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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
10
|
| pubmed:dateCreated |
1996-3-7
|
| pubmed:abstractText |
From January 1990 to February 1994, 400 patients (mean age 59 +/- 9 years) underwent myocardial revascularization using the right gastroepiploic artery (GEA) to bypass the right coronary artery trunk or branches. They represented 40% of all patients undergoing isolated coronary surgery during the same period, from 19% in 1990 to 54% in 1994. Left ventricular function was normal in 32% of patients, moderately impaired in 62% and severely impaired in 6%. The GEA was used alone in six patients, associated with one internal mammary artery (IMA) in 111 patients (two arterial grafts, 2.2 +/- 0.4 anastomoses) and with both IMAs in 283 patients (three arterial grafts, 3.4 +/- 0.6 anastomoses); no vein graft was used. The rate of complete myocardial revascularization was 79%. Early mortality was 1.7% and influenced by left ventricular ejection fraction (P < 0.05). Complications occurred in 37 patients: myocardial infarction 4%, intra-aortic balloon pump 0.5%, reoperation for bleeding 0.5%, mediastinitis 0.25%. Early (15th postoperative day) angiographic control of the GEA graft was performed in 104 patients operated from January 1990 to December 1991 and the patency rate was 92%; anomalies of GEA were three occlusions, five stenoses, three competitive flow, no string or slender sign. Early functional results (3 +/- 1 months postoperatively) were studied in 192 patients during exercise test with medical treatment: 99% were symptom-free and 14% had electrocardiographic (ECG) ischemic modification significantly correlated with incomplete revascularization (P < 0.01). The 2- and 4-year actuarial survival rate was 96.7 +/- 1.9%. The rate of late cardiac events was 2% patient/year; Angioplasty for GEA graft failure was required in four patients. A 2-year postoperative functional assessment without medical treatment was performed during exercise test in 66 patients who had received three arterial grafts: 98% were symptom-free and 26% had ECG ischemic modification significantly correlated with incomplete revascularization (P < 0.01); during the same procedure, thallium myocardial scintigraphy was obtained in 50 patients: 18 patients (36%) had asymptomatic ischemic defects on exercise significantly correlated with incomplete revascularization and ECG ischemic changes (P < 0.01). However, posterior thallium defects demonstrated limited GEA flow at the maximum level of exercise in at least 8% of patients. Myocardial revascularization using the GEA can be achieved with minimal operative risk and offers satisfactory functional results and midterm survival rate.
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| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:issn |
1010-7940
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
9
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
575-80; discussion 581
|
| pubmed:dateRevised |
2010-11-18
|
| pubmed:meshHeading |
pubmed-meshheading:8562103-Adult,
pubmed-meshheading:8562103-Aged,
pubmed-meshheading:8562103-Aged, 80 and over,
pubmed-meshheading:8562103-Anastomosis, Surgical,
pubmed-meshheading:8562103-Angioplasty, Balloon, Coronary,
pubmed-meshheading:8562103-Arteries,
pubmed-meshheading:8562103-Coronary Artery Bypass,
pubmed-meshheading:8562103-Coronary Disease,
pubmed-meshheading:8562103-Female,
pubmed-meshheading:8562103-Follow-Up Studies,
pubmed-meshheading:8562103-Graft Occlusion, Vascular,
pubmed-meshheading:8562103-Hemodynamics,
pubmed-meshheading:8562103-Humans,
pubmed-meshheading:8562103-Male,
pubmed-meshheading:8562103-Middle Aged,
pubmed-meshheading:8562103-Myocardial Infarction,
pubmed-meshheading:8562103-Postoperative Complications,
pubmed-meshheading:8562103-Survival Rate,
pubmed-meshheading:8562103-Treatment Outcome,
pubmed-meshheading:8562103-Ventricular Function, Left
|
| pubmed:year |
1995
|
| pubmed:articleTitle |
Technical aspects and late functional results of gastroepiploic bypass grafting (400 cases).
|
| pubmed:affiliation |
Department of Cardiovascular Surgery, Hôpital cardiologique Louis Pradel, BP Lyon-Monchat, France.
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| pubmed:publicationType |
Journal Article
|