Experience with Bilateral Internal Mammary Artery Grafts for Myocardial Revascularization in Asian Patients

1995 ◽  
Vol 3 (3-4) ◽  
pp. 123-127 ◽  
Author(s):  
Sarajit Kumar Das ◽  
Nainar Madhu Sankar ◽  
Velivela Satyaprasad ◽  
Vellayikodath Velayudhan Bashi ◽  
Kotturathu Mammen Cherian
Keyword(s):  
Internal Mammary Artery ◽  
Myocardial Revascularization ◽  
Inferior Wall ◽  
Asian Patients ◽  
Myocardial Revascularisation ◽  
Diffuse Coronary Artery Disease ◽  
Internal Mammary ◽  
Artery Disease ◽  
Mean Time

Bilateral internal mammary artery grafts were used for direct myocardial revascularisation in 72 patients from August 1988 to January 1994. Twenty-five of them had diffuse coronary artery disease. The coronary arteries were small in the majority of patients and 10 patients needed endarterectomy. Two patients died in the hospital. Fifty-nine patients were followed up and the mean time of follow-up was 25 months. One patient died during the follow-up period and another patient developed inferior wall myocardial infarction. Three patients are on antianginal medications and the rest are doing well.

Right Gastroepiploic Artery in Myocardial Revascularization: Portuguese Experience

1995 ◽  
Vol 3 (2) ◽  
pp. 71-74
Author(s):  
José Roquette ◽  
Jorge Ouininha ◽  
Nelson Castelão ◽  
Filipe Robalo ◽  
Duarte Serra e Melo ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Myocardial Revascularization ◽  
Gastroepiploic Artery ◽  
Inferior Wall ◽  
Perioperative Myocardial Infarction ◽  
Arterial Revascularization ◽  
Right Gastroepiploic Artery ◽  
Internal Mammary ◽  
The Right

Excellent results obtained with the use of the internal mammary artery in myocardial revascularization led us to complement its use with other arterial conduits, and the right gastroepiploic artery (RGEA) emerged as a valid alternative, allowing the expansion of total arterial revascularization. From July 1988 until September 1994 we utilized the RGEA in 101 patients with ages between 30 and 71 years (mean 54 9.43). The RGEA was used to bypass the posterior descending artery in 90 patients and for the marginal branches of the circumflex in 11. Exclusive arterial revascularization was possible in 92% of the cases with a mean of 2.7 bypasses per patient. There were 4 (4%) cases of death, and 3 instances of perioperative myocardial infarction. Angiographic control of the RGEA performed in 46 patients showed a patency of 87%. In conclusion, the RGEA was predominantly used to revascularize the inferior wall of the myocardium as a complement to the internal mammary artery. Its use occurred without significant morbidity and mortality, and postoperative angiographic visualization of these arterial conduits allowed us to expect good mid-and long-term patency.

scholarly journals Minimally Invasive Coronary Bypass Grafting as a Standard Approach for Myocardial Revascularization

2020 ◽  
pp. 9-14
Author(s):  
O. D. Babliak ◽  
V. M. Demianenko ◽  
D. Y. Babliak ◽  
A. I. Marchenko ◽  
E. A. Melnyk ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Minimally Invasive ◽  
Internal Mammary Artery ◽  
Coronary Revascularization ◽  
Myocardial Revascularization ◽  
Bypass Grafting ◽  
Multivessel Coronary Artery Disease ◽  
Internal Mammary ◽  
Artery Disease

  Background. Minimally invasive cardiac surgery is becoming more widespread. The aim of the study was to evaluate the outcomes in 343 consecutive patients with isolated multivessel coronary artery disease who underwent minimally invasive coronary revascularization. Materials and methods. From July 2017 to December 2019 we performed total coronary revascularization via left anterior minithoracotomy (TCRAT) in 343 consecutive patients with isolated multivessel coronary artery disease. In 83 (24.2%) of them we performed multiarterial revascularization using left internal mammary artery (LIMA) and T-shunt with left radial artery or right internal mammary artery (RIMA). Cardiopulmonary bypass (CPB), aortic cross-clamping and blood cardioplegia were used in all patients. The patients were divided into two groups, uniarterial and multiarterial, to compare and analyze perioperative parameters. Results. No cases of postoperative myocardial infarction, surgically induced infection, or conversion to sternotomy were observed in any of the study groups. Total perioperative mortality was 0.58% (2 patients). Total operation time (290.6±48 [205; 495] versus 259.4±53.3 [165; 590], p=0.0001) and aortic cross-clamping time (81.6±18.7 [40; 122] versus 67±18 [35; 146], p<0.0001) were longer in patients with multiarterial revascularization compared to those with uniarterial revascularization. The patient’s mean age in the multiarterial group was 7.4 years less than in the uniarterial group. The mean hospital stay was 0.5 days shorter in the multiarterial group. Conclusions. The technique of minimally invasive coronary artery bypass grafting via left anterior thoracotomy avoids median sternotomy in 97.7% of patients. Both strategies for minimally invasive myocardial revascularization (multiarterial and uniarterial) are safe and effective with comparable perioperative outcomes and a total mortality of 0.58%.

scholarly journals Bilateral internal mammary artery for multi-territory myocardial revascularization: long-term follow-up of pedicled versus skeletonized conduits†

2014 ◽  
Vol 47 (4) ◽  
pp. 698-702 ◽  
Author(s):  
Michele Di Mauro ◽  
Angela L. Iacò ◽  
Angelo Acitelli ◽  
Gabriele D'Ambrosio ◽  
Laura Filipponi ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Myocardial Revascularization ◽  
Long Term Follow Up ◽  
Internal Mammary

scholarly journals Nursing Teleconsultation for the Outpatient Management of Patients with Cardiovascular Disease during COVID-19 Pandemic

