Search Results
Results 551 - 600 of 1130
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Thomas J L - - 1999
At a time when cardiac surgery was still approached with hesitation, Arthur M. Vineberg developed the procedure of direct implantation of the internal mammary artery into the left ventricle for the relief of myocardial ischemia. The Vineberg operation, as it became known, had merit but never received broad endorsement from ...
Scioti G - - 1999
We report the case of a 57-year-old man who had presented with exertional angina early in 1997 and had subsequently undergone myocardial revascularization with the use of both internal mammary arteries. Two months after surgery, the patient was readmitted to the hospital with unstable angina. Coronary angiography revealed a 90% ...
Lachman N - - 1999
The study presents the incidence of a variant terminal branch of the internal thoracic artery (ITA). The ITA's were cannulated in situ, injected with coloured latex and dissected together with its branches in 62 cadavers. Unlike the usual termination of the ITA bifurcating into the musculophrenic and superior epigastric arteries, ...
Brackenbury E - - 1998
The internal mammary artery is regarded as the optimal conduit for coronary artery bypass grafting in adults. Use of this conduit in paediatric surgery is rare and has been reported mainly in patients with Kawasaki's disease. We report five patients who required internal mammary-coronary artery grafting due to adverse anatomical ...
Takahashi T - - 1998
We describe a patient with severely diseased ascending aorta and small internal mammary arteries, who underwent off-pump coronary artery bypass to the left anterior descending coronary artery and right coronary artery using composite arterial grafts consisting of the pedicled proximal internal mammary artery and interposed radial artery graft. The interposed ...
Loop F D - - 1998
In each of the first three decades of myocardial revascularization, conventional treatment has been revised completely. This lecture comments on three areas of discovery that have shaped the evolution of myocardial revascularization: science, technology development, and revascularization. The discoveries in all three areas are inexorably interrelated. The single greatest lesson ...
Chester A H - - 1998
BACKGROUND: Variations in the morphology and vascular reactivity of the proximal and distal radial artery might influence its performance as a bypass conduit. METHODS: The morphologic and functional characteristics of the proximal and distal RAs were compared with those of the left and right internal mammary arteries by using histologic ...
Ostapczuk S - - 1998
BACKGROUND: The patency of biologic small-diameter vascular grafts in the aortocoronary position is still unsatisfactory. Most of the studies suggest that xenografts are to be avoided as an aortocoronary bypass. METHODS: The porcine internal mammary artery treated by the No-React II procedure was developed for use as an alternative coronary ...
Tribouilloy C M - - 1998
BACKGROUND: During the 1980s, mortality from coronary artery disease (CAD) decreased markedly in the United States. This raises the question of whether a parallel decrease occurred in excess mortality due to CAD in patients undergoing surgical correction of valvular regurgitation. METHODS AND RESULTS: Survival of 752 patients (age, 64 +/- ...
Hassen-Khodja R - - 1998
The purpose of this retrospective study was to determine the indications and efficacy of direct revascularization of the internal iliac arteries during aortoiliac reconstruction in the prevention of postoperative colonic and pelvic ischemia. This study included 540 patients who underwent aortoiliac reconstruction between January 1987 and December 1996 for nonruptured ...
Lisi G - - 1998
BACKGROUND: The safe development of minimally invasive coronary artery bypass operations might require alternatives to conventional suture-based anastomotic techniques. In this setting, nonpenetrating stapling is an attractive option because of its simplicity of use and potential for improved endothelial preservation. METHODS AND RESULTS: In the experimental part of this study, ...
Izzat M B - - 1998
The importance of the angiographic assessment of coronary bypass grafts performed on the beating heart has been recognized. We describe a simple technique for intraoperative angiography of left internal mammary artery to left anterior descending coronary artery grafts that does not require selective left internal mammary artery catheterization. This method ...
Magovern J A - - 1998
BACKGROUND: Minimally invasive direct coronary artery bypass grafting (MIDCABG) promises to reduce the morbidity of coronary bypass, but this has not been proved. METHODS: This retrospective study compares the morbidity, mortality, cost, and 6-month outcome of patients less than 80 years old undergoing elective left internal mammary artery to left ...
