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Axillobifemoral bypass grafting  [PDF]
Davidovi? Lazar B.,Mitri? Milan S.,Kosti? Du?an M.,Maksimovi? ?ivan V.
Srpski Arhiv za Celokupno Lekarstvo , 2004, DOI: 10.2298/sarh0406157d
Abstract: INTRODUCTION Axillo-femoral bypass (AxF) means connecting the axillar and femoral artery with the graft that is placed subcutaneously [1]. Usually, this graft is connected with contralateral femoral artery via one accessory subcutaneous graft, and this connection is known as axillobifemoral bypass (AxFF). This extra-anatomic procedure is an alternative method to the standard reconstruction of aortoiliac region when there are contraindications for general or local reasons. OBJECTIVE The objective of this paper is to show early and late results of AxFF bypass grafting as well as to show the indications for AxFF bypass. METHODS The sample consisted of 37 patients. The procedure was performed in 28 patients who suffered from aortoiliac occlusive disease and who were at high risk due to the comorbidity- in one patient with the rupture of juxtarenal aneurysm of abdominal aorta; in five patients with aortoenteric fistula, in two patients with iatrogenic lesion of abdominal aorta and in one female patient with anus preternaturalis definitivus who was treated for rectovaginal fistula. Donor's right axillary artery was used in 26 cases (70.3%), and donor's left axillary artery was used in 9 cases (29.7%). Dacron graft was used in 34 patients and Polytetrafluo-roethlylene graft was used in three patients. Simultaneously, profundo-plastic was done in four patients and femoro-popliteal bypass was performed in three patients. In five patients who suffered from aortoenteric fistula, simultaneous intervention of gastrointerstinal system has been done, x2 test was used for statistical evaluation and life table method was used for verification of late graft patency. RESULTS The rate of early postoperative mortality was 13.5%. The causes of death were: sepsis -1, MOFS - 3, and infarct myocardium -1. The mean follow up period was 40.1 months, ranging from six months to 17 years. During the follow up period, an early graft thrombosis was identified in two and late graft occlusion was reported in four patients. As the cause of occlusion, the progression of occlusive disease of receptive artery was identified in three patients, while anastomotic neointimae hyperplasia of recipient artery was identified in one patient. Three patients died during the follow up period. As the cause of death, CVI was reported in two patients and malignancy of the urinary tract was fpund in one patient. The other complications were - artery angulation on the level of proximal anastomosis in one patient (Figure 1), false aneurysm in one patient, perigraft seroma in one patient and graft infection in
On-pump coronary artery bypass in moyamoya disease: A case report  [PDF]
Ismail Haberal, Onur Gürer, Deniz Ozsoy, Gürkan Cetin, Murat Mert
World Journal of Cardiovascular Diseases (WJCD) , 2013, DOI: 10.4236/wjcd.2013.33050
Abstract:

A 54-year-old female with pre-existing idiopathic moyamoya disease developed chest pain with acute myocardial infarction. Coronary angiography detected occluded and stenotic lesions in the coronary arteries. Right coronary artery stenosis was treated by balloon angioplasty and stenting. Because of the restenosis, on-pump cardiopulmonary bypass was performed. The operation was uneventful and no perioperative cerebral ischemic episode occurred. The conclusion is that on-pump cardiopulmonary bypass preserving intraoperative hemodynamic parameters at an optimal level is a safe procedure in a patient with moyamoya disease.

Characterization of Inpatient Moyamoya in the United States: 1988–2004  [PDF]
Darrin J. Lee,David S. Liebeskind
Frontiers in Neurology , 2011, DOI: 10.3389/fneur.2011.00043
Abstract: Background and Purpose: Moyamoya disease has been classically described by the Asian experience, yet clinical aspects of moyamoya phenomena in the United States remain vastly undefined. The multifocal occlusive arterial disorder may be linked with numerous conditions; however, later stages of this syndrome share common vascular pathophysiology. This study is aimed at characterizing inpatient moyamoya cases in the United States over a broad time span. Methods: A comprehensive analysis of the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project (Releases 1–13, 1988–2004) based on ICD-9-CM code 437.5 was performed. Annual percentages and trends analyses were conducted for demographic variables, admission characteristics, co-morbidities, and procedures. Result: 2247 admissions of moyamoya cases were analyzed from a wide geographic distribution throughout the United States between 1988 and 2004. Age at admission varied considerably (mean 29.6 ± 18.5 years), affecting women more frequently than men (61.9%). Various racial groups were identified (35.4% White, 19.7% African American, 5.6% Hispanic, 8.3% Asian or Pacific Islander, 1.4% Native American). Admissions were typically emergent (38.8%) or urgent (18.7%), although elective admissions occurred (24.4%). Aside from moyamoya, sickle cell disease was diagnosed in 13.6%, ischemic stroke in 20.7%, intracerebral hemorrhage in 7.4%, transient ischemic attack in 3.4%, and subarachnoid hemorrhage in 3.1%. Cerebral angiography was performed in 24.9% while extracranial–intracranial bypass was done in 8.4% of patients. Conclusion: Moyamoya in the United States is a heterogeneous condition affecting individuals of all ages across a diverse racial spectrum and wide geographic distribution. Further recognition of moyamoya syndrome may facilitate ongoing research and future therapeutic approaches.
