Revascularização do miocárdio com emprego de ambas artérias mamárias internas em pacientes com diabetes mellitus

Martins, Stevan Krieger; Santos, Magaly Arrais dos; Tirado, Freddy H. Ponce; Martins, Francisco C. E.; Malat, Hassan F.; Jatene, Adib; Souza, Luiz Carlos Bento de

doi:10.1590/s0102-76382007000300004

Cited by 13 publications

(12 citation statements)

References 26 publications

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“…In a recent article, Martins et al [22] presented their results of a group of patients submitted to CABG utilizing both ITAs. Of a total of 700 patients enrolled, 552 were non-diabetic and 148 were diabetic.…”

Section: Discussionmentioning

confidence: 99%

Dupla artéria torácica esqueletizada versus convencional na revascularização do miocárdio sem CEC em diabéticos

Milani¹,

Brofman²,

Guimarães³

et al. 2008

Rev Bras Cir Cardiovasc

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Dupla artéria torácica esqueletizada versus convencional na revascularização do miocárdio sem CEC em diabéticosDouble skeletonized internal thoracic artery vs. double conventional internal thoracic artery in diabetic patients submitted to OPCAB Abstract Objective: To evaluate the influence of the technique used in the dissection of thoracic arteries in the evolution of diabetic patients submitted to OPCAB.Methods: Seventy diabetic patients submitted to OPCAB using bilateral thoracic arteries were evaluated. In Group A, thoracic arteries were dissected as a pedicle, while in Group B they were skeletonized.Results: The mean age of patients in Group A was 52.14 ± 7.35 years old versus 55.71 ± 8.1 years for Group B (p=0.057). In Group A, six patients (17.1%) were insulin dependent against nine (25.7%) in Group B (p = 0.561). The EUROSCORE was 3.97 ± 2.49 for Group A opposed to 4.14 ± 3.06 for Group B (p = 0.879). The number of distal anastomoses in Group A was 3 ± 0.77 versus 3.03 ± 0.89 in Group B (p = 0.981). Three patients (8.57%) from Group A presented with mediastinitis. Insulin dependence was the only significant risk factor (p=0.008) for mediastinitis. In this group the use of skeletonized ITAs significantly decreased the incidence of mediastinitis (p = 0.044).Conclusion: The incidence of mediastinitis was lower in the group for which thoracic arteries were dissected using skeletonization. Among insulin-dependent diabetics, 50% of the patients from the group in which the pedicled internal thoracic artery was utilized presented with mediastinitis; the utilization of skeletonized ITAs significantly decreases the incidence of mediastinitis. Rev Bras Cir Cardiovasc 2008; 23(3): 351-357 Descriptors

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Section: Discussionmentioning

confidence: 99%

Dupla artéria torácica esqueletizada versus convencional na revascularização do miocárdio sem CEC em diabéticos

Milani¹,

Brofman²,

Guimarães³

et al. 2008

Rev Bras Cir Cardiovasc

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“…Another study identified PU with 62% in stage I, 29% in stage II and 4% in stage III (8) . Another study found that 45% of PU were in stage I (18) .…”

Section: Rev Esc Enfermmentioning

confidence: 98%

“…Many patients were hospitalized the day before the surgery because they already had preoperative exams while others required several days for taking exams and preoperative preparation. In a study addressing skin care provided to patients who underwent cardiac surgery, the author indicates a high duration of hospitalization as an important factor in the development of skin lesions (8) .…”

Section: Rev Esc Enfermmentioning

confidence: 99%

Lesões de pele no intra-operatório de cirurgia cardíaca: incidência e caracterização

