Coronary artery bypass grafting using both internal mammary arteries in patients with diabetes mellitus
| Autor: | Stevan Krieger Martins, Magaly Arrais dos Santos, Freddy H. Ponce Tirado, Francisco C. E. Martins Jr, Luiz Carlos Bento de Souza, Hassan F. Malat, Adib D Jatene |
|---|---|
| Jazyk: | portugalština |
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Internal mammary-coronary artery anastomosis Bypass grafting Population Diabetic angiopathy Revascularização miocárdica Mammary arteries Diabetes mellitus Internal medicine medicine education Artéria torácica interna education.field_of_study business.industry Case-control study Retrospective cohort study General Medicine medicine.disease Surgery Dissection medicine.anatomical_structure Myocardial revascularization Anastomose de artéria torácica interna-coronária Cardiology Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Brazilian Journal of Cardiovascular Surgery v.22 n.3 2007 Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) instacron:SBCCV Brazilian Journal of Cardiovascular Surgery, Volume: 22, Issue: 3, Pages: 291-296, Published: SEP 2007 |
| Popis: | OBJETIVO: Descrever a utilização de ambas artérias mamárias internas (MIs) em pacientes submetidos à operação de revascularização do miocárdio (RM), que sejam portadores de diabetes mellitus (DM). MÉTODO: No período compreendido entre janeiro de 1995 e agosto de 2005, 4.569 pacientes foram submetidos a RM em nossa instituição, sendo que 1.298 eram portadores de DM. A média de idade era de 62 anos, e a mortalidade global foi de 2,18% (100 pacientes). Ambas MIs foram empregadas em 700 pacientes, que foram divididos em dois grupos, portadores de DM (grupo I, com 148 pacientes) e não portadores de DM (grupo II, 552 pacientes). A seleção de pacientes para utilizar estes enxertos foi baseada nas características angiográficas das artérias coronárias e qualidade do esterno quando de sua transsecção. Quando ambos fatores eram considerados favoráveis, foram dissecadas ambas MIs, independente de o paciente ser portador ou não de DM. Durante a dissecção dos enxertos arteriais, tomava-se o cuidado de procurar manter as cavidades pleurais fechadas. RESULTADOS: Houve pouca variação entre os grupos de pacientes no tocante a morbidade e mortalidade. CONCLUSÃO: Nossos dados sugerem que pacientes portadores de DM podem se beneficiar do uso de ambas artérias MIs, com pouco acréscimo de risco quando sua aplicação for adequadamente indicada. OBJECTIVE: We sought to describe the use of both internal mammary arteries (IMA) in patients with diabetes mellitus (DM) submitted to coronary artery bypass grafting (CABG). METHOD: Between January of 1995 to August of 2005, 4.569 patients received isolated CABG in our institution, of these, 1.298 had DM. Mean sample age was 62 years, and total mortality was 2.18% (100 patients). We have used both IMA's in 700 patients, that here are split in two groups, with DM (group I, 148 patients), and without DM (group II, 552 patients). Patient selection for double IMA grafting was based on coronary artery anatomy and sternal bone quality, the later was evaluated during sternal transsection. When these two factors were considered favorable, we harvested both IMA's, not mattering if the patient had or had not DM. During IMA's harvest, care was taken not to open the pleural spaces. RESULTS: There was small difference between the two groups in terms of morbidity and mortality. CONCLUSION: Our data suggest that patients with DM can benefit of double IMA's grafting, with little increase in risk for complications if its application is carefully indicated. |
| Databáze: | OpenAIRE |
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