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1.
Medicine (Baltimore) ; 99(8): e18973, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080075

RESUMO

This study investigated the relationship between angiographic complexities of coronary artery disease (CAD) assessed by SYNTAX Score synergy between percutaneous coronary intervention with taxus and cardiac surgery score (SYNTAX Score) and cardiac biomarker elevation after revascularization procedures.This is a post-hoc analysis of the medicine, angioplasty or surgery study V study of patients with stable CAD. High-sensitivity troponin 1 (hs-TnI) and creatinine kinase-muscle/brain (CK-MB) were assessed before and after cardiovascular procedures. Baselines SYNTAX Scores (SXScores) were calculated by blinded investigators to patient characteristics.Of the 202 patients studied, the mean SXScore was 21.25 ±â€Š9.24; 40.10 ±â€Š7.09 in the high SXScore group and 19.06 ±â€Š6.61 in low/mid SXscore group (P < .0001). Positive correlations existed between SXScore and median peaks after procedural hs-TnI (r = 0.18, P = .009) and CK-MB (r = 0.24, P = .001) levels. In patients with high SXScores (≥33), the median peaks of post-procedural hs-TnI (P = .034)and CK-MB (P = .004) levels were higher than in low/mid SXScore group (<33).The release of hs-TnI at 6 (P = .002), 12 (P = .008), and 24 hours (P = .039) was higher in high SXScore group than in low/mid SXscore group (<33) as was the release of CK-MB at 6 (P < .0001), 12 (P < .0001), 24 (P = .001), 36 (P = .007), 48 (P = .008), and 72 hours (P = .023). After multivariable analysis, high SXScore was a significant independent predictor of release of CK-MB and hs-TnI peaks higher than the median.The increase in release of cardiac biomarkers was significantly associated with the extent of atherosclerosis identified by the SYNTAX Score.


Assuntos
Biomarcadores/metabolismo , Angiografia Coronária/métodos , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/cirurgia , Idoso , Angioplastia/métodos , Aterosclerose/metabolismo , Aterosclerose/patologia , Procedimentos Cirúrgicos Cardíacos/métodos , Angiografia Coronária/tendências , Ponte de Artéria Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/terapia , Intervenção Coronária Percutânea/métodos , Estudos Prospectivos , Troponina I/metabolismo
2.
Nephrol Dial Transplant ; 35(8): 1369-1376, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-30590726

RESUMO

BACKGROUND: Chronic kidney disease (CKD) is associated with a worse prognosis in patients with stable coronary artery disease (CAD); however, there is limited randomized data on long-term outcomes of CAD therapies in these patients. We evaluated long-term outcomes of CKD patients with CAD who underwent randomized therapy with medical treatment (MT) alone, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). METHODS: Baseline estimated glomerular filtration rate (eGFR) was obtained in 611 patients randomized to one of three therapeutic strategies in the Medicine, Angioplasty, or Surgery Study II trial. Patients were categorized in preserved renal function and mild or moderate CKD groups depending on their eGFR (≥90, 89-60 and 59-30 mL/min/1.73 m2, respectively). The primary clinical endpoint, a composite of overall death and myocardial infarction, and its individual components were analyzed using proportional hazards regression (Clinical Trial registration information: http://www.controlled-trials.com. Registration number: ISRCTN66068876). RESULTS: Of 611 patients, 112 (18%) had preserved eGFR, 349 (57%) mild dysfunction and 150 (25%) moderate dysfunction. The primary endpoint occurred in 29.5, 32.4 and 44.7% (P = 0.02) for preserved eGFR, mild CKD and moderate CKD, respectively. Overall mortality incidence was 18.7, 23.8 and 39.3% for preserved eGFR, mild CKD and moderate CKD, respectively (P = 0.001). For preserved eGFR, there was no significant difference in outcomes between therapies. For mild CKD, the primary event rate was 29.4% for PCI, 29.1% for CABG and 41.1% for MT (P = 0.006) [adjusted hazard ratio (HR) = 0.26, 95% confidence interval (CI) 0.07-0.88; P = 0.03 for PCI versus MT; and adjusted HR = 0.48; 95% CI 0.31-0.76; P = 0.002 for CABG versus MT]. We also observed higher mortality rates in the MT group (28.6%) compared with PCI (24.1%) and CABG (19.0%) groups (P = 0.015) among mild CKD subjects (adjusted HR = 0.44, 95% CI 0.25-0.76; P = 0.003 for CABG versus MT; adjusted HR = 0.56, 95% CI 0.07-4.28; P = 0.58 for PCI versus MT). Results were similar with moderate CKD group but did not achieve significance. CONCLUSIONS: Coronary interventional therapy, both PCI and CABG, is associated with lower rates of events compared with MT in mild CKD patients >10 years of follow-up. More study is needed to confirm these benefits in moderate CKD.

