Medium-term survival of diffuse coronary artery disease patients following coronary artery reconstruction with the internal thoracic artery.

Objective: Diffuse coronary artery disease makes cardiac surgeons hesitant regarding whether coronary artery bypass grafting (CABG) surgery is feasible or not. Coronary artery reconstruction using the internal thoracic artery (ITA) allows bypassing of coronary arteries with diffuse atheromatous plaques without systematically resorting to endarterectomy. The aim of the present study was to evaluate the medium-term results of coronary artery reconstruction.

Use of arterial patch to improve re-endothelialization in a sheep model of open carotid endarterectomy. An incentive to use internal thoracic artery as an on-lay patch following coronary endarterecomy?

To better understand the effect of the internal thoracic artery on endothelial growth after open coronary endarterectomy, we designed an experimental test of the hypothesis that closing an endarterectomized artery by an arterial patch improves re-endothelialization. The two carotid arteries were endarterectomized in nine sheep and were randomly chosen for closure by native arterial femoral (ART) patch or polytetrafluoroethylene (PTFE) patch. Three animals were randomly chosen for sacrifice at 8, 15 and 21 days each.

Continuous retrograde blood cardioplegia ensures prolonged aortic cross-clamping time without increasing the operative risk.

The aim of this study was to assess whether the continuous retrograde blood cardioplegia ensures prolonged aortic cross-clamping time without increasing the operative risk. From 1996 to 2003, 204 consecutive patients who had cardiac procedure requiring aortic cross-clamping time > or = 150 min, were prospectively included in this study: low risk group (EuroSCORE < or = 2) 50 patients, medium risk group (EuroSCORE 3-5) 68 patients, high risk group (EuroSCORE > or = 6) 86 patients. The myocardial protection associated induction of cardiac arrest by antegrade injection of hyperkalemic warm blood, continuous retrograde intermediate lukewarm (20 degrees C) blood cardioplegia, retrograde warm blood reperfusion and systemic normothermia.

Same-day combined percutaneous coronary intervention and coronary artery surgery.

Background: Either percutaneous coronary intervention (PCI) or coronary artery bypass grafting can be chosen for the treatment of multiple-vessel coronary artery disease. We report the results of a hybrid procedure performed on the same day, combining PCI of the right coronary artery and internal mammary artery bypass grafting of the left coronary artery, for the treatment of diffuse extensive lesions.

Methods And Results: Since January 2000, 70 patients (53 male, mean age 68.

Homemade expanded-polytetrafluoroethylene flexible mitral annuloplasty ring.

A homemade mitral annular prosthesis has been developed using expanded-polytetrafluoroethylene material. It is safe in that it avoids the risk of prosthesis wrinkle when stitches are tied. Simultaneously, it is strong enough to prevent future stretching and rupture.

Wrapping of the left internal thoracic artery with an expanded polytetrafluoroethylene membrane.

We describe the wrapping of the proximal segment of the left internal thoracic artery graft in a polytetrafluoroethylene membrane. Two groups of patients were compared (99 patients with wrapping, 70 patients as controls). There were no statistical differences between the two groups regarding the postoperative course.

Failure of internal thoracic artery grafts: conclusions from coronary angiography mid-term follow-up.

Background: The objective of this study was to identify causes of the failures of internal thoracic artery bypass grafts according to operative technique, the internal thoracic artery used, and the coronary artery grafted.

Methods: This retrospective study concerns 302 follow-up angiographies performed in patients treated with 512 internal thoracic artery bypass grafts: 115 single grafts, 78 sequential grafts, and 109 grafts with two internal thoracic arteries (61 Y grafts). Postoperative angiography was performed after a mean period of 17.