Open Coronary Endarterectomy of Left Anterior Descending Artery—Case Report and Review of Literature

Robu, Mircea; Marian, Diana Romina; Lazăr, Ecaterina; Radu, Razvan I; Boros, Cristian; Sibișan, Andra; Voica, Cristian; Broască, Marian; Gheorghiță, Daniela; Moldovan, Horațiu; Iliescu, Vlad Anton

doi:10.3390/jcdd9030083

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…The next step in CABG was using bilateral mammary arteries (BIMA). Similar angiographic patency rates were reported between left and right internal mammary arteries [4,5], and multiple studies reported higher survival rates when using BIMA [6][7][8]. Multiple studies report a higher rate (2.5%) of deep SSI a so-called "never event" when BIMA is used [9,10].…”

Section: Introductionsupporting

confidence: 52%

Surgical Strategy for Sternal Closure in Patients with Surgical Myocardial Revascularization Using Mammary Arteries

Robu,

Rădulescu,

Margarint

et al. 2023

JCDD

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Background: Coronary artery bypass grafting has evolved from all venous grafts to bilateral mammary artery (BIMA) grafting. This was possible due to the long-term patency of the left and right internal mammary demonstrated in angiography studies compared to venous grafts. However, despite higher survival rates when using bilateral mammary arteries, multiple studies report a higher rate of surgical site infections, most notably deep sternal wound infections, a so-called “never event”. Methods: We designed a prospective study between 1 January 2022 and 31 December 2022 and included all patients proposed for total arterial myocardial revascularization in order to investigate the rate of surgical site infections (SSI). Chest closure in all patients was performed using a three-step protocol. The first step refers to sternal closure. If the patient’s BMI is below 35 kg/m2, sternal closure is achieved using the “butterfly” technique with standard steel wires. If the patient’s BMI exceeds 35 kg/m2, we use nitinol clips or hybrid wire cable ties according to the surgeon’s preference for sternal closure. The main advantages of these systems are a larger implant-to-bone contact with a reduced risk of bone fracture. The second step refers to presternal fat closure with two resorbable monofilament sutures in a way that the edges of the skin perfectly align at the end. The third step is skin closure combined with negative pressure wound therapy. Results: This system was applied to 217 patients. A total of 197 patients had bilateral mammary artery grafts. We report only 13 (5.9%) superficial SSI and only one (0.46%) deep SSI. The preoperative risk of major wound infection was 3.9 +/− 2.7. Bilateral mammary artery grafting was not associated with surgical site infection in a univariate analysis. Conclusions: We believe this strategy of sternal wound closure can reduce the incidence of deep surgical site infection when two mammary arteries are used in coronary artery bypass surgery.

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Section: Introductionsupporting

confidence: 52%

Surgical Strategy for Sternal Closure in Patients with Surgical Myocardial Revascularization Using Mammary Arteries

Robu,

Rădulescu,

Margarint

et al. 2023

JCDD

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“…The presence of an easily concealable scar reduces the psychological stress associated with operated heart disease. For this reason, there is a worldwide trend in performing more congenital procedures via thoracotomy, in children as well as in adults [ 13 , 21 , 22 ]. One difference between the two groups is that, in children, central cannulation is easier, due to the short distance between the chest wall and the great vessels.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgical Repair of a Partial Atrioventricular Canal Defect in a 20-Year-Old Patient—A Case Report and Review of Literature

Moldovan

Bulescu

Cacoveanu

et al. 2022

JCDD

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The association of an ostium primum-type defect with a cleft anterior mitral valve is known in the medical literature as the partial form of an atrioventricular canal. We present a case report about a 20-year-old woman with minimal symptomatology that discovered her pathology on routine echocardiography. Today, surgical operation remains the gold standard in such pathologies, especially mandatory when there is important valvular regurgitation and left-to-right shunt. Currently living in the era of fast and good cosmetic outcomes, minimally invasive and endovascular approaches should be developed and more often practiced. This scientific presentation is the first step in showing our department steps in performing minimally invasive surgeries as a routine.

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Open Coronary Endarterectomy of Left Anterior Descending Artery—Case Report and Review of Literature

Cited by 2 publications

References 26 publications

Surgical Strategy for Sternal Closure in Patients with Surgical Myocardial Revascularization Using Mammary Arteries

Surgical Strategy for Sternal Closure in Patients with Surgical Myocardial Revascularization Using Mammary Arteries

Minimally Invasive Surgical Repair of a Partial Atrioventricular Canal Defect in a 20-Year-Old Patient—A Case Report and Review of Literature

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