3.
Arq Bras Cardiol ; 113(3): 449-663, 2019 10 10.
Artigo em Português | MEDLINE | ID: mdl-31621787
4.
Rev Assoc Med Bras (1992) ; 65(3): 316-318, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30994825

RESUMO

Coronary artery bypass graft (CABG) is a consolidated treatment in patients with coronary artery disease (CAD) for both symptom control and improvement of prognosis. The patency of venous grafts is still the most vulnerable point of the surgical treatment since it presents a high prevalence of occlusion both in the immediate postoperative period and in the long-term follow-up. Aspirin plays a well-established role in this setting, and for a long time, clopidogrel use has been restricted to patients allergic to aspirin. Recently, subgroup analyses of studies with different anti-platelet therapies have shown reduced mortality and cardiovascular events in patients on dual anti-platelet antiplatelet therapy (DAPT) undergoing CABG, although such studies have not been designed to evaluate this patient profile. However, there is still an insufficient number of randomized studies using DAPT in this context, resulting in a disagreement between the European and American cardiology societies guidelines regarding their indication and generating doubts in clinical practice.


Assuntos
Ponte de Artéria Coronária/métodos , Oclusão de Enxerto Vascular/prevenção & controle , Inibidores da Agregação de Plaquetas/uso terapêutico , Grau de Desobstrução Vascular/efeitos dos fármacos , Aspirina/uso terapêutico , Clopidogrel/uso terapêutico , Ponte de Artéria Coronária/efeitos adversos , Doença da Artéria Coronariana/cirurgia , Humanos , Ticagrelor/uso terapêutico , Resultado do Tratamento
5.
Rev Assoc Med Bras (1992) ; 65(3): 319-325, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30994826

RESUMO

Treatment of stable coronary artery disease (CAD) relies on improved prognosis and relief of symptoms. National and international guidelines on CAD support the indication of revascularization in patients with limiting symptoms and refractory to optimal medical treatment, as well as in clinical situations where there is a prognostic benefit of interventional treatment. Most of the studies that support the guidelines for indication of revascularization date back to the 1980s and1990s of the last century. Recent studies have revisited the theme and brought a new breath. The present review provides a critical analysis of classic indications for revascularization, reviewing evidence from the studies of the 1970s to the recent controversial ORBITA study.


Assuntos
Doença da Artéria Coronariana/cirurgia , Revascularização Miocárdica/normas , Tomada de Decisão Clínica , Humanos , Revascularização Miocárdica/métodos , Prognóstico , Medição de Risco , Fatores de Risco
6.
Rev. Assoc. Med. Bras. (1992) ; 65(3): 316-318, Mar. 2019.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1003030

RESUMO

SUMMARY Coronary artery bypass graft (CABG) is a consolidated treatment in patients with coronary artery disease (CAD) for both symptom control and improvement of prognosis. The patency of venous grafts is still the most vulnerable point of the surgical treatment since it presents a high prevalence of occlusion both in the immediate postoperative period and in the long-term follow-up. Aspirin plays a well-established role in this setting, and for a long time, clopidogrel use has been restricted to patients allergic to aspirin. Recently, subgroup analyses of studies with different anti-platelet therapies have shown reduced mortality and cardiovascular events in patients on dual anti-platelet antiplatelet therapy (DAPT) undergoing CABG, although such studies have not been designed to evaluate this patient profile. However, there is still an insufficient number of randomized studies using DAPT in this context, resulting in a disagreement between the European and American cardiology societies guidelines regarding their indication and generating doubts in clinical practice.


