Base de dados : MEDLINE
Pesquisa : E04.100.376.719.332.400 [Categoria DeCS]
Referências encontradas : 2204 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 221 ir para página                         

  1 / 2204 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28450552
[Au] Autor:Gray AM; Murphy J; Altman DG; Benedetto U; Campbell H; Flather M; Gerry S; Lees B; Taggart DP
[Ad] Endereço:Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Headington, UK.
[Ti] Título:One-year costs of bilateral or single internal mammary grafts in the Arterial Revascularisation Trial.
[So] Source:Heart;103(21):1719-1726, 2017 11.
[Is] ISSN:1468-201X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Coronary artery bypass grafting (CABG) using bilateral internal mammary arteries (BIMA) may improve survival over CABG using single internal mammary arteries (SIMA), but may be surgically more complex (and therefore costly) and associated with impaired sternal wound healing. We report, for the first time, a detailed comparison of healthcare resource use and costs over 12 months, as part of the Arterial Revascularisation (ART) Trial. METHODS: 3102 patients in 28 hospitals in seven countries were randomised to CABG surgery using BIMA (n=1548) or SIMA (n=1554). Detailed resource use data were collected covering surgery, the initial hospital episode, and for 12 months post randomisation. Using UK unit costs, total costs were calculated and compared between trial arms and for subgroups. RESULTS: Patients randomised to BIMA spent 20 min longer in theatre (95% CI 15 to 25, p<0.001) and also required more treatment for sternal wound problems. Mean (SD) total costs per patient at 12 months were £13 839 (£10 534) for BIMA and £12 717 (£9719) for SIMA (mean cost difference £1122, 95% CI £407 to £1838, p=0.002). No tests for interaction between subgroups and treatment allocation were significant. CONCLUSIONS: At 12 months from randomisation, mean costs were approximately 9% higher in BIMA than SIMA patients, primarily due to longer time in theatre and in-hospital stay, and slightly higher costs related to sternal wound problems during follow-up. Follow-up to the primary trial endpoint of 10 years will reveal whether longer-term differences emerge in graft patency or in overall survival. TRIAL REGISTRATION NUMBER: Controlled-trials.com (ISRCTN46552265).
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/economia
Doença da Artéria Coronariana/cirurgia
Custos de Cuidados de Saúde
Anastomose de Artéria Torácica Interna-Coronária/economia
[Mh] Termos MeSH secundário: Idoso
Austrália
Brasil
Doença da Artéria Coronariana/diagnóstico por imagem
Doença da Artéria Coronariana/fisiopatologia
Análise Custo-Benefício
Europa (Continente)
Feminino
Seres Humanos
Índia
Anastomose de Artéria Torácica Interna-Coronária/efeitos adversos
Anastomose de Artéria Torácica Interna-Coronária/métodos
Tempo de Internação/economia
Masculino
Meia-Idade
Modelos Econômicos
Complicações Pós-Operatórias/economia
Complicações Pós-Operatórias/terapia
Fatores de Tempo
Resultado do Tratamento
Grau de Desobstrução Vascular
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1136/heartjnl-2016-311058


  2 / 2204 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28646103
[Au] Autor:Buttar SN; Yan TD; Taggart DP; Tian DH
[Ad] Endereço:The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia.
[Ti] Título:Long-term and short-term outcomes of using bilateral internal mammary artery grafting versus left internal mammary artery grafting: a meta-analysis.
[So] Source:Heart;103(18):1419-1426, 2017 Sep.
