scholarly journals Late results of coronary revascularization with saphenous vein and internal thoracic artery grafts

Medicina ◽  
2009 ◽  
Vol 45 (9) ◽  
pp. 688
Author(s):  
Šarūnas Kinduris ◽  
Juozas Sakalauskas ◽  
Raimonda Verseckaitė ◽  
Gintarė Kaklauskaitė
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Saphenous Vein ◽  
Internal Thoracic Artery ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Late Results ◽  
Saphenous Veins ◽  
Obtuse Marginal ◽  
The Right

Objective. To evaluate the patency of saphenous vein and internal thoracic artery grafts by coronary system using angiographies performed in symptomatic patients after coronary artery bypass grafting. Material and methods. From 1999 to 2006, 685 patients (mean age, 59.1±11.8 years) had angiography of 538 internal thoracic and gastroepiploic artery and 1644 saphenous vein grafts. There were 580 (84.7%) males. The mean period from operation to the performance of reangiogram was 73.3±53.5 months. Graft failure was defined as >95% stenosis. The saphenous vein was grafted to the left anterior descending artery in 106 (6.4%), to the diagonal artery in 364 (22.1%), to the obtuse marginal artery in 629 (38.3%), and to the right coronary artery in 545 (33.1%) cases. Results. During the study, 1496 (68.97%) grafts were patent, and 686 (31.0%) had failed. Unadjusted 1-, 5-, 10-, and >10-year patency was 91.0%, 89.9%, 90.1%, and 75% for internal thoracic arteries and 79.9%, 68.6%, 57.4%, and 51.0% for saphenous veins, respectively. Conclusions. Internal thoracic arteries demonstrate better patency than saphenous veins except when grafting moderately stenosed coronary arteries. When bypassing coronary arteries with less than 70% stenosis, saphenous veins may be a better choice.

Coronary Revascularization in Children at a Mexican Cardiac Center: Thirteen-Year Outcomes

2017 ◽  
Vol 8 (5) ◽  
pp. 600-604 ◽  
Author(s):  
Samuel E. Ramírez-Marroquín ◽  
Alejandra Iturriaga-Hernández ◽  
Juan Calderón-Colmenero ◽  
Antonio Benita-Bordes ◽  
Jorge L. Cervantes-Salazar
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Right Coronary Artery ◽  
Internal Thoracic Artery ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Diagnostic Study ◽  
Bilateral Internal Thoracic Artery ◽  
The Right

Background: The indications for pediatric coronary revascularization are diverse. There are a large proportion of patients with sequelae of severe inflammatory diseases such as Kawasaki disease, and other less common causes. Methods: Retrospective review of ten pediatric patients undergoing coronary artery bypass surgery from January 2004 to December 2016. Results: Ten children and adolescents ranging in age from 2 to 17 (median, 6) years at operation were followed up for as long as 13 years with a median follow-up of 2 years. The surgical indications include ischemia symptoms and/or coronary stenosis angiographically documented. Diagnoses include Kawasaki disease, anomalous origin of the left coronary artery from the pulmonary artery, and iatrogenic lesion of the right coronary artery. All the surgical procedures were performed with cardiopulmonary bypass with crystalloid cardioplegic arrest. The number of distal anastomoses was 1.6 per patient, and the left internal thoracic artery was used in one patient, the right internal thoracic artery in four patients, bilateral internal thoracic artery in four patients, and bilateral internal thoracic artery plus left radial artery in one patient, most frequently for right coronary artery revascularization. The patients underwent noninvasive diagnostic study during follow-up to evaluate their coronary status. The ten patients had no symptoms, and there was no mortality. Conclusions: Although survival was excellent after pediatric coronary bypass in our center, we need to continue the follow-up. Coronary revascularization by means of arterial grafting is a safe and reliable surgical modality for coronary disease in children.

scholarly journals Treatment of Iatrogenic Aortocoronary Arteriovenous Fistula with Coronary Covered Stent