Gulielmos V - - 1998
OBJECTIVE: The treatment of coronary single vessel disease under minimally invasive surgical conditions was followed by the treatment of coronary multivessel disease using a new technique. METHODS: Using this technique 100 patients (80 male, 20 female, median age 61.0+/-8.9 years, ranged from 39 to 82 years) with coronary single vessel ...
Wolf R K - - 1998
OBJECTIVE: We developed a thoracoscopic internal mammary artery harvest technique using an ultrasonic scalpel, the Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH). This is the first report of 9 month follow-up using this technique. METHODS: The Harmonic Scalpel is activated ultrasonically by vibrating at 55000 Hz. Compared with electrocautery, lower heat ...
Calafiore A M - - 1998
BACKGROUND: Left internal mammary artery Doppler flow velocity assessment during the Azoulay maneuver (patient's legs are passively lifted up and actively maintained by the patient) can increase the information on the anastomosis quality after left internal mammary artery to left anterior descending coronary artery grafting after the left anterior, small ...
Mishra Y - - 1998
OBJECTIVE: The recent concept of minimally invasive coronary artery surgery in selected patients has dramatically affected surgical management of coronary artery disease. We explored the possibility of coronary artery bypass grafting of anterior coronary arteries with in situ internal mammary artery through a limited anterior thoracotomy on beating heart. METHOD: ...
Gulielmos V - - 1998
OBJECTIVE: In order to avoid sternotomy-related complication after cardiac surgery minimally invasive cardiac surgery has been developed successfully for the treatment of coronary artery disease, however, those techniques were still limited to the treatment of single-vessel disease. Therefore a new surgical technique for the treatment of multi-vessel disease has been ...
Martinelli G L - - 1998
OBJECTIVE: Left internal mammary artery harvesting through a mini-thoracotomy makes gaining the proximal portion of this vessel very difficult and exposes the patient to the risk of chest wall trauma due to excessive spreading of the ribs. The adoption of video thoracoscopic assistance can give several advantages to the procedure. ...
Enjalbert F - - 1998
The effect of dietary lipids on the fatty acid (FA) profile of cows' milk fat is mainly dependent on digestive processes and mammary gland uptake and metabolism of FA. The objective of this study was to determine the separate effects of high arterial concentrations of 16:0, 18:0 and cis-18:1(n-9) on ...
Weinschelbaum E - - 1998
BACKGROUND: In recent years, minimally invasive direct coronary artery bypass grafting has emerged as a valid tool for revascularization in a select group of patients with severe lesions of the left anterior descending coronary artery. Here we report the clinical results using two devices designed by us to facilitate the ...
Calafiore A M - - 1998
BACKGROUND: Left anterior descending artery stabilization allows performance of left internal mammary artery grafting via a left anterior small thoracotomy on a beating heart. Our surgical experience was reviewed to assess if surgical results have improved as result of specialized instrumentation. METHODS: Of 545 patients who had the left anterior ...
Misumi I - - 1998
A 78-year-old man was admitted to hospital with heart failure and chronic bronchitis. A computed tomographic scan of the chest incidentally demonstrated bilateral abnormal vessels near the left atrium. Selective angiography showed that both internal mammary arteries and bronchial arteries communicated with the pulmonary arteries bilaterally. The patient refused surgery ...
Stephenson E R ER - - 1998
BACKGROUND: As minimally invasive approaches to cardiac surgery have expanded, a significant number of limitations have become apparent, particularly the lack of adequate precision with standard endoscopic instruments. We hypothesized that the use of robotics would eliminate some of these limitations. METHODS: Twenty-five coronary anastomoses on an isolated porcine heart, ...
Mack M J - - 1998
Minimally invasive coronary artery bypass is defined as any maneuver or modification of conventional coronary bypass that decreases adverse effects. These adverse effects fall into three broad categories, which are access trauma, consequences of cardiopulmonary bypass, and aortic manipulation. In the minimally invasive direct coronary artery bypass (MIDCAB) approach, coronary ...