[Is] ISSN:1468-201X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A substantial body of evidence demonstrates that myocardial revascularisation using bilateral internal mammary arteries (BIMA) improves long-term survival compared with single/left internal mammary artery (LIMA) grafting. To date, limited analyses have been made regarding other short-term and long-term outcomes in BIMA strategy. OBJECTIVES: The primary aim of the present review is to update the difference in long-term survival between BIMA and LIMA grafting and to thoroughly investigate other secondary short-term and long-term clinical outcomes between these two grafting procedures. METHODS: Electronic searches were performed using three databases from their inception to November 2015. Relevant studies comparing long-term survival between BIMA and LIMA grafting were identified. Data were extracted by two independent reviewers and analysed according to predefined clinical outcomes. RESULTS: Twenty-nine observational studies were identified, with a total of 89 399 patients. Overall, BIMA cohort had significantly improved long-term survival compared with LIMA cohort (HR 0.78; p<0.00001). BIMA cohort also had significantly reduced hospital mortality rates (1.2% vs 2.1%, p=0.04), cerebrovascular accidents (1.3% vs 2.9%, p=0.0003) and need for revascularisation (4.8% vs 10%, p=0.005), although the incidence of deep sternal wound infection (DSWI) was increased (1.8% vs 1.4%, p=0.0008) in this grafting strategy. Long-term cardiac-free, myocardial infarction-free and angina-free survivals were also superior for the BIMA cohort. CONCLUSIONS: BIMA grafting is associated with enhanced overall long-term outcomes compared with LIMA grafting. While the BIMA cohort demonstrates an increased incidence of DSWI, the survival benefits and other morbidity advantages outweigh this short-term risk.
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/cirurgia
Anastomose de Artéria Torácica Interna-Coronária/métodos
Artéria Torácica Interna/transplante
[Mh] Termos MeSH secundário: Doença da Artéria Coronariana/mortalidade
Seguimentos
Saúde Global
Seres Humanos
Pontuação de Propensão
Taxa de Sobrevida/tendências
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170625
[St] Status:MEDLINE
[do] DOI:10.1136/heartjnl-2016-310864


  3 / 2204 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28566338
[Au] Autor:Taggart DP; Altman DG; Flather M; Gerry S; Gray A; Lees B; Benedetto U; ART (Arterial Revascularization Trial) Investigators
[Ad] Endereço:From Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, United Kingdom (D.P.T., B.L.); Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (D.G.A., S.G.), and Department of Public Health, Health Economics Resea
[Ti] Título:Associations Between Adding a Radial Artery Graft to Single and Bilateral Internal Thoracic Artery Grafts and Outcomes: Insights From the Arterial Revascularization Trial.
[So] Source:Circulation;136(5):454-463, 2017 Aug 01.
[Is] ISSN:1524-4539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Whether the use of the radial artery (RA) can improve clinical outcomes in coronary artery bypass graft surgery remains unclear. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral internal thoracic artery (BITA) over single left internal thoracic artery (SITA). In the ART, a large proportion of patients (≈20%) also received an RA graft instead of a saphenous vein graft (SVG). We aimed to investigate the associations between using the RA instead of an SVG to supplement SITA or BITA grafts and outcomes by performing a post hoc analysis of the ART. METHODS: Patients enrolled in the ART (n=3102) were classified on the basis of conduits actually received (as treated). The analysis included 2737 patients who received an RA graft (RA group; n=632) or SVG only (SVG group; n=2105) in addition to SITA or BITA grafts. The primary end point was the composite of myocardial infarction, cardiovascular death, and repeat revascularization at 5 years. Propensity score matching and stratified Cox regression were used to compare the 2 strategies. RESULTS: Myocardial infarction, cardiovascular death, and repeat revascularization cumulative incidence was 2.3% (95% confidence interval [CI], 1.1-3.4), 3.5% (95% CI, 2.1-5.0), and 4.4% (95% CI, 2.8-6.0) in the RA group and 3.4% (95% CI, 2.0-4.8), 4.0% (95% CI, 2.5-5.6), and 7.6% (95% CI, 5.5-9.7) in the SVG group, respectively. The composite end point was significantly lower in the RA group (8.8%; 95% CI, 6.5-11.0) compared with the SVG group (13.6%; 95% CI, 10.8-16.3; =0.005). This association was present when an RA graft was used to supplement both SITA and BITA grafts (interaction =0.62). CONCLUSIONS: This post hoc ART analysis showed that an additional RA was associated with lower risk for midterm major adverse cardiac events when used to supplement SITA or BITA grafts. CLINICAL TRIAL REGISTRATION: URL: https://www.situ.ox.ac.uk/surgical-trials/art. Unique identifier: ISRCTN46552265.
