all its benefits) has already been proven [5][6][7], including its utilization in over 70-year-old patients. The use of arterial grafts has been the primary goal of all services, trying to reduce the reoperation and cardiovascular event rates [8,9,[11][12][13]. In spite of the great applicability of the saphenous graft, it is known that its evolution over the mid term and long term is unsatisfactory [6,11,14,15].…”

Section: Commentsmentioning

confidence: 99%

<![CDATA[<B>The use of the radial artery as the second choice for arterial graft in patients over 70 years of age</B>]]>

Whitaker¹,

Passos²,

Ramalho³

et al. 2005

Braz. j. cardiovasc. surg.

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Objective: Retrospective study evaluating the morbidmortality and hospital behavior in over 70-year-old patients submitted to myocardial revascularization involving the radial artery as the second arterial graft.Method: During the period of August 1994 to December 2002, 2487 cases of myocardial revascularization were performed by the group of the Juiz de Fora Heart Institute, 476 of whom were 70 years of age or older and 36 (Group II) received the radial artery as the second arterial graft. The same type of surgery was performed in 142 under 70-year-old patients (Group I). Reoperations, off-pump operations (OPCAB) or associated procedures were excluded from this study.Results: The median age was 72.5 years, the mortality rate was 6% in this group of patients and the incidence of complications was low, comparable to the 142 under 70-yearold patients (Group I) submitted to the same type of surgery. Conclusion:The results achieved with this study lead the authors to believe that the radial artery can be safely used as the second arterial graft in well selected septuagenarian patients, despite the greater risk of co-morbidities related to this age group.Descriptors: Coronary artery disease, surgery. Radial artery. Myocardial revascularization, old age.

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“…LYTLE et al [3]. statistically showed that patients undergoing CABG with two mammary arteries instead of one had a longer survival and a longer period free of Redo and/or PTCA [4][5]. Therefore, on the basis of this and other experiences, it was decided to change our technique of coronary revascularization towards the exclusive use of arterial conduits, in order to obtain greater benefits in the long term.…”

Section: Discussionmentioning

confidence: 99%

<![CDATA[<B>Off-pump coronary artery bypass with multiple arterial conduits</B>]]>

Navia¹,

Vrancic²,

Vaccarino³

et al. 2005

Braz. j. cardiovasc. surg.

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Objective: to analyze intra-hospital results in patients undergoing elective off-pump total arterial revascularization and identify morbidity and mortality predictors using this surgical strategy.Methods: From May 1999 to February 2004, 203 myocardial revascularization procedures with total arterial revascularization without cardiopulmonary bypass (off-pump) were carried out in patients with multivessel disease (three vessels 81.7 %, one vessel disease was excluded). We report pre-surgical variables and co-morbidities: average age 63.9 ± ± ± ± ± 9.13 years, men 182 (89.5%), hypertension 132 (65%), smokers 125 (61%), hypercholesterolemia 152 (74.8%), previous myocardial infarction (> 30 days) 73 (35%), moderate to severe ventricular dysfunction 31 (15%), redo 5 (2.5%). Total arterial revascularization included T-grafts and sequential grafts with left internal mammary (100%), right internal mammary (56.6%) and radial (63%) arteries. The total number of distal anastomosis was 576 (mean of 3 grafts/patient), all carried out with external mechanical stabilizers. There were no proximal aortic anastomoses. Conversion to on-pump surgery occurred in 3 patients (1.5%). 90% of the patients was extubated in the operating room. The multiple logistic regression test was used for statistical analysis.Results: The postoperative incidence of atrial fibrillation was 12.8% (26), oligoanuric renal failure 3% (6), dialysis 0.49% (1), postoperative myocardial infarction 1.47% (3), low cardiac output 4% (8), Redo for bleeding 1.47% (3), mediastinitis 1.47% (3), stroke 1.47% (3). Intra-hospital mortality was 2.45% (5). The only independent 30 day morbidity predictor was age (p=0.033; OR 1.04; IC 95%: 1-1.08).Conclusion: Off-pump myocardial revascularization with arterial conduits for multiple vessel disease is feasible with a low 30-day morbidity and mortality.Descriptors: Coronary surgery. Off-pump circulation. Multiple vessel disease. Arterial conduits Cirurgia coronária com condutos arteriais múltiplos sem circulação extracorpóreaOff-pump coronary artery bypass with multiple arterial conduits 40 NAVIA, D ET AL -Off-pump coronary artery bypass with multiple arterial conduits Braz J Cardiovasc Surg 2005; 20(1): 39-45 INTRODUCTIONThe use of cardiopulmonary bypass (CPB) by heart surgeons over the last 35 years has enabled coronary artery bypass grafting in more complex patients with higher surgical risk giving better results. Nevertheless, its use is associated to a certain degree of morbidity and in some clinical situations to a higher incidence of post-surgical morbidity and mortality. The undesirable effects of cardiopulmonary bypass are expressed as physiological disorders secondary to the exposure of blood to plastic tubes, oxygenators and filters, which, combined with the use of surgical field aspirators, destroy red and white blood cells and platelets. Likewise, it has been shown that this activates the inflammatory system with the release of cytokines and the increase of capillary patency and the potential threat to ...

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Seguimento clínico a médio prazo com uso exclusivo de enxertos arteriais na revascularização completa do miocárdio em pacientes com doença coronária triarterial

Cited by 11 publications

References 18 publications

Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas

Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas

<![CDATA[<B>The use of the radial artery as the second choice for arterial graft in patients over 70 years of age</B>]]>

<![CDATA[<B>Off-pump coronary artery bypass with multiple arterial conduits</B>]]>

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