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Ender Ornek ◽  
Harun Kundi ◽  
Emrullah Kiziltunc ◽  
Mustafa Cetin
Keyword(s):  
Coronary Artery ◽  
Arteriovenous Fistula ◽  
Saphenous Vein ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Covered Stent ◽  
Circumflex Artery ◽  
Coronary Vein ◽  
Coronary Artery Stent ◽  
Obtuse Marginal

An 83-year-old man, who underwent coronary artery bypass operation of left internal mammary artery (LIMA) to left anterior descending (LAD) artery, with sequential saphenous vein to the first and second obtuse marginal (OM) branches of circumflex artery 5 years ago and coronary artery stent implantation to right coronary artery 2 months ago, was admitted to the hospital with syncope and chest pain. Aortosaphenous graft selective angiography revealed that first sequential side to side ligation was inadvertently anastomosed to left posterolateral coronary vein with resultant flow into the coronary sinus and distal end to side sequential anastomosis to OM 2 coronary artery which was filling very weakly. In order to close this iatrogenic coronary arteriovenous fistula and to supply saphenous vein flow to OM artery, we decided to implant a graft covered stent into the saphenous vein at the same session.

Planned Simultaneous Beating-heart Totally Endoscopic Coronary Artery Bypass (TECAB) and Percutaneous Intervention in a Single Operative Setting

2006 ◽  
Vol 1 (5) ◽  
pp. 239-242 ◽  
Author(s):  
Sudhir Srivastava ◽  
Suresh Gadasalli ◽  
Orlando Tijerina ◽  
Reyna Barrera ◽  
Shaune Quismundo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Hybrid Approach ◽  
Percutaneous Intervention ◽  
Beating Heart ◽  
Coronary Artery Revascularization ◽  
First Case ◽  
The Right

Background Staged hybrid revascularization integrated with minimally invasive coronary artery bypass grafting (CABG) and arrested heart totally endoscopic CABG has been reported. We report the first case of planned simultaneous hybrid coronary revascularization, integrating beating-heart TECAB, and percutaneous intervention (PCI) in the same operative setting. Methods A 73-year-old woman with symptoms of angina and a history of diabetes was found to have 2-vessel coronary artery disease involving the left anterior descending (LAD) and the right coronary artery (RCA). Left internal thoracic artery (LITA) to the LAD grafting was done on a beating heart in a totally endoscopic manner using the da Vinci robotic system through 4 ports. Immediately after LITA to LAD TECAB, percutaneous angioplasty and stent placement was done through the right femoral artery using the OEC 9800 mobile C-arm in the operating room. Results There was no stenosis noted in the RCA after the intervention. LITA angiography showed a completely patent anastomosis. The total operative time for both procedures was 165 minutes. Occlusion and anastomotic times were 14 and 8 minutes, respectively. Total PCI and fluoroscopy times were 10 and 3 minutes, respectively. The patient received clopidogrel (Plavix) and aspirin in the immediate postoperative period and was discharged home on the second postoperative day. Conclusion This planned hybrid approach involving a beating-heart single-vessel TECAB and simultaneous angioplasty-stent in a single operative setting achieved complete coronary artery revascularization in a less invasive way.

scholarly journals Angiographic Patency of Coronary Artery Bypass Conduits: A Network Meta‐Analysis of Randomized Trials

2021 ◽  
Vol 10 (6) ◽  
Author(s):  
Mario Gaudino ◽  
Irbaz Hameed ◽  
N. Bryce Robinson ◽  
Yongle Ruan ◽  
Mohamed Rahouma ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Randomized Trials ◽  
Internal Thoracic Artery ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Gastroepiploic Artery ◽  
Graft Occlusion ◽  
Right Internal Thoracic Artery

