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Rodgers-Fischl PM, Makdisi G. Internal Thoracic Artery and Vascular Adaptations. Ann Thorac Surg 2021; 113:695. [PMID: 34102180 DOI: 10.1016/j.athoracsur.2021.05.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Peter M Rodgers-Fischl
- Division of Cardiothoracic Surgery, University of Kentucky Medical Center, 800 Rose Street MN 150 Lexington, KY 40536-0298.
| | - George Makdisi
- Division of Cardiothoracic Surgery, University of South Florida, Tampa, FL, USA
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Manenti A, Roncati L, Manco G. The internal thoracic artery remodeling. Ann Thorac Surg 2021; 113:694-695. [PMID: 33716010 DOI: 10.1016/j.athoracsur.2021.02.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/26/2021] [Indexed: 11/01/2022]
Affiliation(s)
- Antonio Manenti
- Department of Surgery, University of Modena, Polyclinic -Hospital, v.Pozzo, 41124, Modena, Italy.
| | - Luca Roncati
- Department of Pathology, University of Modena, Italy
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Fayad ESA, Amr MA. Short-term outcomes of reconstruction of extensively diseased left anterior descending artery with or without endarterectomy: a propensity score analysis. THE CARDIOTHORACIC SURGEON 2021. [DOI: 10.1186/s43057-021-00044-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Surgical management of extensively diseased left anterior descending artery (LAD) is challenging. Reconstruction of the LAD with endarterectomy may lead to intimal disruption and affect the outcomes of surgery. We aimed to compare hospital outcomes of surgical reconstruction of extensively diseased LAD with and without endarterectomy.
Results
This retrospective multicenter study included 275 patients who had reconstruction of extensively diseased LAD from 2015 to 2019. We divided patients into two groups: group 1 (n = 138) included patients who had plaque exclusion and patching, and group 2 (n = 137) included patients who had endarterectomy and patching. All patients had primary isolated on-pump coronary artery bypass grafting with the left internal mammary artery (LIMA) grafting to LAD. On-lay LIMA patch was used in 118 patients in group 1 and 132 patients in group 2. A saphenous vein patch was used in 20 patients in group 1 and 5 patients in group 2. Propensity score matching identified 100 matched pairs. The age in group 1 was 56.1 ± 7.8 years versus 55.2 ± 7.1 in group 2 (P = 0.34). There were 119 (86.2%) males in group 1 and 113 (82.5%) in group 2 (P = 0.39). After matching, there was no difference in preoperative and operative data. In the matched groups, low cardiac output occurred in 6 (6%) patients in group 1 and 4 (4%) patients in group 2 (P = 0.73). There was no difference in mechanical ventilation time between groups (9 (25th- 75th percentiles: 7.5–14) hours in group 1 vs. 9 (7–14) hours in groups 2; P = 0.93). Length of hospital stay was 7 (6–9) days in group 1 and 7 (6–10) days in group 2 (P = 0.57). Mortality occurred in one patient in group 1. We did not report early graft occlusion cases in group 1, and one patient had a myocardial infarction in group 2.
Conclusion
The outcomes after reconstructing extensively diseased LAD with endarterectomy or plaque exclusion and patching are satisfactory and comparable in both approaches.
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