RESUMO A cirurgia de revascularização miocárdica (CRM) é tratamento fundamental em pacientes com doença arterial coronariana (DAC) tanto para controle de sintomas quanto para melhora do prognóstico. A patência dos enxertos venosos ainda hoje é o ponto mais vulnerável do tratamento cirúrgico, por apresentar alta prevalência de oclusão tanto no pós-operatório imediato como no seguimento em longo prazo. A aspirina tem papel bem estabelecido neste cenário e, por muito tempo, o uso do clopidogrel ficou restrito a pacientes alérgicos a aspirina. Recentemente, análises de subgrupos de estudos com diferentes terapias antiplaquetárias demonstraram redução de mortalidade e eventos cardiovasculares em pacientes em uso de dupla antiagregação plaquetária (Dapt) submetidos à CRM, ainda que tais estudos não tenham sido desenhados para avaliar este perfil de pacientes. Contudo, há ainda uma quantidade insuficiente de estudos randomizados com uso de Dapt nesse contexto, resultando em uma discordância entre as diretrizes europeia e americana de cardiologia quanto à sua indicação e gerando dúvidas na prática clínica.

7.
Rev. Assoc. Med. Bras. (1992) ; 65(3): 319-325, Mar. 2019. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1003042

RESUMO

SUMMARY Treatment of stable coronary artery disease (CAD) relies on improved prognosis and relief of symptoms. National and international guidelines on CAD support the indication of revascularization in patients with limiting symptoms and refractory to optimal medical treatment, as well as in clinical situations where there is a prognostic benefit of interventional treatment. Most of the studies that support the guidelines for indication of revascularization date back to the 1980s and1990s of the last century. Recent studies have revisited the theme and brought a new breath. The present review provides a critical analysis of classic indications for revascularization, reviewing evidence from the studies of the 1970s to the recent controversial ORBITA study.


RESUMO O tratamento da doença arterial coronariana estável (DAC) se baseia na melhora do prognóstico e alívio de sintomas. Diretrizes nacionais e internacionais sobre a DAC respaldam a indicação de revascularização em pacientes com sintomas limitantes e refratários ao tratamento medicamentoso, bem como em situações clínicas nas quais há benefício prognóstico do tratamento intervencionista. Grande parte dos estudos que norteiam as diretrizes de indicação de revascularização data das décadas de 1980 e 1990. Estudos recentes têm revisitado o tema e trazido novo fôlego. A presente revisão faz uma análise crítica das indicações clássicas de revascularização, revisando a evidência desde os estudos da década de 1970 ao recente e polêmico estudo Orbita.

9.
ABC., imagem cardiovasc ; 31(4)Out.- Dez. 2018. ilus
Artigo em Português | LILACS | ID: biblio-963978
11.
Rev. Assoc. Med. Bras. (1992) ; 64(9): 783-786, Sept. 2018. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-976863

RESUMO

SUMMARY The treatment of patients with ST-segment elevation myocardial infarction concomitant with the presence of multivessel disease has been studied in several recent studies with the purpose of defining the need, as well as the best moment to approach residual lesions. However, such studies included only stable patients. The best therapeutic approach to cardiogenic shock secondary to acute coronary syndrome, however, remains controversial, but there are recommendations from specialists for revascularization that include non-event related injuries. Recently published, the CULPRIT-SHOCK study showed benefit of the initial approach only of the injury blamed for the acute event, in view of the multivessel percutaneous intervention, in the context of cardiogenic shock. In this perspective, the authors discuss the work in question, regarding methodological questions, limitations and clinical applicability.


