[Assessment of pulse wave velocity as a marker of post-operative cardiovascular risk in off-pump coronary artery bypass grafting patients].

OBJECTIVE: Pulse wave velocity is widely used as an index of arterial stiffness. The aim of this study is to assess the usefulness of pulse wave velocity as a risk factor in patients who underwent off-pump coronary artery bypass grafting (CABG) [OPCAB]. METHODS AND RESULTS: Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV) and the ratio of patient's baPWV to age-matched normal value was calculated in 90 OPCAB patients. The mean age and male/female ratio were 69.1 years old and 68/22, respectively. baPWV was higher in CABG patients (1,891 +/- 511 cm/s) than that in age-matched normal value (p<0.01). Preoperatively, baPWV ratio did not correlate to the severity of coronary artery diseases. There were 1 (1.1%) in-hospital death and 48 incidences of postoperative complication in 38 patients. The baPWV ratio in the group with postoperative major complications except atrial fibrillation tended to be higher than that in the non-complication group (1.38 +/- 0.36 vs 1.26 +/- 0.30, p = 0.09). CONCLUSION: The elevated baPWV may be a useful predictor of operative risk in patients who undergo CABG.

Large saphenous vein graft aneurysm with a fistula to the right atrium.

We report on a case of a 65-year-old man who was admitted for anterior chest pain on effort. He had received coronary artery bypass grafting (CABG) surgery 20 years ago with saphenous vein grafts (SVGs) to the left anterior descending artery (LAD) and right coronary artery (RCA). An angiography demonstrated large aneurysmal dilatation of both grafts and a fistulous communication between the middle portion of the right SVG and the right atrium (RA). The aneurysm was excised surgically, and the fistula was closed with the right atrial wall with additional bypass grafts of the left internal thoracic artery (LITA) and gastroepiploic artery (GEA).

Adventitial cystic disease of the femoral vein: report of a case.

Adventitial cystic disease (ACD) of the veins is a rare phenomenon, and ACD of the femoral vein is particularly difficult to diagnose due to the similarity in symptoms to those of deep vein thrombosis. We report a case of ACD of the femoral vein, which was initially misdiagnosed as deep vein thrombosis, in a 48-year-old woman who presented with a painless swelling in her right lower leg. The extensive cystic involvement of the femoral vein was completely resected and reconstructed with an 8-mm ringed polytetrafluoroethylene vascular graft with good results.