A best evidence topic was written according to a structured protocol. The question addressed was whether the right internal thoracic artery (RITA) provides a superior outcome for revascularization of the right coronary artery (RCA) compared with the saphenous vein graft (SVG). Using a designated search strategy, 226 articles were found, of which five represented the best available evidence. The authors, journal, date, country of publication, study type, patient group studied, relevant outcomes and results were tabulated. Of these five studies, one offered level I evidence (data from a randomized trial) and four were level II studies (reports of observational data). The outcome measures varied considerably, but most included graft patency at varying levels of the follow-up. The randomized data showed strong evidence favouring the SVG, mainly in terms of mid-term patency. With the exception of a large cohort study that demonstrated the superior patency of the RITA compared with the SVG in the right coronary territory, the observational studies showed better results for SVG in graft patency, reintervention and cardiovascular complication rate. Overall, and in view of the methodological limitations and the different weight of evidence among studies, it appears that the SVG may offer a superior outcome for revascularization of the RCA when compared with the RITA.
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http://dx.doi.org/10.1093/icvts/ivs180 | DOI Listing |
J Multidiscip Healthc
January 2025
School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Objective: Common examinations for diagnosing obstructive sleep apnea (OSA) are polysomnography (PSG) and home sleep apnea testing (HSAT). However, both PSG and HSAT require that sensors be attached to a subject, which may disturb their sleep and affect the results. Hence, in this study, we aimed to verify a wireless radar framework combined with deep learning techniques to screen for the risk of OSA in home-based environments.
View Article and Find Full Text PDFCureus
December 2024
Intensive Care Unit, General Chest Diseases Hospital Sotiria, Athens, GRC.
Descending necrotizing mediastinitis (DNM) is a rare and potentially life-threatening condition characterized by the rapid spread of infection within the mediastinum. This severe form of mediastinitis poses a significant challenge to clinicians due to its aggressive nature and potential for rapid deterioration. In this case report, we present a challenging case of descending necrotizing mediastinitis in a 39-year-old patient with persistent pyrexia and an extended hospital stay in the intensive care unit (ICU), cardiothoracic unit (CTU), and surgical intensive care unit (SICU).
View Article and Find Full Text PDFAnat Sci Int
January 2025
Department of Anatomy, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan.
This case report presents an atypical transverse cervical artery with its detailed anatomy, morphogenesis, and association with the high arch-shaped subclavian artery. The atypical arteries, related arteries, and adjacent cervical and brachial plexuses were macroscopically examined in a 98-year-old Japanese female cadaver donated to The Nippon Dental University for medical education and research. The atypical deep branch of the transverse cervical artery originated from the internal thoracic artery and passed through between the C5 and C6 roots, in close contact with the C5 and C6 junction, to reach the dorsal side of the brachial plexus.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pennsylvania, USA.
A man in his 60s with advanced COPD and lung adenocarcinoma presented with sepsis and acute hypoxaemic respiratory failure. Imaging revealed bilateral pleural effusions, and he was found to have a polymicrobial empyema which included Despite appropriate treatment, he continued to deteriorate and ultimately died of sepsis. species, typically benign constituents of the oral microbiota, rarely can instigate pleuropulmonary infections, especially in immunocompromised individuals.
View Article and Find Full Text PDFThorac Cardiovasc Surg
January 2025
Cardiac Surgery, Leipzig Heart Centre University Hospital, Leipzig, Germany.
Background: The survival advantages of bilateral internal thoracic artery (BITA) grafts in coronary artery bypass surgery (CABG) remain unclear. Therefore, this study aims to systematically evaluate the time-dependent influence of BITA on long-term survival in elective CABG patients presenting with stable multi-vessel coronary artery disease.
Methods: Data from 3,693 patients undergoing isolated CABG with single internal thoracic artery (SITA) or BITA, with or without additional vein grafts, between 2002 and 2012 were retrospectively analyzed.
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