2021 ◽  
Vol 18 (4) ◽  
pp. 2087
Author(s):  
Vincenzo Russo ◽  
Roberta Cassini ◽  
Valentina Caso ◽  
Chiara Donno ◽  
Annunziata Laezza ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Continuity Of Care ◽  
Medical Intervention ◽  
Lipid Lowering ◽  
Outpatient Management ◽  
Medical Interventions ◽  
Artery Disease ◽  
Clinical Conditions ◽  
Mean Time

Introduction: During the COVID-19 outbreak, non-urgent clinic visits or cardiac interventional procedures were postponed to a later date, and the implementation of telemedicine has guaranteed continuity of care for patients with chronic diseases. The aim of our study was to describe the medical interventions following nursing teleconsultation for the outpatient management of patients with cardiovascular diseases during the COVID-19 pandemic. Materials and Methods: All patients who did not attend the follow-up visit from 4 to 15 April 2020 at our institution and who were re-scheduled due to the COVID-19 lockdown were selected to be enrolled in the study. Each patient was followed by a semi-structured telephonic interview performed by a nurse. The outcomes of our study were to assess the patients’ adherence to nursing teleconsultation and the usefulness of nursing teleconsultation to detect clinical conditions in need of medical intervention. Results: In total, 203 patients (81%) underwent nursing teleconsultation in a mean time of 7 ± 3 days from the outpatient visit lost due to the COVID-19 lockdown. Furthermore, 53 patients (26%) showed poor adherence to nursing teleconsultation. Among the 150 patients (mean age 67 ± 10 years; 68% male) who completed the telephonic interview, the nursing teleconsultation revealed the need of medical intervention in 69 patients (46%), who were more likely at very high cardiovascular risk (77% vs. 48%; p < 0.0003) and who showed a higher prevalence of dyslipidemia (97% vs. 64%; p < 0.0001) and coronary artery disease (75% vs. 48%, p < 0.0008) compared to those not in need of any intervention. The up-titration of the lipid-lowering drugs (n: 32, 74%) was the most frequent medical intervention following the nursing teleconsultation. The mean time between the nursing teleconsultation and the date of the rescheduled in-person follow-up visit was 164 ± 36 days. Conclusions: Nursing teleconsultation is a simple and well-tolerated strategy that ensures the continuity of care and outpatient management for patients with cardiovascular diseases during the COVID-19 pandemic.

scholarly journals Myocardial revascularization by internal mammary artery implant procedures

1967 ◽  
Vol 54 (3) ◽  
pp. 359-370 ◽  
Author(s):  
Rene G. Favaloro ◽  
Donald B. Effler ◽  
Laurence K. Groves ◽  
F. Mason Sones ◽  
David J. G. Fergusson
Keyword(s):  
Internal Mammary Artery ◽  
Myocardial Revascularization ◽  
Internal Mammary

scholarly journals Total arterial myocardial revascularization using bilateral internal mammary arteries and the role of postoperative sternal stabilization to reduce wound infections in a large cohort study

2019 ◽  
Vol 29 (2) ◽  
pp. 224-229 ◽  
Author(s):  
Marc Albert ◽  
Ragi Nagib ◽  
Adrian Ursulescu ◽  
Ulrich F W Franke
Keyword(s):  
Retrospective Study ◽  
Wound Infection ◽  
Internal Mammary Artery ◽  
Wound Closure ◽  
Myocardial Revascularization ◽  
Wound Complications ◽  
Wound Infections ◽  
Term Survival ◽  
Mammary Arteries ◽  
Internal Mammary

Abstract OBJECTIVES Total arterial myocardial revascularization using bilateral internal mammary arteries shows improved results for mortality, long-term survival and superior graft patency. It has become the standard technique according to recent guidelines. However, these patients may have an increased risk of developing sternal wound infections, especially obese patients or those with diabetes. One reason for the wound complications may be early sternum instability. This situation could be avoided by using a thorax support vest (e.g. Posthorax® vest). This retrospective study compared the wound complications after bilateral internal mammary artery grafting including the use of a Posthorax vest. METHODS Between April 2015 and May 2017, 1613 patients received total arterial myocardial revascularization using bilateral internal mammary artery via a median sternotomy. The Posthorax support vest was used from the second postoperative day. We compared those patients with 1667 patients operated on via the same access in the preceding 26 months. The end points were the incidence of wound infections, when the wound infection occurred and how many wound revisions were needed until wound closure. RESULTS The demographic data of both groups were similar. A significant advantage for the use of a thorax support vest could be seen regarding the incidence of wound infections (P = 0.036) and the length of hospital stay when a wound complication did occur (P = 0.018). CONCLUSIONS As seen in this retrospective study, the early perioperative use of a thorax stabilization vest, such as the Posthorax vest, can reduce the incidence of sternal wound complications significantly. Furthermore, when a wound infection occurred, and the patient returned to the hospital for wound revision, patients who were given the Posthorax vest postoperatively had a significantly shorter length of stay until wound closure.

Inverted internal mammary artery for myocardial revascularization

1991 ◽  
Vol 51 (3) ◽  
pp. 524-525
Author(s):  
Ugolino Livi ◽  
Uberto Bortolotti ◽  
Vincenzo Gallucci
Keyword(s):  
Internal Mammary Artery ◽  
Myocardial Revascularization ◽  
Internal Mammary
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