This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular ris...This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.展开更多
A novel technique of stabilization of the coronary targets with autogenous pericardial bands is described in off pump coronary revascularizations. Pericardial bands are placed across the coronary targets and snared to...A novel technique of stabilization of the coronary targets with autogenous pericardial bands is described in off pump coronary revascularizations. Pericardial bands are placed across the coronary targets and snared to the pericardial well for local cardiac immobilization. This technique can be used as an alternate to mechanical stabilizers for immobilization of the coronary targets.展开更多
Breast is an external organ with abundant blood supply which renders it vulnerable to many inflammatory or neoplastic conditions, yet it remains immune to ischemia. Various chest wall surgical procedures may directly ...Breast is an external organ with abundant blood supply which renders it vulnerable to many inflammatory or neoplastic conditions, yet it remains immune to ischemia. Various chest wall surgical procedures may directly or indirectly affect the breast or its overlying skin. Cardiac surgery with its designed incisions is closely related to the breast terrain. Breast necrosis is very rare and only few cases were reported in the literature. We report two cases of breast necrosis in diabetic patients following cardiac bypass surgery. This emerging quandary is an alert to cardiothoracic surgeons to generate special preparation for a subset of patients prior to cardiac surgical procedures in order to minimize the occurrence of ischemia.展开更多
文摘This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.
文摘A novel technique of stabilization of the coronary targets with autogenous pericardial bands is described in off pump coronary revascularizations. Pericardial bands are placed across the coronary targets and snared to the pericardial well for local cardiac immobilization. This technique can be used as an alternate to mechanical stabilizers for immobilization of the coronary targets.
文摘Breast is an external organ with abundant blood supply which renders it vulnerable to many inflammatory or neoplastic conditions, yet it remains immune to ischemia. Various chest wall surgical procedures may directly or indirectly affect the breast or its overlying skin. Cardiac surgery with its designed incisions is closely related to the breast terrain. Breast necrosis is very rare and only few cases were reported in the literature. We report two cases of breast necrosis in diabetic patients following cardiac bypass surgery. This emerging quandary is an alert to cardiothoracic surgeons to generate special preparation for a subset of patients prior to cardiac surgical procedures in order to minimize the occurrence of ischemia.
