| Coronary artery disease progression in patients who need repeat surgical revascularisation: the surgeon's point of view. | |
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MedLine Citation:
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PMID: 18268427 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to evaluate changes in native coronary arteries in patients undergoing repeat myocardial revascularisation late (>3 years) after primary coronary artery bypass grafting (CABG). METHODS: The angiographic images of 30 patients obtained at first and redo CABG were assessed for significant (>75%), short (<1 cm) and long (>1 cm) stenosis or total occlusion in native coronary arteries. Bypass grafts were also evaluated for significant stenosis (>50%) or occlusion. RESULTS: At first CABG, a mean number of 3.3 grafts/patient (range 1-5) were implanted. The mean time interval from first CABG to reoperation was 11.4 years (range 3-21 years). All patients showed disease progression in the native coronary arteries. At redo CABG, 3 (3.5%) grafts were non-stenotic, 27 (31%) stenotic, and 57 (65.5%) occluded. In native coronary vessels, five patients developed a new left main coronary artery stenosis, and there was a four-to-six-fold increase in total occlusions. Indications for redo CABG were disease progression in non-bypassed vessels (n = 3), bypass lesions (n = 19), and both bypass lesions and disease progression in the distal segments of native coronary arteries (n = 8). CONCLUSIONS: Late after CABG, coronary artery disease is highly progressive, mainly affecting the proximal segments of native coronary arteries, with a high incidence of coronary occlusion. Conversely, a low incidence of disease progression is observed in the distal segments of native coronary arteries, except in diabetic patients. Total arterial revascularisation as a primary strategy for CABG should be highly recommended, and more aggressive risk factor management is desirable. |
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Authors:
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Andreas Borowski; Ilja Vchivkov; Ali Ghodsizad; Emmeran Gams |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of cardiovascular medicine (Hagerstown, Md.) Volume: 9 ISSN: 1558-2027 ISO Abbreviation: J Cardiovasc Med (Hagerstown) Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-02-12 Completed Date: 2008-03-06 Revised Date: 2009-05-28 |
Medline Journal Info:
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Nlm Unique ID: 101259752 Medline TA: J Cardiovasc Med (Hagerstown) Country: United States |
Other Details:
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Languages: eng Pagination: 85-8 Citation Subset: IM |
Affiliation:
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Clinic for Thoracic and Cardiovascular Surgery, University of Düsseldorf, Germany. borowski@med.-uni.duesseldorf.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Coronary Angiography Coronary Artery Bypass / methods* Coronary Disease / physiopathology, radiography*, surgery Disease Progression Female Follow-Up Studies Humans Male Middle Aged Prognosis Reoperation Retrospective Studies Risk Factors Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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