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Titolo:
PROBLEMS AND RESULTS OF REOPERATIVE CORON ARY-BYPASS SURGERY
Autore:
CARREL T; TKEBUCHAVA T; PASIC M; NIEDERHAUSER U; TURINA M;
Indirizzi:
UNIV SPITAL ZURICH,HERZ & GEFASSCHIRURG KLIN,RAMISTR 100 CH-8091 ZURICH SWITZERLAND
Titolo Testata:
Schweizerische medizinische Wochenschrift
fascicolo: 4, volume: 124, anno: 1994,
pagine: 136 - 145
SICI:
0036-7672(1994)124:4<136:PARORC>2.0.ZU;2-J
Fonte:
ISI
Lingua:
FRE
Soggetto:
INTERNAL-MAMMARY-ARTERY; RIGHT GASTROEPIPLOIC ARTERY; INFERIOR EPIGASTRIC ARTERY; ENDOTHELIUM-DEPENDENT RELAXATION; RETROGRADE BLOOD CARDIOPLEGIA; LEFT-VENTRICULAR FUNCTION; SAPHENOUS-VEIN GRAFTS; RIGHT HEART ISOLATION; MYOCARDIAL REVASCULARIZATION; CARDIOPULMONARY BYPASS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
97
Recensione:
Indirizzi per estratti:
Citazione:
T. Carrel et al., "PROBLEMS AND RESULTS OF REOPERATIVE CORON ARY-BYPASS SURGERY", Schweizerische medizinische Wochenschrift, 124(4), 1994, pp. 136-145

Abstract

Reoperative coronary bypass surgery has been encountered with increasing frequency over the last few years. It is associated with several major problems: difficulties with myocardial protection secondary to progression of arterial disease and occluded saphenous vein grafts, leftventricular dysfunction, and concomitant medical and vascular disease. We present our experience with 194 consecutive patients operated on between 1980 and 1992. They represent 4.0% of the overall number of isolated coronary revascularizations performed during the same period. There were 178 men and 16 women, mean age 58.6+/-7.4 years. The interval between primary coronary bypass grafting operation and redo-operation extended from 4 to 12 years, mean 8.2 years. At reoperation, 91.7% (178/194) of the patients received at least one arterial conduit, whereas revascularization with arterial conduits only was performed in 16 patients. Perioperative mortality amounted to 4.6% and was significantly higher than mortality of primary isolated coronary operations (1.6%)during the same period; the following significant morbidity was encountered: perioperative myocardial infarction (8.2%), postoperative low output requiring intraaortic conterpulsation (8.7%), postoperative bleeding (8.2%) and infectious complications (9.2%). First postoperative follow-up showed a significant improvement of symptomatology with a decrease of 1.5 point in NYHA functional class. Mid term survival is promising with a 5-year survival rate of 88.5%. Improved myocardial preservation and a trend towards complete revascularization should become routine and will probably reduce perioperative mortality and morbidity.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 08:18:20