Document Detail


Early outcomes of radial artery use in all-arterial grafting of the coronary arteries in patients 65 years and older.
MedLine Citation:
PMID:  20548806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We retrospectively evaluated early clinical results of coronary revascularization using none but arterial grafts in patients aged 65 years and older. The cases of 449 consecutive patients who had undergone isolated myocardial revascularization were divided into 2 groups: the arterial conduit group (n=107) received a left internal mammary artery (LIMA) graft and 1 or both radial arteries (RAs), while the mixed-conduit group (n=342) received a LIMA graft and 1 or more saphenous vein grafts (SVGs), with or without an RA. There was no significant difference between the groups' rates of mortality. The arterial conduit group had a significantly shorter overall postoperative hospital stay than did the mixed-conduit group (mean, 6.6 +/- 0.9 vs 7.2 +/- 5 days; P=0.04). Linear regression analysis revealed that the presence of hypertension (beta=0.13; 95% confidence interval [CI], 0.054-0.759; P=0.02) and high EuroSCORE (beta=0.24; 95% CI, 0.053-0.283; P=0.004) were the major predicting factors for long hospital stay. Graft-harvest-site infection was statistically more frequent in the mixed-conduit group than in the arterial conduit group (6.4% vs 0, respectively; P=0.007). Angiography was performed postoperatively (mean, 24.9 +/- 16.3 mo; range, 11-65 mo) in 21 patients. In these patients, all LIMA grafts were patent, as were 86.9% of the SVGs and 90.9% of the RA grafts. Myocardial revascularization using all arterial grafts (at least 50% RAs) in patients aged 65 years and older is safe and reliable, produces short-term results equal to those of saphenous vein grafting, and can reduce graft-harvest-site infections.
Authors:
Nevzat Erdil; Vedat Nisanoglu; Tamer Eroglu; Iyad Fansa; Hasan Berat Cihan; Bektas Battaloglu
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  37     ISSN:  1526-6702     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-09-27     Revised Date:  2010-09-30    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  301-6     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Turgut Ozal Medical Center, Inonu University, 44315 Malatya, Turkey. nerdil@inonu.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Chi-Square Distribution
Coronary Angiography
Coronary Artery Bypass / adverse effects,  methods*,  mortality
Coronary Artery Disease / mortality,  radiography,  surgery*
Female
Humans
Length of Stay
Linear Models
Male
Radial Artery / radiography,  transplantation*
Retrospective Studies
Risk Assessment
Risk Factors
Saphenous Vein / radiography,  transplantation*
Surgical Wound Infection / etiology
Time Factors
Tissue and Organ Harvesting / adverse effects
Treatment Outcome
Turkey
Vascular Patency
Comments/Corrections

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


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