[Mh] Termos MeSH primário: Doenças Vasculares Periféricas/terapia
Artéria Radial/transplante
Artérias Torácicas/transplante
[Mh] Termos MeSH secundário: Idoso
Bloqueadores dos Canais de Cálcio/uso terapêutico
Ponte de Artéria Coronária/efeitos adversos
Ponte de Artéria Coronária/métodos
Doença da Artéria Coronariana/diagnóstico
Doença da Artéria Coronariana/epidemiologia
Doença da Artéria Coronariana/etiologia
Doença da Artéria Coronariana/mortalidade
Feminino
Seres Humanos
Anastomose de Artéria Torácica Interna-Coronária/métodos
Anastomose de Artéria Torácica Interna-Coronária/mortalidade
Masculino
Meia-Idade
Infarto do Miocárdio/diagnóstico
Infarto do Miocárdio/epidemiologia
Infarto do Miocárdio/etiologia
Infarto do Miocárdio/mortalidade
Pontuação de Propensão
Modelos de Riscos Proporcionais
Recidiva
Reoperação
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Calcium Channel Blockers)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.1161/CIRCULATIONAHA.117.027659


  4 / 2204 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28549578
[Au] Autor:Weigeldt M; Lahmann S; Krieger K; Buttenberg S; Stephan V; Stiller B; Stengel D
[Ad] Endereço:Center for Clinical Research and Department of Anesthesiology, Critical Care and Pain Medicine, Unfallkrankenhaus Berlin, Warener Str. 7, 12683 Berlin, Germany. Electronic address: moritz.weigeldt@ukb.de.
[Ti] Título:Pediatric out-of-hospital cardiac arrest caused by left coronary-artery agenesis with primary shockable rhythm.
[So] Source:Am J Emerg Med;35(11):1718-1723, 2017 Nov.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To illustrate a rare cause of out-of-hospital cardiac arrest in children, its differential diagnoses, emergency and subsequent treatment at various steps in the rescue chain, and potential outcomes. CASE PRESENTATION: A 4-year-old boy with unknown agenesis of the left coronary ostium sustained out-of-hospital cardiac arrest. Bystander cardio-pulmonary resuscitation was initiated and defibrillation was performed via an automated external defibrillator (AED) shortly after paramedics arrived at the scene, restoring sinus rhythm and spontaneous circulation. After admission to the intensive care unit the child was intubated for airway and seizure control. Further diagnostic work-up by angiography revealed agenesis of the left coronary artery. After initial seizures, the boy's neurological recovery was complete. He subsequently underwent successful internal mammary artery in-situ bypass surgery to the trunk of the left coronary artery. One year after cardiac arrest, the patient had completely recovered with no physical or intellectual sequelae. A catheter examination proved excellent growth of the bypass and good cardiac function. CONCLUSIONS: This case illustrates the long term outcome after agenesis of the LCA while reiterating that prompt access to pediatric defibrillation may be lifesaving-albeit in a minority of pediatric OHCA.
[Mh] Termos MeSH primário: Anomalias dos Vasos Coronários/complicações
Parada Cardíaca Extra-Hospitalar/etiologia
[Mh] Termos MeSH secundário: Reanimação Cardiopulmonar/métodos
Pré-Escolar
Angiografia Coronária
Anomalias dos Vasos Coronários/diagnóstico por imagem
Anomalias dos Vasos Coronários/cirurgia
Desfibriladores
Cardioversão Elétrica/métodos
Seres Humanos
Anastomose de Artéria Torácica Interna-Coronária/métodos
Masculino
Parada Cardíaca Extra-Hospitalar/terapia
Recuperação de Função Fisiológica
Convulsões/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170528
[St] Status:MEDLINE


  5 / 2204 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28329325
[Au] Autor:Pevni D; Ben-Gal Y; Mohr R; Teich N; Raviv Z; Kramer A; Paz Y; Medalion B; Nesher N
[Ad] Endereço:Department of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
[Ti] Título:Comparison of radial and bilateral internal thoracic artery grafting in patients with peripheral vascular disease†.