Kulkarni R - - 1998
A wide spectrum of complications is associated with invasive hemodynamic monitoring. We report an unusual case of perforation of the left internal mammary artery that occurred during percutaneous insertion of a Swan-Ganz catheter using the subclavian vein approach. To the best of our knowledge, this complication has not been previously ...
Groh M A - - 1998
Complete coronary artery revascularization results in improved symptom-free survival. Standard cardiac revascularization uses cardiac arrest for microvascular anastomoses. The Port-Access system allows multiple coronary anastomoses in an arrested blood-free field. The technique of Port-Access coronary artery bypass grafting has evolved from one based on internal mammary artery inflow to one ...
Elbeery J R - - 1998
BACKGROUND: Minimally invasive direct coronary artery bypass grafting involving beating heart left internal mammary artery to left anterior descending coronary artery anastomoses are performed with increasing frequency. Controversy exists regarding the need for intraoperative assessment of graft patency. METHODS: We designed a technique to perform arteriography of the left internal ...
Bedogni F - - 1998
Elective stenting for severe stenosis involving the origin of a right internal mammary artery graft was performed in a 60-year-old patient with severe unstable angina 2 yr after surgical revascularization. The procedure had an excellent immediate result which persisted at 6-mo angiographic follow-up. This unusual localization of arterial narrowing will ...
Gulielmos V - - 1998
We report about a 71-year-old man with coronary artery double-vessel disease who received minimally invasive coronary artery bypass grafting through a 9-cm left lateral chest incision in the third intercostal space. Both mammary arteries were harvested either directly (left internal mammary artery) or thoracoscopically (right internal mammary artery) and anastomosed ...
Hearne S E - - 1998
Secondary to the low attrition rate of internal mammary artery grafts, limited data are available on the clinical and angiographic outcome of patients who have undergone balloon angioplasty of an internal mammary artery stenosis. This study examined a consecutive series of 68 patients who underwent balloon angioplasty of an internal ...
Bonatti J - - 1998
BACKGROUND: Superior long-term patency rates of the internal mammary artery (IMA) versus saphenous vein (SV) after coronary artery bypass grafting are well documented. Higher production rates of vasodilating and platelet-inhibiting mediators (prostacyclin and nitric oxide) by the IMA seem to have a major impact on its long-term durability and resistance ...
Ti L K - - 1998
The anesthetic technique for two patients who underwent thoracoscopic harvesting of the LIMA followed by a mini-thoracotomy for surgical myocardial revascularization of isolated LAD artery stenosis is reported. Both patients unexpectedly showed esmolol resistance during anastomosis of the LIMA to the LAD artery. However, excellent graft patency, early extubation, and ...
Gulielmos V - - 1998
BACKGROUND: To avoid sternotomy-related complications after cardiac operations, we developed a minimally invasive surgical technique for the treatment of multivessel coronary artery disease. METHODS: From November 1996 to May 1997, 39 patients (age range, 50 to 78 years) with coronary artery disease were treated with the use of this technique. ...
Rousou J A - - 1998
Exposure for internal mammary artery harvesting and immobilization of the coronary artery during the performance of minimally invasive direct coronary artery bypass grafting requires the use of appropriate retractors and instruments. We have successfully used existing retractors and instruments, modified for such use, which are reusable and cost effective. The ...
Ochi M - - 1998
A fifty-seven year old male patient with severe three-vessel coronary artery disease underwent successful coronary bypass surgery in six vessels utilizing the in situ left internal thoracic and right gastroepiploic arteries. Each arterial conduit was anastomosed sequentially to as many as three coronary vessels respectively. Surgical results were excellent and ...
Bonatti J - - 1998
A direct comparison of the three coronary artery bypass conduits internal mammary artery (IMA), right gastroepiploic artery (RGEA), and saphenous vein (SV) concerning arachidonic acid (AA) stimulated release of the vasodilating and platelet inhibiting mediator prostacyclin was the aim of the present study. Pieces of saphenous vein (n = 16), ...
Chamiot-Clerc P - - 1998
OBJECTIVE: The aim of this study was to analyse the arterial wall mechanics and the vasoreactive properties of the radial artery in comparison with those of the internal mammary artery and to discuss their implications for coronary bypass grafts. METHODS: Measurements of pressure and diameter were obtained from cylindrical segments, ...
