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Effects of Skeletonized versus Pedicled Internal Thoracic Artery Grafts on Free Flow Capacity during Bypass

Journal of Huazhong University of Science and Technology(Medical Sciences) 2000年第4期20卷 308-310页

作者：黄畦 Department of Thoracic and Cardiovascular surgery Tongji Hospital Tongji Medical University Wuhan Department of Thoracic and Cardiovascular surgery University Hospital Hamburg Homburg/Soar Germany

The free flow of skeletonized ITA grafts was compared with that of pedicled ITA grafts. One hundred patients with coronary artery diseases underwent elective CABG. In the group Ⅰ(n= 50), the left ITA was dissected using the skeletonization technique. In the group Ⅱ(n=50), the ITA was harvested as a pedicled graft. Free flow of the ITA was recorded before and 15 min after in- traluminal application of diluted papaverine. Mean arterial pressure was maintained at 9. 31 kPa (70 mmHg). The results showed that before the application of papaverine, free flow of skeletonized and pedicled ITA grafts was identical between the two groups. After treatment with papaverine, the maximum free flow was significantly higher in the skeletonized ITA's in the group Ⅰ(199. 3±69. 6 ml/min) than in the group Ⅱ(145. 7±70. 3 ml/min, P<0. 05). There was on significant differ- ence between the free flow after dilatation of the left and right ITA in the group Ⅰ (left 199. 3±69. 6 ml/mm, right 198. 9±61. 8 ml/mm, respectively). It was concluded that preparation of the ITA with the skeletonization technique resulted in significantly higher free flow capacity than in pedicled grafts and would improve the results of arterial revascularization. The complication rate seems to be lower than with the conventional method.

关键词： coronary surgery internal thoracic artery skeletonization vessel preparation tech- nique

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Surgical Myocardial Revascularization in a Sub-Saharan African Country: Indications and Results

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World Journal of Cardiovascular surgery 2021年第11期11卷 95-103页

作者： Kouassi Antonin Souaga Gnamien Randolph Niava Eric Koutoua Katché Kwadjau Anderson Amani Yoboua Aimé Kirioua-Kamenan Jean Calaire Degré Arnau Ekou Aka Roland N’guetta Joseph Kouamé Landry Kohou-Koné Yapo Paul Yapo Kouassi Flavien Kendja Kouassi Michel Kangah Cardiovascular surgery Department of the Abidjan Heart Institute Abidjan C&#244te d’Ivoire Hemodynamics Department of the Abidjan Heart Institute Abidjan C&#244te d’Ivoire Anesthesia and Intensive Care Department of the Abidjan Heart Institute Abidjan C&#244te d’Ivoire

Introduction: Despite the advances of interventional catheterization, surgery remains the treatment of choice for some coronary lesions. Objective: To report the indications and results of surgical revascularization of the myocardium at the Abidjan Heart Institute. Patient and Methods: This is a retrospective study of patients with coronary insufficiency who underwent surgical myocardial revascularization between March 2014 and May 2020 in the Cardiovascular surgery Department of the Abidjan Heart Institute. There were 17 patients, 11 of whom were men (64.7%) and 6 women (35.3%), The mean age of the patients was 57.5 years ± 8.8. All patients were symptomatic with disabling angina in class III of the Canadian Cardiac Society (CCS). This sym- ptomatology had been evolving on average for 5 years and 6 patients had a history of acute coronary syndrome, 2 of whom had undergone prior angioplasty. coronary angiography revealed mono-truncated (17.6%), bi-truncated (23.5%) and tri-truncated (58.8%) lesions. Results: The patients were operated under cardiopulmonary bypass (CPB) 15 cases (88.2%) and off pump in 2 cases (11.8%). They underwent a single bypass in 23.5% of cases, a double bypass in 47.1% of cases and a triple bypass in 29.4% of cases. We observed 3 cases of complications (17.6%), namely transient acute renal failure, mediastinitis and postoperative bleeding. The operative and hospital mortality was nil. After a mean follow-up of 3 ± 1.8 years, all patients were

关键词： Myocardial Revascularization coronary surgery Bypass

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