[So] Source:Interact Cardiovasc Thorac Surg;24(6):911-917, 2017 Jun 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The composite T-graft with radial artery (RA) attached end-to-side to the left internal thoracic artery (ITA) provides arterial myocardial revascularization without the increased risk of deep sternal wound infection associated with harvesting 2 ITAs. However, many surgeons are reluctant to use RA in patients with peripheral vascular disease (PVD) due to concerns regarding the quality of the conduit in this subset of patients. The purpose of this study is to compare early- and long-term outcomes of arterial grafting with bilateral ITAs (BITA) to that of single ITA and RA in patients with PVD. METHODS: Between 1999 and 2010, 619 consecutive patients with PVD (500 BITAs and 119 single ITA and RA) underwent myocardial revascularization in our institution. RESULTS: Occurrence of following risk factors as female sex, age 70+, diabetes, unstable angina, emergency operation, cerebrovascular disease and chronic obstructive pulmonary disease was higher in the RA-ITA group. The RA-ITA group also had a higher logistic EuroSCORE (22.1 vs 13.3). Operative mortality and occurrence of deep sternal wound infection of the two groups was similar (4.2% vs 5.0% and 2.5% vs 4.0% for the radial and bilateral ITA, respectively). Median follow-up was 9.75 years. Unadjusted Kaplan-Meier 10-year survival of the two groups was similar (44.1% vs 49.6%, P = 0.7). After propensity score matching (100 pairs), assignment to BITA was not associated with better adjusted survival (hazard ratio 0.593, 95% confidence interval 0.265-1.327, P = 0.20, Cox model). CONCLUSIONS: In patients with PVD, complete arterial revascularization with left ITA and RA can be justified with regards to survival.
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/cirurgia
Anastomose de Artéria Torácica Interna-Coronária/métodos
Artéria Torácica Interna/transplante
Doenças Vasculares Periféricas/cirurgia
Pontuação de Propensão
Artéria Radial/transplante
[Mh] Termos MeSH secundário: Idoso
Doença da Artéria Coronariana/complicações
Feminino
Seres Humanos
Masculino
Doenças Vasculares Periféricas/complicações
Modelos de Riscos Proporcionais
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw449


  6 / 2204 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28219559
[Au] Autor:Dubique JY; Turbendian H; Chu D
[Ad] Endereço:University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
[Ti] Título:Neovascularization of Thymoma From Left Internal Mammary Artery Bypass Graft.
[So] Source:Ann Thorac Surg;103(3):e247-e248, 2017 Mar.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:We present the case of a type AB thymoma in a 69-year-old man with previous coronary artery bypass grafting (CABG) in whom angiography revealed a left internal mammary artery graft supplying blood flow to a thymic neoplasm, which simultaneously occluded the graft. This required a redo sternotomy, lysis of pericardial adhesions, complete thymectomy, and redo one vessel off-pump CABG. This case seeks to sensitize physicians to the possibility of coronary adverse events in patients with a previous CABG in the setting of management of mediastinal neoplasms, and it presents the novel findings on cardiac imaging associated with this case.
[Mh] Termos MeSH primário: Anastomose de Artéria Torácica Interna-Coronária/efeitos adversos
Neoplasias do Mediastino/irrigação sanguínea
Neovascularização Patológica/etiologia
Timoma/irrigação sanguínea
[Mh] Termos MeSH secundário: Idoso
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170413
[Lr] Data última revisão:
170413
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE


  7 / 2204 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28186272
[Au] Autor:Glineur D; Etienne PY; Kuschner CE; Shaw RE; Ferrari G; Rioux N; Papadatos S; Brizzio M; Mindich B; Zapolanski A; Grau JB
[Ad] Endereço:Department of Thoracic and Cardiovascular Surgery, Cliniques St Luc Bouge, Namur, Belgium.
[Ti] Título:Bilateral internal mammary artery Y construct with multiple sequential grafting improves survival compared to bilateral internal mammary artery with additional vein grafts: 10-year experience at 2 different institutions†.
