Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
1990-5-2
pubmed:abstractText
Patients with coronary disease associated with carotid artery stenosis and/or abdominal aortic aneurysm often raise problems of operative strategy; in particular, the order in which these lesions must be treated is a frequent source of controversy. We report the results of sequential or simultaneous combined surgery for multiple arterial lesions. Between 1979 and 1988, 65 patients with such lesions underwent either cerebral revascularization simultaneously with coronary bypass (n = 48) or repair of infrarenal aortic aneurysm a few weeks after myocardial revascularization (n = 17). After simultaneous surgery on the carotid and coronary arteries, the postoperative mortality rate was 4.2 per cent (2 patients). Myocardial infarction occurred in 3 cases (6.2 per cent). No neurological disorder consecutive to carotid endarterectomy was observed. Late postoperative mortality involved 5 patients; in 2 of these the cause of death was non-cardiovascular. No other late complication due to coronary or carotid artery disease was noted. The 5-year survival rate, operative mortality included, was 74.8 +/- 8.6 per cent. After coronary bypass followed by abdominal aortic aneurysm repair, there was no operative death, and no perioperative complication due to coronary disease was observed. Late mortality involved 2 patients. One patient underwent bilateral femoro-popliteal bypass 4 years after repair of an aortic aneurysm. Percutaneous angioplasty for proximal stenosis of a venous coronary graft implanted 8 years previously was performed in one patient with primary success. All other patients are now asymptomatic as regards both coronary and peripheral arteries. The 7-year survival rate is 85.7 +/- 9.4 per cent. The absence of neurological disorders after simultaneous myocardial and cerebral revascularization, and the absence of cardiac complications after aortic aneurysm repair preceded by coronary bypass enable us to recommend systematic combined or sequential vascular surgery. The long-term survival rate obtained in this series supports this recommendation.
pubmed:language
fre
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0755-4982
pubmed:author
pubmed:issnType
Print
pubmed:day
17
pubmed:volume
19
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
460-4
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
1990
pubmed:articleTitle
[Surgical strategy in polyarterial disease. Value and results of combined surgery].
pubmed:affiliation
Service de Chirurgie thoracique et cardiovasculaire, Hôpital de la Pitié, Paris.
pubmed:publicationType
Journal Article, English Abstract