RESUMO O tratamento de pacientes com infarto do miocárdio com elevação do segmento ST concomitante à presença de doença multiarterial tem sido estudado em vários estudos recentes com o objetivo de definir a necessidade, bem como o melhor momento, de abordagem das lesões residuais. No entanto, tais estudos incluíam apenas pacientes estáveis. A melhor abordagem terapêutica do choque cardiogênico secundário à síndrome coronariana aguda, no entanto, ainda permanece controversa, havendo porém recomendação de especialistas para uma revascularização que inclua as lesões não relacionadas ao evento. Publicado recentemente, o estudo CULPRIT-SHOCK mostrou benefício da abordagem inicial apenas da lesão culpada pelo evento agudo, perante a intervenção percutânea multiarterial, no contexto do choque cardiogênico. No presente ponto de vista, os autores discutem o trabalho em questão, no que concerne a questões metodológicas, limitações e aplicabilidade clínica.

12.
Rev Assoc Med Bras (1992) ; 64(9): 783-786, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30672997

RESUMO

The treatment of patients with ST-segment elevation myocardial infarction concomitant with the presence of multivessel disease has been studied in several recent studies with the purpose of defining the need, as well as the best moment to approach residual lesions. However, such studies included only stable patients. The best therapeutic approach to cardiogenic shock secondary to acute coronary syndrome, however, remains controversial, but there are recommendations from specialists for revascularization that include non-event related injuries. Recently published, the CULPRIT-SHOCK study showed benefit of the initial approach only of the injury blamed for the acute event, in view of the multivessel percutaneous intervention, in the context of cardiogenic shock. In this perspective, the authors discuss the work in question, regarding methodological questions, limitations and clinical applicability.


Assuntos
Síndrome Coronariana Aguda/cirurgia , Doença da Artéria Coronariana/cirurgia , Intervenção Coronária Percutânea/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Choque Cardiogênico/cirurgia , Síndrome Coronariana Aguda/complicações , Doença da Artéria Coronariana/complicações , Europa (Continente) , Humanos , Revascularização Miocárdica/métodos , Guias de Prática Clínica como Assunto , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Choque Cardiogênico/etiologia , Resultado do Tratamento
13.
Rev. Assoc. Med. Bras. (1992) ; 63(9): 793-800, 2017. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-896398

RESUMO

Summary Coronary artery disease (CAD) associated with left ventricular systolic dysfunction is a condition related to poor prognosis. There is a lack of robust evidence in many aspects related to this condition, from definition to treatment. Ischemic cardiomyopathy is a spectrum ranging from stunned myocardium associated with myocardial fibrosis to hibernating myocardium and repetitive episodes of ischemia. In clinical practice, relevance lies in identifying the myocardium that has the ability to recover its contractile reserve after revascularization. Methods to evaluate cellular integrity tend to have higher sensitivity, while the ones assessing contractile reserve have greater specificity, since a larger mass of viable myocytes is required in order to generate contractility change. Since there are many methods and different ways to detect viability, sensitivity and specificity vary widely. Dobutamine-cardiac magnetic resonance with late gadolinium enhancement has the best accuracy is this setting, giving important predictors of prognostic and revascularization benefit such as scar burden, contractile reserve and end-systolic volume index. The latter has shown differential benefit with revascularization in some recent trials. Finally, authors discuss interventional procedures in this population, focusing on coronary artery bypass grafting and evolution of evidence from CASS to post-STICH era.


Resumo A doença arterial coronariana (DAC) associada à disfunção sistólica do ventrículo esquerdo é uma condição relacionada a mau prognóstico. Há uma falta de evidência robusta em muitos aspectos relacionados a essa condição, desde a definição ao tratamento. A cardiomiopatia isquêmica é um espectro que varia de miocárdio atordoado por fibrose miocárdica, passando por miocárdio hibernante, a episódios repetitivos de isquemia. Na prática clínica, a importância do problema é identificar o miocárdio que tem a capacidade de recuperar sua reserva contrátil após revascularização. Métodos para avaliar a integridade celular tendem a ter maior sensibilidade, enquanto os que avaliam a reserva contrátil têm maior especificidade, uma vez que uma maior massa de miócitos viáveis para gerar uma mudança de contratilidade é necessária. Tendo em vista que existem muitos métodos e diferentes formas de detecção de viabilidade, a sensibilidade e a especificidade variam amplamente. O uso da ressonância magnética cardíaca com detecção de realce tardio associada a estresse com dobutamina tem a melhor acurácia na avaliação de viabilidade, além de fornecer importantes preditores de benefício prognóstico com a revascularização, tais como carga de cicatriz, reserva contrátil e índice de volume sistólico final. Finalmente, os autores discutem sobre procedimentos intervencionistas nessa população, com foco na revascularização cirúrgica do miocárdio e na evolução da evidência desde o estudo CASS até os trials da era pós-STICH.