Schumacher B - - 1998
BACKGROUND: The present article is a report of our animal experiments and also of the first clinical results of a new treatment for coronary heart disease using the human growth factor FGF-I (basic fibroblast growth factor) to induce neoangiogenesis in the ischemic myocardium. METHODS AND RESULTS: FGF-I was obtained from ...
Reichenspurner H - - 1998
BACKGROUND: To reduce surgical trauma, we performed minimally invasive Port-Access (Heartport Inc, Redwood City, CA) coronary artery bypass grafting with cardiopulmonary bypass and cardioplegic arrest. METHODS: Thirty-six men and 6 women with a median age of 59 years (range, 31 to 75 years) and isolated lesions of the left anterior ...
Süngün M - - 1998
BACKGROUND: Various studies in progress on the flow and diameter parameters based assessment and suitability of internal mammary artery by preoperative colour Doppler examination in coronary artery surgery. Postoperative visualisation of these grafts is also in evolution. Due to its noninvasive approach, colour Doppler sonography is taking its place in ...
Gitter R - - 1998
BACKGROUND: Mechanical circulatory assistance is frequently needed in postcardiotomy patients to support the failing heart. A balloon catheter called SupraCor (ABIOMED Cardiovascular, Inc, Danvers, MA) has been developed and is similar to the existing intraaortic balloon pump with the exception of placement in the ascending versus the descending thoracic aorta. ...
Frank M W - - 1998
This report describes a late, near-fatal rupture of a false aneurysm of the right internal mammary artery subsequent to coronary artery bypass grafting. The patient presented to us in shock due to hemorrhaging, 8 weeks after bypass surgery that had been complicated by sternal fracture, dehiscence, and infection. Emergent thoracotomy ...
Gulbins H - - 1998
BACKGROUND: The direct left internal mammary artery (LIMA) bypass to the left anterior descending (LAD) without the use of extracorporal circulation through a small anterolateral thoracotomy has become established among the minimally invasive techniques in cardiac surgery. Technical difficulties may occur in patients with an enlarged left ventricle and subsequent ...
Tang L - - 1998
Elevated plasma homocysteine is an established risk factor for vascular disease although the mechanisms are unclear. Homocysteine has been reported to stimulate DNA synthesis and proliferation in rat aortic smooth muscle cells. Human vascular smooth muscle cells (HVSMC) from saphenous veins (n = 8), internal mammary arteries (n = 6) ...
Rigaud J - - 1998
The internal thoracic a. is much used in cardiac surgery because of its anatomic position, but its mobilisation may lead to devascularisation of the sternum. The aim of this study was to establish a precise systematisation of the vascularisation of the sternum by means of dissections and radiography after injection ...
Coulson A S - - 1998
BACKGROUND: Minimally invasive direct coronary artery bypass grafting (MIDCAB) is an attractive new alternative for revascularizing patients with high perioperative risk for standard coronary surgery. However, limited surgical exposure through a small thoracotomy makes harvesting the full length of the internal mammary artery (IMA) very difficult and time consuming. We ...
Ferrara L E - - 1998
Coronary artery disease remains the major cause of death and disability in the United States. Surgical procedures such as the internal mammary artery (IMA) bypass grafting of coronary arteries might be associated with complications, such as the coronary subclavian steal syndrome (CSSS). Cardiovascular nurses need to increase their knowledge and ...
Lachman N - - 1998
The surgical significance of the internal thoracic arteries (ITA's) in procedures such as coronary artery bypass grafting, transverse rectus abdominis myocutaneous flaps and minimal incision direct coronary artery bypass surgery is well recognised. However, the detailed morphometry of these vessels is not well documented. This study aimed to detail the ...
Ehrsam J E - - 1998
We report our experience in visualizing the internal mammary artery (IMA) with new enhanced Doppler technology. Twenty-three patients without previous coronary artery bypass grafting formed the study group. Bilateral transthoracic two-dimensional and color flow Doppler IMA images were acquired from multiple intercostal spaces with a prototype ultrasound machine equipped with ...
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