Background Several randomized trials have compared the patency of coronary artery bypass conduits. All of the published studies, however, have performed pairwise comparisons and a comprehensive evaluation of the patency rates of all conduits has yet to be published. We set out to investigate the angiographic patency rates of all conduits used in coronary bypass surgery by performing a network meta‐analysis of the current available randomized evidence. Methods and Results A systematic literature search was conducted for randomized controlled trials comparing the angiographic patency rate of the conventionally harvested saphenous vein, the no‐touch saphenous vein, the radial artery (RA), the right internal thoracic artery, or the gastroepiploic artery. The primary outcome was graft occlusion. A total of 4160 studies were retrieved of which 14 were included with 3651 grafts analyzed. The weighted mean angiographic follow‐up was 5.1 years. Compared with the conventionally harvested saphenous vein, both the RA (incidence rate ratio [IRR] 0.54; 95% CI, 0.35–0.82) and the no‐touch saphenous vein (IRR 0.55; 95% CI, 0.39–0.78) were associated with lower graft occlusion. The RA ranked as the best conduit (rank score for RA 0.87 versus 0.85 for no‐touch saphenous vein, 0.23 for right internal thoracic artery, 0.29 for gastroepiploic artery, and 0.25 for the conventionally harvested saphenous vein). Conclusions Compared with the conventionally harvested saphenous vein, only the RA and no‐touch saphenous vein grafts are associated with significantly lower graft occlusion rates. The RA ranks as the best conduit. Registration URL: https://www.crd.york.ac.uk/prospero ; Unique identifier: CRD42020164492.

scholarly journals Study of the expression of genes associated with post-translational changes in histones in the internal thoracic artery and the saphenous vein grafts used in coronary artery bypass grafting procedure

2020 ◽  
Vol 8 (4) ◽  
pp. 183-189
Author(s):  
Sandra Kałużna ◽  
Mariusz J. Nawrocki ◽  
Rut Bryl ◽  
Katarzyna Stefańska ◽  
Marek Jemielity ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Saphenous Vein ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Transcript Levels ◽  
Artery Bypass Grafting ◽  
Selection Of

AbstractCoronary artery disease (CAD) is one of the leading causes of mortality in the world. The most advanced forms of CAD are usually treated by means of coronary artery bypass grafting (CABG). The selection of the appropriate vessels as aortocoronary conduits is of paramount importance. The internal thoracic artery (ITA) or the great saphenous vein (SV) are often harvested. Furthermore, epigenetic processes have been recently associated with atherosclerosis, hypertension, and heart failure, and post-translational histone processes may play a key role in understanding the genetic predisposition of vessels to vascular diseases.In the experiment performed, the transcript levels of JHDM1D, PHF8, and HDAC 1-3 in SV and ITA used for CABG procedures with RT-qPCR were examined. Total RNA was isolated by the method of Chomczyński and Sachi. RNA samples were reverse transcribed into cDNA using a commercial kit. The determination of the level of the transcripts of the mentioned genes was performed using the Light Cycler® 96 Real-Time PCR kit. Our analyzes confirmed that the studied genes related to post-translational modifications of histones are expressed in SV and ITA. In the saphenous vein, the expression of each of the individual genes was higher. The most considerable difference in transcript levels was recorded for HDAC1 and the smallest difference in expression for HDAC2.Our research suggests that more processes related to histone demethylation and acetylation occur in the saphenous vein, which may affect the selection of a vessel for CABG, but this research requires more research and additional analysis.Running title: Histone regulating gene expression in common coronary artery bypass graft vessels

scholarly journals Anomalous Origin of All Coronary Arteries from Right Sinus of Valsalva

2020 ◽  
Vol 47 (2) ◽  
pp. 170-172
Author(s):  
Harini Bollempalli ◽  
Vijay G. Divakaran ◽  
Andrew C. Kontak ◽  
Patricia C. Lee
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Sinus Of Valsalva ◽  
Exertional Dyspnea ◽  
Atherosclerotic Stenosis ◽  
Obtuse Marginal Branch ◽  
Obtuse Marginal ◽  
The Right ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries

Anomalous coronary arteries are rare and often incidental findings. Most variants are benign. We present the case of a 75-year-old man with exertional dyspnea in whom the left anterior descending coronary artery arose from the right sinus of Valsalva, and the left circumflex coronary artery originated from the distal right coronary artery and supplied the obtuse marginal branch. No arteries originated from the left sinus of Valsalva. The patient was prescribed optimal medical therapy for atherosclerotic stenosis in his ramus intermedius. His symptoms were stable 3 years later.

Sign in / Sign up

Export Citation Format

Share Document