[So] Source:Eur J Cardiothorac Surg;51(2):368-375, 2017 02 01.
[Is] ISSN:1873-734X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Utilization of bilateral internal mammary arteries (BIMAs) has been shown to improve long-term outcomes in patients undergoing coronary artery bypass grafting. To achieve complete revascularization, BIMAs may be used as either sole conduits for revascularization through a Y-graft configuration (BIMA-Y) or deployed with additional grafts used in conjunction with BIMAs. The purpose of this study was to compare the long-term outcomes of two institutions that predominantly used either the BIMA-Y configuration or BIMA plus additional grafts to achieve optimal revascularization. METHODS: From 1 January 2000 to 31 December 2010, 436 patients were revascularized using a non-sequential BIMA grafting at one institution (Group A), with veins being used for additional targets. At the second institution (Group B), 771 patients were revascularized using a BIMA-Y graft for all distal targets. Kaplan­Meier analysis was used to compare unadjusted survival between the groups. Cox proportional hazards regression modelling was used to provide an adjusted comparison of survival between the groups. RESULTS: There was no statistically significant difference between the average number of anastomotic sites used in Group A and Group B (A = 4.0 ± 0.7 vs B = 4.0 ± 0.7; P = 0.24). Group A did not have a significantly greater in-hospital mortality (0.7% vs 1.0% P = 0.39), stroke (0.5% vs 0.8% P = 0.40), deep sternal wound infection (0.0% vs 0.6% P = 0.11) or reoperation for bleeding (1.6% vs 0.6% P = 0.10) than Group B. Cox proportional hazards analyses demonstrated that at 14 years, Group B had a significantly improved survival compared to Group A (Group B = 88% vs Group A = 81%) with an overall reduction in mortality (adjusted hazard ratio 0.780, 95% confidence interval 0.448­0.849; P = 0.043). CONCLUSION: Utilization of the BIMA-Y configuration was associated with improved survival when compared to BIMA grafting with additional vein grafts. Further studies are necessary to evaluate the efficacy of BIMA-Y grafting against other means of providing complete arterial revascularization.
[Mh] Termos MeSH primário: Anastomose de Artéria Torácica Interna-Coronária/métodos
[Mh] Termos MeSH secundário: Idoso
Bélgica/epidemiologia
Feminino
Mortalidade Hospitalar
Seres Humanos
Anastomose de Artéria Torácica Interna-Coronária/efeitos adversos
Anastomose de Artéria Torácica Interna-Coronária/mortalidade
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
New Jersey/epidemiologia
Modelos de Riscos Proporcionais
Reoperação
Estudos Retrospectivos
Fatores de Risco
Veia Safena/transplante
Acidente Vascular Cerebral/epidemiologia
Acidente Vascular Cerebral/etiologia
Infecção da Ferida Cirúrgica/epidemiologia
Infecção da Ferida Cirúrgica/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170211
[St] Status:MEDLINE
[do] DOI:10.1093/ejcts/ezw282


  8 / 2204 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28110487
[Au] Autor:Hegazy YY; Hassanein W; Ennker J; Keshk N; Bauer S; Sodian R
[Ad] Endereço:Department of Cardiac Surgery, Mediclin Heart Institute, Lahr/Baden, Germany.
[Ti] Título:The Use of Bilateral Internal Mammary Artery Grafting in Different Degrees of Obesity.
[So] Source:Thorac Cardiovasc Surg;65(4):278-285, 2017 Jun.
