| Midterm outcomes of myocardial revascularization in children. | |
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MedLine Citation:
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PMID: 20005530 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Pediatric coronary artery bypass grafting is uncommon. Small target vessels and appropriate conduit choice are the main technical challenges. METHODS: Fourteen patients undergoing coronary artery bypass grafting from January 1986 to December 2008 were retrospectively reviewed. RESULTS: Median age was 10 years (range, 3-15 years); median weight was 36 kg (range, 12-71 kg). Indications included symptoms or evidence of inducible ischemia and angiographically documented coronary stenosis. Diagnoses included Kawasaki disease (5/14), anomalous left coronary artery originating from the pulmonary artery (2/14), previous stent implant (1/14), and metabolic disease (3/14). The remaining 3 patients had coronary stenosis after other cardiac operations. Preoperatively 5 patients (45%) had no symptoms and 9 (64%) had positive stress test. Single-vessel disease was demonstrated in 2 (14%), double-vessel disease in 7 (50%), triple-vessel disease in 1 (7%), and left main coronary artery involvement in 4 (29%). With standard cardiopulmonary bypass, 18 (81%) in situ internal thoracic arteries and 4 (19%) long saphenous veins were grafted. There was 1 early reoperation for graft failure. All patients survived to hospital discharge. Follow-up angiography was performed in 5 patients (36%; median, 2 years; range, 1 day-10 years), and 1 (7%) required late balloon dilatation. Median follow-up was 3.3 years (1 month-10 years), and 12 patients had no symptoms. There was 1 late death of noncardiac cause. CONCLUSIONS: Pediatric coronary artery bypass grafting can be performed for a wide range of indications. Midterm results are excellent. Preoperative stress testing can detect silent myocardial ischemia. |
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Authors:
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Nicola Viola; Abdullah A Alghamdi; Osman O Al-Radi; John G Coles; Glen S Van Arsdell; Christopher A Caldarone |
Publication Detail:
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Type: Journal Article Date: 2009-12-14 |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 139 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-28 Completed Date: 2010-03-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 333-8 Citation Subset: AIM; IM |
Copyright Information:
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2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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The Labatt Family Heart Centre, The Hospital for Sick Children and the University of Toronto, Ontario, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Balloon Dilatation Cardiac Surgical Procedures / statistics & numerical data Child Child, Preschool Coronary Artery Bypass Coronary Vessel Anomalies / surgery Heart Defects, Congenital / mortality, surgery* Humans Kaplan-Meiers Estimate Length of Stay Male Mucocutaneous Lymph Node Syndrome / surgery* Myocardial Revascularization Retrospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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