14.
Rev Assoc Med Bras (1992) ; 63(9): 793-800, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29239459

RESUMO

Coronary artery disease (CAD) associated with left ventricular systolic dysfunction is a condition related to poor prognosis. There is a lack of robust evidence in many aspects related to this condition, from definition to treatment. Ischemic cardiomyopathy is a spectrum ranging from stunned myocardium associated with myocardial fibrosis to hibernating myocardium and repetitive episodes of ischemia. In clinical practice, relevance lies in identifying the myocardium that has the ability to recover its contractile reserve after revascularization. Methods to evaluate cellular integrity tend to have higher sensitivity, while the ones assessing contractile reserve have greater specificity, since a larger mass of viable myocytes is required in order to generate contractility change. Since there are many methods and different ways to detect viability, sensitivity and specificity vary widely. Dobutamine-cardiac magnetic resonance with late gadolinium enhancement has the best accuracy is this setting, giving important predictors of prognostic and revascularization benefit such as scar burden, contractile reserve and end-systolic volume index. The latter has shown differential benefit with revascularization in some recent trials. Finally, authors discuss interventional procedures in this population, focusing on coronary artery bypass grafting and evolution of evidence from CASS to post-STICH era.


Assuntos
Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/terapia , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/terapia , Medicina Baseada em Evidências , Humanos
15.
Rev Col Bras Cir ; 38(2): 95-9, 2011.
Artigo em Inglês, Português | MEDLINE | ID: mdl-21710046

RESUMO

OBJECTIVE: To describe the epidemiological, clinical and surgical features of patients with iatrogenic bile duct injury (IBDI) attending the General Hospital of Fortaleza (HGF) during the period from 2005 to 2009. METHODS: We conducted a retrospective study of medical records of patients admitted to HGF with the diagnosis of IBDI, evaluating the following variables: gender, age, origin, conditions of cholecystectomy, type of surgery, symptoms, exams performed, surgical findings, classification of injury, treatment, complications, total duration of hospitalization and discharge conditions. RESULTS: There were 27 confirmed cases of IBDI. Two injuries occurred during laparoscopic cholecystectomy. Only one patient was diagnosed intraoperatively. The most frequent sign was jaundice after cholecystectomy. Hepato-duodenal Y-en-Roux anastomosis was the most often employed surgical technique (85.2%). Most patients were discharged from hospital in good clinical condition (88.8%), however, we found high morbidity rates for this disease, exemplified by the multiple hospitalizations and longer hospital stay (mean 31 days). CONCLUSION: Most injuries occurred during open cholecystectomy, jaundice was the most frequent sign upon admission. There was a high hospitalization length of stay, caused by postoperative complications, which could be explained by delayed diagnosis resulting in a large delay in treatment.


Assuntos
Ductos Biliares/lesões , Ductos Biliares/cirurgia , Colecistectomia , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/cirurgia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Complicações Intraoperatórias/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
Rev. Col. Bras. Cir ; 38(2): 95-99, mar-abr. 2011. ilus, tab
Artigo em Português | LILACS | ID: lil-591387

