Total Arterial Revascularization on Beating Heart: Experience in 803 Cases

2003 ◽  
Vol 11 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Sushil Kumar Singh ◽  
Surya Kumar Mishra ◽  
Deepak Kumar ◽  
Ram Deo Yadave ◽  
Rajiv Agarwal ◽  
...  
Keyword(s):  
Beating Heart ◽  
Arterial Revascularization ◽  
Vessel Disease ◽  
Total Arterial Revascularization ◽  
Triple Vessel Disease ◽  
Mammary Arteries ◽  
Internal Mammary ◽  
Left And Right ◽  
Almost All ◽  
Single Vessel Disease

To avoid the deleterious effects of cardiopulmonary bypass, total arterial revascularization was performed on the beating heart, using an Octopus stabilizer, in this prospective study of 803 patients without selection bias. Single-vessel disease was present in 71 (9%) patients, double-vessel disease in 204 (25%), and triple-vessel disease in 528 (66%). An ejection fraction < 30% was found in 127 (16%) cases. Angiography was carried out before discharge in 204 (25%) patients. Grafts included left and right internal mammary arteries and the radial artery. There were 2,661 grafts placed with a mean of 3.31 grafts per patient (range, 1 to 6). Operative mortality was 0.5%. There was no postoperative stroke and few incidences of renal impairment, even in patients with chronic renal failure. Blood transfusion was not required in 558 (69%) patients. Mean hospital stay was 5.6 days. Overall angiographic patency was 98.6%. Total arterial revascularization on the beating heart was found to be safe, effective, and reproducible in almost all patients, with excellent short-term patency rates and minimal morbidity.

Total Arterial Revascularization with a Single Y-Composite Graft for Triple-Vessel Disease: Comparison of 2- and 3-Artery Grafts

2004 ◽  
Vol 7 (5) ◽  
pp. E382-E386 ◽  
Author(s):  
Ji-Hyuk Yang ◽  
Kiick Sung ◽  
Young Tak Lee ◽  
Kay-Hyun Park ◽  
Tae-Gook Jun ◽  
...  
Keyword(s):  
Composite Graft ◽  
Arterial Revascularization ◽  
Vessel Disease ◽  
Total Arterial Revascularization ◽  
Triple Vessel Disease

Prediction value of EuroSCORE II in total arterial revascularization and its usage in the evaluation of postoperative complications: Single-center experience

2021 ◽  
pp. 021849232199705
Author(s):  
Aleksandar V Milutinovic ◽  
Stasa D Krasic ◽  
Igor S Zivkovic ◽  
Andja M Cirkovic ◽  
Slobodan Z Lokas ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Arterial Revascularization ◽  
Total Arterial Revascularization ◽  
Mammary Arteries ◽  
Internal Mammary

Background Total arterial revascularization is the most durable and technically the most demanding type of coronary artery bypass grafting procedure. It has proven long-term supremacy in comparison to conventional coronary artery bypass grafting. In our study, we investigated the reliability of EuroSCORE II as a predictor of intrahospital death. We showed its impact on adverse perioperative events. Methods In this nonrandomized prospective study, we analyzed 116 consecutive patients who underwent the total arterial revascularization procedure at our Institute from January 2011 until the present. For myocardial revascularization, the most suitable combinations with left internal mammary artery, right internal mammary artery, and radial artery grafts were used. Main fact in this research was intrahospital mortality value in comparison with the value predicted. Results There were 104 (89.7%) males and 12 (10.3%) females. Mean preoperative EuroSCORE II prediction value was 1.98% and postoperative we obtained 1.72%. Postoperative redo for bleeding was 6%. Positive correlation was proven between the EuoroSCORE II value and intensive care unit stay (0.452; p < 0.001). Among patients who received two internal mammary arteries, the highest EuroSCORE II was among those with presternal wound infection (p = 0.005). Patients with bilateral internal mammary arteries and diabetes showed that they have the highest values of EuroSCORE II and, at the same time, that they are extremely prone to wound problems. Conclusions We achieved a lower intrahospital mortality level than it was predicted with preoperative EuroSCORE II value. This tool is a reliable method for preoperative death risk calculation in this group of patients.