Neuropsychological outcomes of coronary artery bypass grafting
Nafisa Cassimjee,Caroline L Couzens,Frans J Smith,Claire Wagner
Health SA Gesondheid , 2004, DOI: 10.4102/hsag.v9i3.167
Abstract: People with coronary heart disease have recourse to a palliative intervention such as Coronary Artery Bypass Grafting (CABG). Opsomming Persone met ‘n koronêre hartsiekte is soms genoodsaak om ‘n hartomleiding (CABG), wat ‘n tydelike intervensie ter verligting is, te ondergaan. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
Optic Neuropathy Following Coronary Artery Bypass Grafting  [cached]
Ashok Kumar,Krishnagopal Srikanth
Australasian Medical Journal , 2012,
Abstract: Postoperative vision loss (POVL) after major non-ocular surgery is a very rare but devastating complication since it has the potential to cause bilateral, severe and permanent loss of vision. The common major procedures resulting in POVL are cardiac and spinal procedures. We are reporting two patients who presented with features of bilateral anterior ischaemic optic neuropathy after coronary artery bypass grafting.
The radial artery for coronary artery bypass grafting  [PDF]
Ne?i? D.,Milojevi? P.,?irkovi? M.,Kne?evi? A.
Acta Chirurgica Iugoslavica , 2005, DOI: 10.2298/aci0503011n
Abstract: Coronary artery bypass grafting (CABG) is the standard surgical procedure for the treatment of advanced coronary artery disease. CABG surgery has been demonstrated to improve symptoms and, in specific subgroups of patients, to prolong life. Despite its success, the long-term outcome of coronary bypass surgery is strongly influenced by the fate of the vascular conduits used. Previous long-term studies have shown unsatisfactory patency of saphenous vein grafts used for myocardial revascularisation, compared with internal mammary artery grafts. Recently, the use of radial artery for CABG has enjoyed a revival, on the basis of the belief that it will help improving long-term results of coronary operations. The recent reports of encouraging mid-term and long-term patency rates of the radial artery, supports its continued use as a bypass conduit. In this paper, we review the current knowledge about the radial artery as a bypass graft, with special emphasis on the clinical results.
Concurrent Stenoocclusive Disease of Intracranial and Extracranial Arteries in a Patient with Polycythemia Vera
Le H. Hua,Robert L. Dodd,Neil E. Schwartz
Case Reports in Medicine , 2012, DOI: 10.1155/2012/151767
Abstract: Moyamoya disease is a stenoocclusive disease involving the intracranial carotid and proximal middle cerebral arteries. There are rarely any additional extracranial stenoses occurring concurrently with moyamoya. The pathophysiology of moyamoya remains obscure, but hematologic disorders, notably sickle-cell anemia, have been associated in some cases. We describe the novel case of polycythemia vera associated with severe steno-occlusive disease of both intracranial and extracranial large arteries. A 47-year-old woman with polycythemia vera had multiple transient ischemic attacks, and noninvasive vessel imaging revealed steno-occlusive disease of bilateral supraclinoid internal carotid arteries with moyamoya-type collaterals, proximal left subclavian artery, right vertebral artery origin, bilateral renal arteries, superior mesenteric artery, and right common iliac artery. Laboratory workup for systemic vasculitis was negative. She required bilateral direct external carotid to internal carotid bypass procedures and percutaneous balloon angioplasty of her right VA origin stenosis. This case suggests that hematologic disorders can lead to vessel stenoses and occlusion. The pathophysiology may be due to a prothrombotic state leading to repeated endothelial injury, resultant intimal hyperplasia, and progressive steno-occlusion.
