Journal of cardiac surgery
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Randomized Controlled Trial Comparative Study
Endothoracic injection of room air for internal mammary artery harvest.
Arterial spasm is described as an event occurring after internal mammary artery (IMA) harvesting. Endothoracic papaverine and carbon dioxide application have been used to prevent IMA spasm before surgical dissection. This technique may make harvest quicker and easier. The aim of this study is to evaluate the effect of room air injection into the endothoracic fascia on IMA blood flow and harvest time. ⋯ Injection of room air beneath the endothoracic fascia before IMA dissection may prevent spasm and shorten harvest time, which avoids any risk of intimal injury.
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Coronary revascularization methods continue to be refined, and the emergence of the drug-eluting stent (DES) has especially changed clinical practice related to ischemic heart disease. For chronic hemodialysis (HD) patients, however, the impact of DES on clinical outcome is yet to be determined. Forty-six consecutive chronic HD patients who underwent myocardial revascularization in our institute were retrospectively reviewed. ⋯ The one-year patency rate for the CABG grafts was 93.3% (left ITA: 100%, right ITA: 84.6%, sapenous vein: 90.9%, gastro-epiploic artery: 100%), and six-month restenosis rate for PCI was 57.1% (balloon angio-plasty: 75%, bare metal stent 40%, DES: 58.3%). Even in the era of DES, clinical results favored CABG. The difference in clinical results is due to the sustainability of successful revascularization.
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Comparative Study
Results of treatment methods in cardiac arrest following coronary artery bypass grafting.
Emergency re-revascularization and invasive/noninvasive interventions in intensive care unit (ICU) are two main treatment methods in cardiac arrest following coronary artery bypass grafting (CABG). We evaluated the short- and long-term consequences of these two methods and discussed the indications for re-revascularization. ⋯ Better short- and long-term results were observed in the re-revascularization group.