Document Detail

Developments in surgical techniques for coronary revascularization.
MedLine Citation:
PMID:  8573974     Owner:  NLM     Status:  MEDLINE    
The wider application of arterial conduits represents a current trend in myocardial revascularization. More complex and demanding surgical techniques are being developed as alternatives to traditional grafting procedures, in order to permit total arterial revascularization in patients with diffuse coronary artery disease. The rationale behind this strategy is the expected higher long-term patency rate of arterial conduits as compared with vein grafts. Avoidance of proximal anastomoses is another argument in favor of coronary revascularization with arterial grafts, particularly in patients with atherosclerotic changes in the ascending aorta. Although the reported operative results are good, total arterial revascularization in multivessel disease is a complex procedure, and serious perioperative complications are possible. In planning the revascularization strategy, therefore, the surgeon should take into account age, clinical condition, coexisting medical problems, coronary anatomy, and left ventricular function. The method of myocardial revascularization is an important aspect of the surgical procedure and plays a major role in the outcome of the operation in the presence of severe left ventricular dysfunction or when the operation requires prolonged ischemic times. To avoid the inevitable damaging effects of cardiopulmonary bypass and aortic cross-clamping, myocardial revascularization is carried out without extracorporeal circulation. This technique should be part of the armamentarium of the cardiac surgeon and should occasionally be considered in patients who have serious coexisting medical problems or severe left ventricular dysfunction.
O Alfieri; R Lorusso
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  10     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1996-03-14     Completed Date:  1996-03-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  556-61     Citation Subset:  IM    
Divisione Cardiochirurgica, Ospedale Civile, Brescia, Italy.
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MeSH Terms
Age Factors
Anastomosis, Surgical / methods
Arteries / transplantation
Cardiopulmonary Bypass / adverse effects
Coronary Artery Bypass / adverse effects,  methods*
Coronary Disease / pathology,  physiopathology,  surgery
Treatment Outcome
Vascular Patency
Veins / transplantation
Ventricular Dysfunction, Left / physiopathology
Ventricular Function, Left

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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