Robotically-Assisted Coronary Artery Bypass Grafting  [PDF]
Thierry A. Folliguet,Alain Dibie,Fran?ois Philippe,Fabrice Larrazet,Michel S. Slama,Fran?ois Laborde
Cardiology Research and Practice , 2010, DOI: 10.4061/2010/175450
Abstract: Objectives. Robotic surgery enables to perform coronary surgery totally endoscopically. This report describes our experience using the da Vinci system for coronary artery bypass surgery. Methods. Patients requiring single-or-double vessel revascularization were eligible. The procedure was performed without cardiopulmonary bypass on a beating heart. Results. From April 2004 to May 2008, fifty-six patients were enrolled in the study. Twenty-four patients underwent robotic harvesting of the mammary conduit followed by minimal invasive direct coronary artery bypass (MIDCAB), and twenty-three patients had a totally endoscopic coronary artery bypass (TECAB) grafting. Nine patients (16%) were converted to open techniques. The mean total operating time for TECAB was minutes and for MIDCAB was minutes. Followup was complete for all patients up to one year. There was one hospital death following MIDCAB and two deaths at follow up. Forty-eight patients had an angiogram or CT scan revealing occlusion or anastomotic stenoses (>50%) in 6 patients. Overall permeability was 92%. Conclusions. Robotic surgery can be performed with promising results. 1. Introduction Coronary artery bypass grafting (CABG) provides complete revascularization with excellent long-term results and a low mortality. However it generates significant complications and important costs. The tendency is actually to perform operations through smaller and smaller incisions as to reduce hospital stay and to fasten postoperative recovery. More recently robotic-assisted thoracoscopic coronary surgery provides the ability to perform revascularization either totally endoscopic (TECAB) [1–3] or via small thoracostomies (MIDCAB) [4–6]. Our institution initiated robotic cardiac surgery in 2004 using the da Vinci surgical system (Intuitive surgical, Sunnyvale, CA), and we have completed over 150 cases of robotic cardiac surgeries. The current study describes our experience with robotic coronary artery revascularization, specifically addressing feasibility safety and efficacy while discussing its potential value and limitations to the patient. 2. Patients and Methods Patients with single-or-double vessel coronary artery disease referred for surgical revascularization were eligible for the study. We report our experience from April 2004 to June 2008 which includes 56 patients. All patients gave informed consent for coronary artery bypass surgery using the da Vinci surgical system (first generation). 2.1. Training Protocol Before starting the series we underwent a stepwise training program including basic da Vinci
Quality of Life after Coronary Artery Bypass Grafting in
Z. Esmaeili, M.Sc.
Journal of Mazandaran University of Medical Sciences , 2007,
Abstract: Z. Esmaeili, M.Sc. + Sh. Ziabakhsh Tabari, M.D.** N. Vaez zadeh, M.Sc. * R.A. Mohammad pour, Ph.D. ***AbstractBackground and Purpose : Improvement of the quality of life for patients must be considered as a main objective of treatment. Therefore, increased attention to coronary artery surgery, coupled with patients quality of life, is significant for patients after surgery.Materials and Methods : This descriptive study was preformed on 172 patients, after a coronary artery grafting bypass. Data was collected by a SF-36 questionnaire, comprising of 36 questions divided in 8 domains. The score was designated as 0 to 100; with the higher score being indicative of a better quality of life. The obtained data was analyzed by descriptive statistics, t-test and analysis of variance methods.Results : Findings showed that 75% of subjects reported well quality of life, while the mean score regarding quality of life in men, were higher than women in all health related dimensions. Based on t-test difference, the of quality of life in men and women for physical health (p<0.014), mental limitation (p<0.033), somatic pain (p<0.032) and mental health (p<0.049) was observed.Conclusion : Considering a greater quality of life after coronary artery bypass grafting in patients, it is recommended to pay more attention to increase quality of life through treatment, care, follow- up in order to achive the best quality of life for patients.
Combined Procedure for Coronary Artery Bypass Grafting and Pulmonary Hydatid Disease  [PDF]
A. Al Khaddour, S. Al Hashimi, N. Abbas
World Journal of Cardiovascular Surgery (WJCS) , 2016, DOI: 10.4236/wjcs.2016.61003
Abstract: In this study we reported one case of combined procedure for coronary artery bypass grafting and excision of right pulmonary hydatid cyst. Concerns of possible hydatid systemic dissemination as a result of direct vascular breaches are raised. We suggest that avoidance of cardiopulmonary bypass (CPB) if that possible is beneficial for the treatment. If not possible then the excision and clearance of the hydatid cyst should be done in the first place before going on bypass.
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