revascularização do miocárdio com enxerto livre de artéria radial: experiência inicial
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ID: 131620
1997
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Abstract
Foram estudados os resultados precoces do uso do enxerto livre de artéria radial (AR) para a revascularização do miocárdio em 20 pacientes operados no período de maio a novembro de 1996. Pertenciam ao sexo masculino 16 (80%) com média de idades de 57,1 anos (35 a 69). Foi utilizada a esternotomia mediana com o auxílio da circulação extracorpórea e a cardioplegia sangüínea intermitente em todos os casos. A AR foi retirada do membro superior não dominante e utilizada como parte aorto-coronária em 100% dos casos. Foi realizado um total de 64 enxertos, com média de 3,2 por pacientes (2 a 5). A AR foi anastomosada ao ramo diagonal 9 (45%) vezes, ao ramo marginal esquerdo da artéria circunflexa 6 (30%), à coronária direita 4 (20%) e ao ramo interventricular anterior 1 (5%). A artéria torácica interna esquerda (ATIE) foi utilizada em 100% dos pacientes, a artéria torácica interna direita (ATID) em 7 (35%), e a veia safena em 13 (65%). O diltiazen oral foi utilizado no período per-operatório para a prevenção do espasmo arterial. Não houve mortalidade hospitalar ou durante o seguimento de até 10 meses. Foi realizado estudo cineangiocoronáriográfico no período pós-operatório imediato em 17 (85%) pacientes, que mostrou fluxo normal na AR em 16 (94,1%). Não houve seqüelas no membro superior do doador. Os resultados observados são semelhantes aos obtidos com a revascularização do miocárdio pelas técnicas usuais no Serviço, sem incremento na morbimortalidade precoce. A normalidade precoce do enxerto de artéria radial mostrou-se comparável ao da artéria torácica interna esquerda, coincidindo com os recentes relatos da técnica.
Twenty patients underwent myocardial revascularization with a radial artery (RA) between May and November 1996. The mean age was 57.1 years (35 to 69) and 16 patients (80%) were male. Midsternotomy, extracorporeal circulation and antegrade blood cardioplegia were always used. A total of 64 grafts, 3.2 per patient (2 to 5), were performed: in 9 patients (45%) to the diagonal branch, in 6 (30%) to the obtuse marginal branch, in 4 (20%) to the right coronary artery and 1(5%) to the left anterior descending artery. The left internal mammary artery (LIMA) was also used in every patient, the right IMA in 7 (35%) and additional saphenous vein grafts in another 13 (65%). Calcium channel blockers were used orally to prevent RA spasm. There were no hospital deaths nor during follow up of 10 months. Seventeen immediate coronary angiographies have been performed. RA grafts were patent in 16 (94.1%). There was no ischemic sequelae of the superior limb secondary to graft harvesting. Our results are similar to many other recent published series, and no morbidity or mortality increase has been noticed with RA used for Coronary artery bypass grafting.
Twenty patients underwent myocardial revascularization with a radial artery (RA) between May and November 1996. The mean age was 57.1 years (35 to 69) and 16 patients (80%) were male. Midsternotomy, extracorporeal circulation and antegrade blood cardioplegia were always used. A total of 64 grafts, 3.2 per patient (2 to 5), were performed: in 9 patients (45%) to the diagonal branch, in 6 (30%) to the obtuse marginal branch, in 4 (20%) to the right coronary artery and 1(5%) to the left anterior descending artery. The left internal mammary artery (LIMA) was also used in every patient, the right IMA in 7 (35%) and additional saphenous vein grafts in another 13 (65%). Calcium channel blockers were used orally to prevent RA spasm. There were no hospital deaths nor during follow up of 10 months. Seventeen immediate coronary angiographies have been performed. RA grafts were patent in 16 (94.1%). There was no ischemic sequelae of the superior limb secondary to graft harvesting. Our results are similar to many other recent published series, and no morbidity or mortality increase has been noticed with RA used for Coronary artery bypass grafting.
| Reference Key |
pieracciani1997brazilianrevascularizao
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| Authors | ;Giorgio PIERACCIANI;Ricardo Barros CORSO;José Alberto Martins da MATA;José Carlos Raimundo BRITO;Antônio Gilson Lapa GODINHO;José Péricles ESTEVES |
| Journal | 2017 international conference on information technology systems and innovation, icitsi 2017 - proceedings |
| Year | 1997 |
| DOI |
10.1590/S0102-76381997000300005
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| URL | |
| Keywords | Keywords not found |
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