RESUMO

OBJETIVO: Descrever os aspectos epidemiológicos, clínicos e cirúrgicos dos pacientes com lesão iatrogênica das vias biliares (LIVB) atendidos no Hospital Geral de Fortaleza (HGF) durante o período de 2005 a 2009. MÉTODOS: Realizou-se estudo retrospectivo dos prontuários dos pacientes internados no HGF diagnóstico de LIVB, obtendo-se as seguintes variáveis: sexo, idade, procedência, condições da colecistectomia, tipo de operação, sintomatologia, exames realizados, achados cirúrgicos, classificação da lesão, tratamento, complicações, tempo total de internamento e condições de alta. RESULTADOS: Foram confirmados 27 casos de LIVB. Duas lesões ocorreram durante a colecistectomia videolaparoscópica. Apenas um paciente foi diagnosticado no intra-operatório.. O sinal mais freqüente foi a icterícia pós-colecistectomia. A hepático-jejunostomia em "Y" de Roux foi a técnica cirúrgica mais empregada (85,2 por cento). A maioria dos pacientes recebeu alta hospitalar em boas condições clínicas (88,8 por cento); no entanto, constatou-se, a elevada morbidade desta patologia, exemplificada pelos múltiplos internamentos e longa permanência hospitalar (média de 31 dias). CONCLUSÃO: A maioria das lesões ocorreu durante a colecistectomia por laparotomia, a icterícia foi o sinal mais freqüente quando da internação Verificou-se uma elevada permanência hospitalar .causada pelas complicações pós-operatórias o que poderia ser explicado pelo diagnóstico tardio ocasionando um grande retardo no tratamento neste pacientes.


OBJECTIVE: To describe the epidemiological, clinical and surgical features of patients with iatrogenic bile duct injury (IBDI) attending the General Hospital of Fortaleza (HGF) during the period from 2005 to 2009. METHODS: We conducted a retrospective study of medical records of patients admitted to HGF with the diagnosis of IBDI, evaluating the following variables: gender, age, origin, conditions of cholecystectomy, type of surgery, symptoms, exams performed, surgical findings, classification of injury, treatment, complications, total duration of hospitalization and discharge conditions. RESULTS: There were 27 confirmed cases of IBDI. Two injuries occurred during laparoscopic cholecystectomy. Only one patient was diagnosed intraoperatively. The most frequent sign was jaundice after cholecystectomy. Hepato-duodenal Y-en-Roux anastomosis was the most often employed surgical technique (85.2 percent). Most patients were discharged from hospital in good clinical condition (88.8 percent), however, we found high morbidity rates for this disease, exemplified by the multiple hospitalizations and longer hospital stay (mean 31 days). CONCLUSION: Most injuries occurred during open cholecystectomy, jaundice was the most frequent sign upon admission. There was a high hospitalization length of stay, caused by postoperative complications, which could be explained by delayed diagnosis resulting in a large delay in treatment.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Ductos Biliares/lesões , Ductos Biliares/cirurgia , Colecistectomia , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/cirurgia , Estudos de Coortes , Complicações Intraoperatórias/etiologia , Estudos Retrospectivos
17.
Rev Bras Cir Cardiovasc ; 25(1): 118-21, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20563479

RESUMO

The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some complications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS.


Assuntos
Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Artéria Torácica Interna/transplante , Veia Safena/transplante , Angiografia Coronária , Doença da Artéria Coronariana/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
18.
Rev. bras. cir. cardiovasc ; 25(1): 118-121, Jan.-Mar. 2010. ilus
Artigo em Inglês, Português | LILACS | ID: lil-552851

RESUMO

O uso de enxerto composto de artéria torácica interna esquerda (ATIE) com segmentos arteriais ou segmentos de veia safena magna (VSM) pode permitir a revascularização completa do sistema coronariano esquerdo (SCE) sem circulação extracorpórea (CEC) e sem manuseio da aorta ascendente (MAA), como forma de tentar reduzir alguns riscos e complicações no pós-operatório imediato. Neste trabalho, relatamos os resultados angiográficos, após oito anos, de dois pacientes submetidos à cirurgia de revascularização do SCE com enxerto composto de ATIE e VSM, sem CEC e sem MAA.


The use of a composite graft with left internal thoracic artery (LITA) and arterial or saphenous vein (SV) grafts can allow the complete revascularization of the left coronary system (LCS) without cardiopulmonary bypass (CPB) and without ascending aorta manipulation (AAM), in order to reduce some complications in the immediate postoperative. This study shows 8-year angiographic follow-up results of two patients underwent no-touch aorta off-pump coronary artery bypass grafting (CABG) using LITA and SV as a composite graft to supply LCS.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos , Doença da Artéria Coronariana , Artéria Torácica Interna/transplante , Veia Safena/transplante , Angiografia Coronária , Doença da Artéria Coronariana/cirurgia
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