[Is] ISSN:1439-1902
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Obesity is a limiting factor for the use of bilateral internal mammary arteries (BIMAs). Therefore, we assessed the safety of their use in different degrees of obesity. We studied two groups of patients with obesity using propensity matching. The first group received single internal mammary artery and saphenous vein grafts (SIMA group, 526 patients) and the second group received bilateral internal mammary arteries (BIMA group, 526 patients). Patients were classified further according to their body mass index (BMI) into overweight (BMI = 25-29.9 kg/m ), obese (BMI = 30-34.9 kg/m ), and severely obese (BMI ≥ 35 kg/m ). Preoperative data were similar regarding age (62.78 ± 9.96 vs. 62.98 ± 9.66 years; = 0.734), female sex (17.5 vs. 18.6%; = 0.631), diabetes mellitus (26.3 vs. 27.2%; = 0.74), EuroSCORE (3.21 ± 2.23 vs. 3.18 ± 2.41; = 0.968), and COPD (16 vs. 16%; = 1). No significant differences were noticed between the two groups regarding the number of peripheral anastomoses (3.09 ± 0.84 vs. 3.12 ± 0.83; = 0.633), myocardial infarction (1.7 vs. 1.7%; = 1), reexploration (1.3 vs. 2.1%; = 0.34), deep sternal wound infection (DSWI) (2.1 vs. 2.9%; = 0.43), and 30-day mortality (0.8 vs. 1.1%; = 0.53). Multivariate analysis identified BMI and intensive care unit stay as independent predictors for DSWI. However, postoperative blood loss (694.56 ± 631.84 vs. 811.67 ± 688.73 mL; < 0.001) and the incidence of pneumothorax (1 vs. 2.7%; = 0.037) were higher in BIMA group. Patients with obesity can benefit from BIMA grafting. However, postoperative blood loss and the incidence of pneumothorax can be higher using this technique.
[Mh] Termos MeSH primário: Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos
Doença da Artéria Coronariana/cirurgia
Anastomose de Artéria Torácica Interna-Coronária/métodos
Obesidade/complicações
[Mh] Termos MeSH secundário: Idoso
Índice de Massa Corporal
Ponte Cardiopulmonar
Distribuição de Qui-Quadrado
Ponte de Artéria Coronária sem Circulação Extracorpórea/efeitos adversos
Doença da Artéria Coronariana/complicações
Doença da Artéria Coronariana/diagnóstico por imagem
Feminino
Seres Humanos
Anastomose de Artéria Torácica Interna-Coronária/efeitos adversos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Obesidade/diagnóstico
Razão de Chances
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/terapia
Pontuação de Propensão
Estudos Retrospectivos
Fatores de Risco
Índice de Gravidade de Doença
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170123
[St] Status:MEDLINE
[do] DOI:10.1055/s-0037-1598028


  9 / 2204 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28109568
[Au] Autor:Pevni D; Ben-Gal Y; Mohr R; Ganiel A; Paz Y; Kramer A; Nesher N
[Ad] Endereço:Department of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: pevnid@gmail.com.
[Ti] Título:One or Two Internal Thoracic Grafts? Long-Term Follow-Up of 957 Off-Pump Coronary Bypass Surgeries.
[So] Source:Ann Thorac Surg;104(1):70-77, 2017 Jul.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The potential survival benefit of bilateral internal thoracic artery (BITA) grafting in patients undergoing off-pump coronary artery bypass graft surgery (OPCABG) is controversial owing to the technical complexity of these operations. Our objective was to compare the outcome of patients undergoing OPCABG with BITA to the outcome of patients undergoing OPCABG with a single internal thoracic artery (SITA) and saphenous vein grafts or radial artery. METHODS: Five hundred and thirty-five consecutive patients who underwent OPCABG BITA at our institute between 2000 and 2008 were compared with 422 patients who underwent OPCABG with SITA. Propensity score matching was used to account for differences between groups in preoperative characteristics. RESULTS: Being female (20.9% versus 36.0%, p < 0.001), having diabetes mellitus (36.6% versus 55.7%, p > 0.001), recent myocardial infarction (23.6% versus 33.2%, p > 0.001), aged 70 years or more (41.1% versus 49.8%, p = 0.001), peripheral vascular disease (26.1% versus 46.7%, p > 0.001), and chronic renal failure (7.9% versus 15.9%, p > 0.001) were less frequent in the BITA group than in the SITA group, respectively. The European System for Cardiac Operative Risk Evaluation score was significantly higher for the SITA group (7.62, versus 5.46 for BITA group, p = 0.001), whereas operative mortality (1.7% BITA versus 2.6% SITA) and sternal wound infections (1.7% BITA versus 2.1% SITA) were similar. The mean follow-up was 11.6 ± 3.5 years. The BITA patients' 10-year survival (Kaplan-Meier) was better (72.2% versus 55.1% for SITA, p > 0.001). However, after propensity matching, survival for BITA and SITA were similar. CONCLUSIONS: This large cohort study suggests that long-term outcomes for patients undergoing OPCABG are not better with BITA grafting.