Total Arterial Revascularization in Triple-Vessel Disease With Off-Pump and Aortic No-Touch Technique

2008 ◽  
Vol 86 (6) ◽  
pp. 1861-1865 ◽  
Author(s):  
Wook Sung Kim ◽  
Jaejin Lee ◽  
Young Tak Lee ◽  
Kiik Sung ◽  
Ji-Hyuk Yang ◽  
...  
Keyword(s):  
Arterial Revascularization ◽  
Off Pump ◽  
Vessel Disease ◽  
Total Arterial Revascularization ◽  
Triple Vessel Disease

scholarly journals Angiographic profile of young patients (≤ 40 years) in a tertiary care center of Nepal

2020 ◽  
Vol 11 (6) ◽  
pp. 68-71
Author(s):  
Binay Kumar Rauniyar ◽  
Arun Kadel ◽  
Kiran Prasad Acharya ◽  
Kartikesh Kumar Thakur ◽  
Rakesh Bahadur Adhikari ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Tertiary Care ◽  
Significant Coronary Artery Disease ◽  
Young Patients ◽  
Vessel Disease ◽  
Single Vessel ◽  
Triple Vessel Disease ◽  
Artery Disease ◽  
Single Vessel Disease

Background: With rise in prevalence of conventional risk factors like diabetes, hypertension, smoking, dyslipidemia and obesity the incidence of coronary artery disease in young patients have increased in the recent decades even in developing world. There have been multiple studies done in Nepal studying the angiographic profile of coronary disease in general population. However, only few studies has been done till date on the angiographic profile in the young population in our country. Aims and Objectives: In this study, we aim to determine the angiographic profile of young patient ≤ 40 years in a tertiary care centre of Nepal. Materials and Methods: A retrospective analytic study was done in Shahid Gangalal National Heart Centre from January 2019 to December 2019. Individuals of both genders with age ≤ 40 years who underwent coronary angiography were included. Results: Total 109 patients were included. Out of 109, 89 were male and 20 were female. The mean age for male was 35.55 ± 4.31 and for female was 38.55 ± 1.90 (P = 0.003). Among 61 (55.96%) patients who had significant coronary artery disease, 33 patients (30.27%) with single vessel disease, 15 patients (13.76%) had double vessel disease, and 13 patients (11.92%) had triple vessel disease. Left anterior descending (LAD) artery was found to be most frequently involved in all patterns of Coronary artery disease (CAD). Smoking was the most common coronary risk factor present in 29.3% of patients followed by hypertension, family history of premature CAD and diabetes in 14.6%, 7.5% and 5.5% of patients respectively. Overall, the prevalence of smoking was more in males (31.4%) than in females (20%). Conclusion: Single vessel disease (SVD) was most prevalent in young patients with significant CAD. LAD is the most commonly involved coronary artery followed by Right coronary artery (RCA) and Left Circumflex (LCX).

scholarly journals Total arterial revascularization in patients with multi–vessel coronary artery disease: modern insight on conduit selection

2018 ◽  
pp. 33-37
Author(s):  
Ю. Ю. Стуков ◽  
С. А. Руденко ◽  
А. В. Руденко ◽  
В. В. Лазоришинець
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Long Term Results ◽  
Arterial Revascularization ◽  
Vein Grafts ◽  
Total Arterial Revascularization ◽  
Vessel Coronary Artery Disease ◽  
Internal Mammary ◽  
Artery Disease ◽  
Vessel Coronary Artery

Coronary artery bypass grafting (CABG) remains the most common operation performed by cardiac surgeons today. Fundamental basis of CABG is to reestablish perfusion to the myocardium, however there are different approaches in accomplishing this goal. The collection of scientific publications suggest the use of multiple arterial conduits in patients of young age, preferable without advanced comorbidity and low body surface area. Despite common use of saphenous vein grafts, lots publications demonstrate advantages of arterial conduits. Internal mammary artery (IMA) has patency rates in the region of 90–95% ten to fifteen years after CABG. Based on superior long-term results of the internal mammary artery (IMA), other arteries is being used in CABG. Radial artery (RA) nowadays it is the most popular arterial graft after the IMA in both low- and high-risk patients. Although, this conduit is underused, despite numerous observational studies, which documented excellent RA patency of 89% at 10 years. Furthermore RA and ITA grafting shows a strong protective effect against native coronary artery disease progression in symptomatic patients after CABG. The constellation of recent data and 2018 guidelines of European Society of Cardiology and European Association for Cardiothoracic Surgeons on myocardial revascularization suggest performing total arterial revascularization in patients with multi-vessel coronary artery disease. Purpose. Literature review on recent data in surgical revascularization using multiple arterial grafts in patients with multi-vessel coronary artery disease. Conclusions. Total arterial revascularization is safe and effective method in treatment of multi-vessel coronary artery disease. There is undoubted benefit of total arterial revascularization in short-, mid- and long–term results in frames of angina recurrence, major adverse cardiac events and redo surgery, associated with graft failure, compared to saphenous vein grafts. Total arterial revascularization may have protective effect on native coronary artery from disease progression, along with excellent patency rates in patients after CABG. However, clinical choice of grafts should be based on patient’s general condition, coronary artery anatomy and severity of stenosis.

Sign in / Sign up

Export Citation Format

Share Document