Complete revascularization on cardiopulmonary bypass: a closer look at existing technology*1
| Autor: | Robert W. Emery, Kit V. Arom, Ann M. Emery |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Pulmonary and Respiratory Medicine
Cephalic vein medicine.medical_specialty business.industry medicine.medical_treatment General Medicine Gastroepiploic Artery Anterior Descending Coronary Artery Revascularization Surgery medicine.anatomical_structure medicine.artery Internal medicine Varicose veins cardiovascular system medicine Cardiology Radial artery medicine.symptom Cardiology and Cardiovascular Medicine business Vein Lower limbs venous ultrasonography |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 16:S66-S68 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/s1010-7940(99)00191-8 |
| Popis: | During the 1990s, two significant advancements altered the thinking on the surgical treatment of coronary artery disease. The first is the documentation that complete arterial revascularization further improves patients survival, increases the symptom free interval and decreases the incidence of reoperation as compared to saphenous vein grafting with and without left internal mammary artery grafting [1‐5]. This concept is an evolution in the ongoing development of the treatment of ischemic heart disease. Moreover, life span is prolonged by coronary interventional therapy only if the internal mammary artery bypass to the anterior descending coronary artery is performed [6]. When coupled with completeness of revascularization utilizing arterial conduits, including the radial artery, gastroepiploic artery and one or two mammary arteries, further longevity can be predicted [4]. Arterial conduits are of consistent quality whereas saphenous veins are variable. Saphenous vein diameter, wall thickness and status of the valves differ among patients. In females and the elderly, veins may be fragile or may contain significant disease such that they become substantively inert conduits. In patients with severe varicose veins, early occlusion can be expected. Predictors of the development of vein graft disease are not well delineated. Other venous conduits, including the cephalic vein, have demonstrated poor long-term patency. Decision making regarding the choice of conduit influences the conduct of the operation proposed for the patient. Secondly, but not less important, is the development of |
| Databáze: | OpenAIRE |
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