[Mh] Termos MeSH primário: Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos
Doença da Artéria Coronariana/cirurgia
Anastomose de Artéria Torácica Interna-Coronária/métodos
Artéria Torácica Interna/transplante
Medição de Risco
[Mh] Termos MeSH secundário: Idoso
Doença da Artéria Coronariana/mortalidade
Feminino
Seguimentos
Seres Humanos
Israel/epidemiologia
Masculino
Pontuação de Propensão
Estudos Retrospectivos
Fatores de Risco
Taxa de Sobrevida/tendências
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171115
[Lr] Data última revisão:
171115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170123
[St] Status:MEDLINE


  10 / 2204 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28106618
[Au] Autor:Balkhy HH; Nathan S; Arnsdorf SE; Krienbring DJ
[Ad] Endereço:From the Departments of *Cardiothoracic Surgery and †Cardiology, University of Chicago Medicine, Chicago, IL USA.
[Ti] Título:Right Internal Mammary Artery Use in 140 Robotic Totally Endoscopic Coronary Bypass Cases: Toward Multiarterial Grafting.
[So] Source:Innovations (Phila);12(1):9-14, 2017 Jan/Feb.
[Is] ISSN:1559-0879
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Benefits of adding a second arterial graft in coronary bypass are well documented. In patients requiring mulitvessel grafting robotic totally endoscopic coronary bypass (TECAB) has allowed for routine harvesting and use of the right internal mammary artery (RIMA). We retrospectively reviewed the technical considerations and target choice in 140 cases of beating heart TECAB where a RIMA graft was used. METHODS: In 2008, we introduced beating heart TECAB with anastomotic connectors into our practice, first with single IMA and then with bilateral internal mammary artery. A robotic stabilizer was used not only to facilitate exposure of the coronary targets but also to aid the RIMA harvest using a skeletonized approach. Flow measurements were obtained routinely. We reviewed the technical aspects, target choice, and intraoperative flows in our TECAB patients who underwent grafting with RIMA grafts. RESULTS: From February 2008 to January 2015, a total of 404 patients underwent beating heart TECAB with anastomotic connectors, of which 194 (48%) were mulitvessel procedures. One hundred forty patients (35%) had a RIMA graft and constitute the patient population for this review. One hundred thirty-one RIMA grafts were harvested via left-sided ports and grafted to left coronary targets, and nine RIMA grafts were harvested via right-sided ports and grafted to the right coronary artery. Flow was greater than 25 mL/min (pulsatility index < 2) in 95% of grafts. Perioperative mortality was 0.7% and mean ± standard deviation length of hospital stay was 3.1 (1.5) days. The RIMA was used as an in situ graft in 124 cases (84%) and as a free T-graft in 24 cases (16%) cases. Right internal mammary artery graft use in all TECABS increased from 23% in the first 5 years to 53% in the last 2 years. CONCLUSIONS: Robotic TECAB allows the routine harvesting and use of the RIMA graft in a safe and reproducible manner. Skeletonization and sternal sparing allow the RIMA to reach various coronary targets. Further studies are needed for this approach to impact the adaption of multiarterial grafting.
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/cirurgia
Anastomose de Artéria Torácica Interna-Coronária/instrumentação
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Anastomose de Artéria Torácica Interna-Coronária/métodos
Anastomose de Artéria Torácica Interna-Coronária/tendências
Tempo de Internação
Masculino
Meia-Idade
Estudos Retrospectivos
Procedimentos Cirúrgicos Robóticos/instrumentação
Análise de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170308
[Lr] Data última revisão:
170308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170121
[St] Status:MEDLINE
[do] DOI:10.1097/IMI.0000000000000341



página 1 de 221 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde