Coronary artery revascularization with arterial grafts Koroner bypass cerrahisinde arterial greftlerle revaskularizasyon
Erciyes Tip Dergisi, cilt.22, sa.2, ss.87-97, 2000 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 22 Sayı: 2
- Basım Tarihi: 2000
- Dergi Adı: Erciyes Tip Dergisi
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.87-97
- Anahtar Kelimeler: Coronary artery bypass, Epigastric artery, Myocardial revascularization, Radial artery, Thoracic arteries
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: Arterial gratis in coronary bypass patients provides superior late results when compared with vein grafts. Experience with patients who have been revascularized by multiple arterial gratis will be described in this study. Material and methods: From August 1992 to December 1998, coronary bypass was performed on 3339 patients. Amongst these patients, 68 of them were revascularized with multiple arterial grafts. There were 57 male (84 %), and II female (16 %) patients; their ages ranged from 35 to 78 (mean: 56.2±10.3 years). Five patients underwent coronary bypass without cardiopulmonary bypass. The number of distal bypasses were between two to six (mean: 3.8±1.3). Bilateral internal thoracic artery in 10 cases, sequential left internal thoracic artery in 46 cases, sequential left internal thoracic artery and sequential left radial artery in one case, left internal thoracic artery and sequential left radial artery in two cases, left internal thoracic artery and sequential right radial artery in one case, left internal thoracic artery and left radial artery in six cases, and left internal thoracic artery and inferior epigastric artery in two cases were the arterial grafts. In 22 patients revascularization was performed with only arterial grafts. Aneurysmectomy in two cases, mitral valve replacement in one case, and ascending-to-descending aortic bypass in one case were performed as associated procedures. Results: In the early postoperative period, reoperation due to excessive bleeding was performed on three patients (4.4 %). There was a case of cerebrovascular accident in I patient (1.4 %), and mediastinitis in one patient (1.4 %). There was no perioperative myocardial infarction or hospital mortality. A patent sequential left internal thoracic artery to diagonal artery and proximal and distal left anterior descending artery was determined in a case by control arteriography before discharge. All cases were followed-up, and follow-up time ranged from one to 58 months (mean: 11.6±13.1 months), a total of 692 patient-months. Control coronary arteriography was performed on two of the three symptomatic cases after 16 and 22 months postoperatively, which revealed patent sequential internal thoracic arteries. Conclusion: Multiple arterial revascularization does not increase risk in the early postoperative period, and carries potential advantages due to the nature of the grafts.