A successful surgical case of concomitant aorto-coronary bypass grafting and aorto-right iliac, left femoral bypass grafting was presented. A sixty-two years old male admitted to our institution with complaints of angina pectoris and intermittent claudication of both legs who had a history of acute inferior myocardial infarction for which emergency percutaneous coronary balloon dilatation was carried out prior to this admission. In this admission, he was found out to have diabetes mellitus moreover and he hoped to have one staged operation for two different type of the disease. After general anesthesia, at first, aorto-right coronary bypass grafting with saphenous vein graft was carried out under cardio-pulmonary bypass, then aorto-right iliac, left femoral bypass grafting with a dacron bifurcated graft was made only with one time of systemic heparinization. His postoperative course was uneventful and discharged in good condition. We conclude that simultaneous aorto-coronary bypass and revascularization of both legs can be done with minimal risk.
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J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA.
Vasoplegia is a pathophysiologic state of hypotension in the setting of normal or high cardiac output and low systemic vascular resistance despite euvolemia and high-dose vasoconstrictors. Vasoplegia in heart, lung, or liver transplantation is of particular interest because it is common (approximately 29%, 28%, and 11%, respectively), is associated with adverse outcomes, and because the agents used to treat vasoplegia can affect immunosuppressive and other drug metabolism. This narrative review discusses the pathophysiology, risk factors, and treatment of vasoplegia in patients undergoing heart, lung, and liver transplantation.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Surgery, Alberta Health Services, Calgary, Alberta, Canada.
Introduction: To improve surgical quality and safety, health systems must prioritise equitable care for surgical patients. Racialised patients experience worse postoperative outcomes when compared with non-racialised surgical patients in settler colonial nation-states. Identifying preventable adverse outcomes for equity-deserving patient populations is an important starting point to begin to address these gaps in care.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
1(st) Department of Pathology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic.
Objectives: Studies comparing alternative autologous vein grafts (AAVG) to single-segment great saphenous vein (ssGSV) grafts report mixed results. The status of AAVG as first choice when ssGSV is unavailable is not unequivocal, based on current evidence. Our study compares results between AAVG and ssGSV in lower extremity bypass surgery.
View Article and Find Full Text PDFOper Neurosurg (Hagerstown)
January 2025
Department of Neurosurgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
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