1,720,976 research outputs found
Myocardical revascularization via coronary ostial plasty, surgical outcome and mid-term follow-up
No full textConcomitant carotid endarterectomy and coronary bypass surgery: should cardiopulmonary bypass be used for the carotid procedure?
No full textLambda graft with the radial artery or free internal mammary artery anostomosed to the right internal mammary artery: flow dynamics.
No full textUrgent/emergent surgical revascularization in unstable angina: influence of different type of conduits
No full textAbstract
AIM:
In patients with unstable angina (UA) undergoing nonelective myocardial revascularization we compare the outcomes of skeletonized bilateral internal mammary arteries (BIMA) vs left internal mammary artery (LIMA) and saphenous vein grafts (SVGs) vs SVGs only.
METHODS:
Between January 1997 and December 2003, 758 patients: 612 (80.7%) males, mean age 62+/-12 years, underwent nonelective coronary artery bypass grafting (CABG) for unstable angina; 205 (27%) were operated emergently and 553 (73%) urgently. BIMA were employed in 320 (42%) patients (Group B) , isolated LIMA and/or SVGs in 332 (44%) patients (Group M) and only SVGs in 106 (14%) (Group S).
RESULTS:
In-hospital mortality (B=5.9%, M=4.5% and S=7.5%), and perioperative myocardial infarction (B=2.2%; M=1.9%, S=3.7%) were similar between the 3 groups (P=NS). Actuarial survival at 1, 3 and 7 years was 98.7%, 97.5% and 96.2% in group B, 99.3%, 94.8% and 89.4% in group M (P65 years (P= 0.02), left ventricular ejection fraction (LVEF) 1 ischemic irreversible area (P= 0.03) as independent predictors for late deaths, while the use of the LIMA (P= 0.006) and both mammary arteries (P= 0.001) decreased the risk of late deaths.
CONCLUSIONS:
The use of BIMA in nonelective CABG for UA is safe and effective. There is a trend, however, toward a survival benefit with improved freedom from late cardiac events (recurrence of angina, freedom from reoperation and infarction)
Does off-pump coronary revascularization reduce the release of the cerebral markers, S-100beta and NSE?
No full textAbstract
OBJECTIVES:
The aims of this study were to (1) compare the release of S-100 beta and NSE in off-pump coronary artery bypass grafting (CABG) versus on-pump surgery; (2) investigate whether the S-100 beta and NSE serum concentrations correlate with cardiopulmonary bypass (CPB) duration.
MATERIALS AND METHODS:
Between October 2002 and May 2004, 42 patients undergoing first time CABG surgery were enrolled in the study. The exclusion criteria were: LVEF70 years, previous myocardial infarction, REDO surgery, the presence of valvular heart disease and/or cerebrovascular disease, abnormal preoperative carotid vessels angiography, coronary artery disease involving the distal circumflex artery, renal dysfunction, coagulopathy. The patients were randomly assigned either to undergo on-pump CABG surgery [group I, n=24 patients] or off-pump CABG [group II, n=18 patients]. Blood was not re-transfused from the cardiotomy suction. All patients presenting haemolysis were excluded from the study.
RESULTS:
The preoperative S-100beta was 0.13+/-0.08 (microg/l) and NSE 7+/-1.5 (microg/l) in group I and 0.12+/-0.1 (microg/l) and 6.9+/-2.7 (microg/l), respectively in group II. Six hours after the surgery, S-100beta in patients of group I reached a maximum level of 1.38+/-0.4 (microg/l) and NSE of 17.7+/-6.5 (microg/l) compared to 0.5+/-0.11 (microg/l) [S-100B] and NSE 8.6+/-4.2 (microg/l) in group II (p=0.001). Three (12%) patients in group I and none (0%) in group II suffered postoperative delirium, p=0.247. No strokes occurred linear regression analysis revealed a strong correlation between cardiopulmonary bypass duration and S-100beta and NSE peak levels, p<0.0021 (r(2)=0.36) and p<0.0001 (r=0.81), respectively.
CONCLUSION:
Coronary artery bypass surgery with CPB causes a significantly greater increase in NSE and S-100beta serum levels than off-pump surgery and correlates with CPB duration
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Mitral valve surgery simultaneous to coronary revascularization in patients with end-stage ischemic cardiomyopathy
No full textMitral valve regurgitation (MVR), occurring as a result of myocardial ischemia and global left ventricular (LV) dysfunction, predicts a poor outcome in terms of survival and morbidity. Between 1995 and 2003, 180 consecutive patients with impaired LV function and chronic ischemic MVR underwent cardiac surgery. Fifty-four patients (group I), MVR (grade III-IV) underwent simultaneous MV surgery and coronary artery bypass grafting (CABG); 40 patients (group II), MVR (grade II-III), and 86 patients (group III), MVR (grade I-II), underwent CABG alone. In group I, MV repair was performed in 36 patients (group IA) and MV replacement in 18 (group IB). The incidence of hospital death was similar between groups. The actuarial event-free survival was significantly lower in group than in groups II and III (P = 0.0045) and I (P = 0.038). The overall actuarial survival was significantly higher in group IA than in group IB (P = 0.027). Postoperatively, the LV ejection fraction (P < 0.001), LV end-diastolic diameter (P < 0.001), LV end-systolic diameter (P < 0.01), and cardiac index (P < 0.001) improved significantly in group I. The regurgitation fraction decreased significantly in Groups I and III after surgery (P < 0.001 and P = 0.003, respectively). Both MV repair and replacement that preserves subvalvular apparatus in patients with end-stage ischemic myocardiopathy offer an acceptable outcome. Mitral valve repair simultaneous to CABG improves significantly the LV function and its geometry. In patients with mild to moderate mitral regurgitation, CABG alone may be performed with good overall survival, but with lower event-free survival than those undergoing concomitant mitral valve repai
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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