Revascularização do miocárdio sem circulação extracorpórea: resultados imediatos

Autor: Hemerson C Gama, Luis Gonzaga Granja, Luís Daniel Torres, Mônica Farias, José Teles de Mendonça, José Wanderley Neto, Ricardo de Carvalho Lima, Mozart Escobar, Décio O Elias, Ricardo Lagreca, Renato Dellassanta
Rok vydání: 1993
Předmět:
Zdroj: Brazilian Journal of Cardiovascular Surgery v.8 n.3 1993
Brazilian Journal of Cardiovascular Surgery
Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron:SBCCV
ISSN: 0102-7638
DOI: 10.1590/s0102-76381993000300001
Popis: Myocardial revascularization surgery without the use of cardiopulmonary bypass was performed by Trapp and Ankeney in the 1970's. However it fell to Buffolo in Brazil and Benetti in Argentina to introduce its systematic use, standardization and recommendation as a valid and safe alternative modality of treatment. With the aim of evaluating the technique's reproducibility, morbidity and mortality, its technical difficulties and the possibilities of incorporating it into routine practice, the authors present the results obtained in 182 patients submitted to myocardial revascularization with saphenous and/or thoracic internal bypass without the use of cardiopulmonary bypass. One hundred and eighty-two patients were operated on using this technique: 128 (70.3%) males and 54 (29.7%) females, whose ages ranged from 40 to 79 years (mean = 58.8 years), with lesions of coronary arteries: interventricular anterior (IA); right coronary (RD); diagonal artery (DI) and marginal artery (MG). Two hundred and seventy-seven arteries were revasculahsed: 159/277 IA's (57.4%), 62/277 CD's (22.4%), 44/277 DI's (15.9%) and 12/277 MG's (4.3%). The left thoracic internal artery was used on 60/277 (21.7%) occasions and the saphenous vein on 217/277 (78.3%). The duration of the ischemia ranged from 5 to 33 minutes with a mean of 14 minutes. The following conditions were noted in the study as complications: coronary spasm in 6/182 cases (3.3%), acute myocardial infarct in 3/182 (0.6%), bleeding in 2/182 (1.1%), pulmonary embolism in 1/182 (0.6%) and mediastinitis in 1/182 (0.6%). Five/182 patients (2.7%) died in the immediate postoperative period from causes unrelated to the technique employed. The authors conclude that the technique may be safely carried out by most surgeons in selected cases with good results. The technique reduces the costs of surgery and in some subgroups, such as the elderly and those suffering from systemic disease, it may be the best alternative.
Databáze: OpenAIRE
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