1,720,973 research outputs found
Primary Endovascular Repair of the Ascending Aorta.
No full textDifferent case series have been published demonstrating the feasibility of endovascular repair of the ascending aorta in selected patients deemed unfit for open surgery. However, the use of commercially available stent graft in the ascending aorta remains off-label, and their excessive length often prevents their deployment in the ascending aorta. Here we report a case of successful primary endovascular repair of the ascending aorta using a physician modified off-the-shelf device
Valutazione ecocardiografica a breve termine di pazienti sottoposti a sostituzione valvolare aortica con bioprotesi Shelhigh Stentless
No full textComplications after radial artery harvesting for coronary artery bypass grafting: our experience.
No full textBackground. The aim of this study was to evaluate the incidence of complications in the upper limbs as
a new event after radial artery (RA) harvesting for coronary artery bypass grafting (CABG).
Methods. From June 1997 to August 2001, the RA graft was used in 271 patients who underwent cardiac
surgery at our department. These patients were prospectively reviewed. All patients were preoperatively
examined to determine the presence of normal sensation and circulation in the upper limbs; then
we evaluated the incidence of complications at discharge, 8 weeks, and 6 months.
Results. No donor arms developed symptoms of ischemia or motor dysfunction. At 8 weeks 2 patients
(0.7%) reported donor arm weakness, and cutaneous paresthesia was noted postoperatively in 10 upper
limbs (3.7%). The univariate statistical analysis showed that significant risk factors for persistent cutaneous
paresthesia were diabetes and smoking.
Conclusions. This study demonstrates that complications after harvesting the RA for CABG are a rare
consequence. The main symptom is a persistent cutaneous paresthesia present in 10 patients at 6-month
follow-up. (Surgery 2003;133:283-7.
Complications after radial artery harvesting for coronary artery bypass grafting: Our experience
No full textBackground. The aim of this study was to evaluate the incidence of complications in the upper limbs as a new event after radial artery (RA) harvesting for coronary artery bypass grafting (CABG). Methods. From June 1997 to August 2001, the RA graft was used in 271 patients who underwent cardiac surgery at our department. These patients were prospectively reviewed. All patients were preoperatively examined to determine the presence of normal sensation and circulation in the upper limbs; then we evaluated the incidence of complications at discharge, 8 weeks, and 6 months. Results. No donor arms developed symptoms of ischemia or motor dysfunction. At 8 weeks 2 patients (0.7%) reported donor arm weakness, and cutaneous paresthesia was noted postoperatively in 10 upper limbs (3.7%). The univariate statistical analysis showed that significant risk factors for persistent cutaneous paresthesia were diabetes and smoking. Conclusions. This study demonstrates that complications after harvesting the RA for CABG are a rare consequence. The main symptom is a persistent cutaneous paresthesia present in 10 patients at 6-month follow-up
64-slice computed tomography of bovine internal mammary artery coronary grafts.
No full textIn cases where conventional aortocoronary grafts cannot be used, No-React bovine internal mammary artery is a possible alternative. The aim of this study was to assess the patency and clinical performance of bovine internal mammary artery as a coronary bypass conduit, using 64-slice computed tomography coronary angiography. Eleven patients (mean age, 68.2 + or - 5.9 years) received 11 bovine grafts between 2002 and 2006. Eight of these patients were alive after a mean follow-up of 29.4 + or - 16.3 months. Their mean additive EuroSCORE was 6.5 + or - 3.2. The mean number of distal anastomoses was 2.5 + or - 0.5. Six grafts were anastomosed to the right coronary artery, 2 to the left anterior descending artery, and 3 to the circumflex artery. All 11 bovine grafts were found to be occluded after 14.1 + or - 3.6 months. This demonstrates very poor results with the bovine coronary graft, thus we do not recommend its use, and we suggest considering an hybrid approach in selected cases
Immediate endovascular treatment of blunt aortic injury: mid-term results
No full textObjective: Post-traumatic aortic rupture is a potentially lethal injury. Stentgraft
repair has recently proved to be a valid option for these patients.
Timing of the treatment, anyway, is still a debated issue. We here report
mid-term results of our experience with immediate stent graft repair.
Methods: From 1998 to 2006 17 patients (12 males, five females) with
blunt aortic injury were submitted to immediate endovascular repair. In
ten patients with clinical and radiological signs of impending rupture stent
grafting was performed on an emergency setting. In the remaining seven
patients aortic lesion was treated urgently after clinical management. When
present, immediate life-threatening non-aortic lesions were treated before
endovascular treatment (seven cases). In one case emergent laparotomy and
stent positioning were performed simultaneously. Endovascular procedure
was carried out in a cardiac surgery operating theatre and monitored by
trans-oesophageal echocardiography in all cases.
Results: Stent grafting was successful in 100% of the patients. Two patients
died perioperatively as a consequence of a multi-organ failure. Both patients
were in ASA class V and presented severe intractable hemorrhagic shock
before procedure. CT scan performed before discharge showed correct positioning
of the stent-graft and absence of endoleaks in all cases. At a mean
follow-up of 36 months (range 1–72) all patients are alive and no intervention
related complication occurred.
Conclusions: Immediate endovascular repair of blunt aortic injury is a feasible
and safe procedure. Mid-term results are promising. Longer follow-up
and larger series are mandatory to definitively validate this approach
Midterm clinical results in myocardial revascularization using the radial artery
No full textStudy objectives: The aim of this study was to evaluate the immediate and midterm results of coronary artery bypass grafting with the radial artery (RA) as a conduit. Patients: Two hundred forty-one patients underwent myocardial revascularization using the RA. In 78.5% of patients, three coronary vessels were involved, and in 25% of patients, the left main coronary artery was involved. The mean (± SD) preoperative ejection fraction was 58 ± 13%. Interventions: The RA was implanted on branches of the circumflex artery in 81% of the cases, and the left internal mammary artery was implanted on the left anterior descending artery in 94% of patients. Total arterial myocardial revascularization was performed in 58% of patients. Measurements and results: The in-hospital mortality rate was 0.8%. Two patients had acute myocardial infarction, and three patients experienced a transient low-cardiac output syndrome. We reviewed the records of all 171 patients who had undergone at least 6 months of follow-up after surgery. The late mortality rate in this group was 0.6% (one patient died 2 months after surgery because of cardiocirculatory arrest due to untreatable ventricular fibrillation). At a mean follow-up time of 545 ± 253 days, two patients showed class 3 residual angina according to the Canadian Cardiovascular Society (CCS) guidelines. One patient required another hospital admission 6 months after undergoing surgery for PTCA/stenting on a circumflex artery that had not previously undergone bypass. The second patient, 8 months after undergoing coronary artery bypass grafting, underwent angiography and stenting on a stenosed anastomosis of a posterolateral branch of the circumflex artery that previously had been bypassed with the right internal mammary artery. Conclusions: The routine use of the RA for coronary bypass grafting is a safe surgical technique, providing excellent clinical mid-term results in terms of cardiac event-free expectancy
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