RESUMO
AIM: The aim of the present study was to investigate the predictive value of preoperative neutrophil-lymphocyte ratio (NLR) in postoperative saphenous vein graft patency in patients undergoing coronary artery bypass grafting (CABG) surgery. METHOD: We retrospectively analyzed 444 patients who had undergone CABG and a further control coronary angiography due to recurrence of symptoms. The patients were divided into tertile groups according to the NLR. The primary end point was 50% saphenous vein graft stenosis or more or complete occlusion. RESULT: The saphenous vein graft failure in the 3 groups based on NLR was 33%, 66.2%, and 79.1%, in the low-, middle- and high-risk groups, respectively. In multivariate regression modeling, current smoker, diabetes mellitus, target artery diameter <1.5 mm, and NLR independently predicted saphenous vein graft patency in patients after CABG. CONCLUSION: Preoperative NLR is clearly an independent predictor of saphenous vein graft patency in patients after CABG.
Assuntos
Ponte de Artéria Coronária/efeitos adversos , Doença da Artéria Coronariana/cirurgia , Oclusão de Enxerto Vascular/etiologia , Linfócitos , Neutrófilos , Veia Safena/transplante , Adulto , Idoso , Doença da Artéria Coronariana/sangue , Feminino , Oclusão de Enxerto Vascular/sangue , Humanos , Contagem de Leucócitos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Estudos RetrospectivosRESUMO
BACKGROUND: Aortic injury after blunt trauma that is missed during the first admission will soon be seen as a chronic aneurysm. The objective of this study is to show the importance of the diagnosis and appropriate treatment of these aneurysms. METHODS: Between 2009 and 2012, 8 patients (mean age, 50±31 years) diagnosed with chronic traumatic aortic aneurysm were treated with either thoracic endovascular aortic repair (TEVAR) or conventional surgery 20 years on average after the trauma. RESULTS: Treatments included TEVAR in four patients, conventional surgery in two patients, and hybrid intervention in one patient. One patient died postoperatively. One patient had an endoleak requiring a repeat TEVAR, which was successful. Brachial embolectomy was performed after placing the endovascular stent. No paraplegia or lower extremity ischemia was seen. One patient died preoperatively due to rupture of the aneurysm. CONCLUSION: Chronic traumatic aortic aneurysms may cause general symptoms years after a blunt trauma. Aortic injury must always be considered in the assessment and follow-up of trauma patients.
Assuntos
Aorta Torácica/lesões , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/etiologia , Ferimentos não Penetrantes/complicações , Adulto , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Through a median sternotomy, we performed a single-stage repair of severe aortic coarctation, ventricular septal defect, patent foramen ovale, and mitral valve insufficiency. The severe aortic coarctation was repaired by interposing a synthetic graft between the distal ascending aorta and the descending aorta. We first repaired the coarctation with the 38-year-old man on cardiopulmonary bypass, before aortic cross-clamping, in order to shorten the cross-clamp time.