Carneiro

Leite

2011

Rev. esc. enferm. USP

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Neste estudo exploratório, descritivo e de coorte o objetivo principal foi verificar a incidência de pacientes submetidos à cirurgia cardíaca que desenvolveram lesões de pele no período intra-operatório, caracterizar as lesões. A coleta de dados foi realizada no Centro Cirúrgico (CC) de um hospital público de ensino, de atenção terciária à saúde, predominantemente cirúrgico, especializado em cardiologia no Município de São Paulo. A amostra do estudo foi de 182 pacientes. O estudo foi feito com um p significativo (<0,05) frente aos testes estatísticos não-paramétricos. Quanto à incidência de pacientes submetidos à cirurgia cardíaca, que desenvolveram lesões de pele em decorrência do período intra-operatório, obteve-se incidência de 20,9%. Tivemos que 19,2% das lesões apresentaram-se como Úlceras por Pressão (UP) no estágio I; 1,1% das lesões caracterizaram-se como abrasão; 1,1% feridas incisas; 0,5% laceração; 0,5% queimadura elétrica superficial e 0,5% UP no estágio II.

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“…Therefore, alternative arterial grafts have been continuously researched. The most commonly used arterial grafts are the left and right internal thoracic [1,2,[5][6][7][8] and radial arteries [9,10]. The inferior epigastric and gastroepiploic arteries are less frequently used [1,5,7,10].…”

Section: Introductionmentioning

confidence: 99%

The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts

Gaiotto

Vianna

Busnardo

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(3):317-24 Gaiotto FA, et al. -The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts RBCCV 44205-1476 DOI: 10.5935/1678 The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts Ramo descendente da artéria circunflexa lateral femoral é boa opção para revascularização do miocárdio com enxertos arteriais ORIGINAL ARTICLE Abstract Introduction:The descending branch of the lateral femoral circumflex artery is an option for coronary artery bypass grafting.Objective: To evaluate the early patency and adaptation of lumen diameter using multidetector computed angiotomography.Methods: Thirty-two patients were selected to undergo coronary artery bypass grafting using the descending branch of the lateral circumflex artery, the internal thoracic artery, and other grafts. Evaluations were carried out through high resolution computed tomography performed on the 7 th and 90 th postoperative day. Diameters of the descending branch of the lateral circumflex artery and the left internal thoracic artery were measured 3 cm before the distal anastomosis, in the middle portion, and 3 cm after the proximal anastomosis. Diameters were compared using paired t-test (P<0.05).Results: Descending branch of the lateral femoral circumflex artery wDescending branch of the lateral femoral circumflex artery was used in 26 patients, as its use was not viable in six patients (18%). It was used as composite graft in all cases. The anterior descending branch was revascularized by the left internal thoracic artery in all cases. Patency rates of the descending branch of the lateral femoral circumflex artery were 96% and 92%, respectively. No occlusions were observed in the left internal thoracic artery (LITA) and no ischemic events were observed in the descending branch of the lateral circumflex. Descending branch of the lateral femoral circumflex artery increased the lumen diameter in the middle (P=0.001) and distal portions (P=0.006); the left internal thoracic artery (LITA) increased in the middle portion (P=0.001).Conclusion: Similar to the left internal thoracic artery, the descending branch of the lateral femoral circumflex artery showed high patency rate and positive luminal adaptation. This early evaluation confirms the descending branch of the lateral femoral circumflex artery as a potential alternative for grafting. Due to anatomical variations, preoperative femoral angiographic evaluation appears to be mandatory. Descriptors:Tomography. Myocardial revascularization. Coronary disease. 318Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(3):317-24 Gaiotto FA, et al. -The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts RevThe first case in which the DLFCA was used as a graft in CABG was performed in Japan and was reported by Tatsumi et al. [13], in 1996, when the DLFCA was us...

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Revascularização do miocárdio com emprego de ambas artérias mamárias internas em pacientes com diabetes mellitus

Cited by 13 publications

References 26 publications

Dupla artéria torácica esqueletizada versus convencional na revascularização do miocárdio sem CEC em diabéticos

Dupla artéria torácica esqueletizada versus convencional na revascularização do miocárdio sem CEC em diabéticos

Lesões de pele no intra-operatório de cirurgia cardíaca: incidência e caracterização

The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts

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