ABSTRACT
BACKGROUND: We analyzed post-operative angiography performed in symptomatic patients to evaluate the patency rates and the roles of grafts. MATERIAL AND METHOD: We reviewed 52 (15%) coronary angiograms performed for recurrent angina after prior coronary artery bypass surgery from January 1995 to June 2005. A total of 345 patients underwent coronary artery bypass surgery during this period. There were 41 men and 11 women and the mean age was 64.07+/-15.58 years. The median period from operation to re-angiogram was 68.5 months (range, 1 to 126 months). The numbers of grafts and peripheral anastomoses were 42 and 43 for internal thoracic artery (ITA), 14 and 20 for radial artery (RA), and 49 and 89 for saphenous vein. The mean number of anastomosis was 2.9 per patient. RESULT: The patency rates of ITA, RA and saphenous vein graft (SVG) were 37/43 (86%), 17/20 (85%) and 34/89 (38.2%). The patency rate of arterial grafts was significantly higher than that of SVG (p<0.001) and the patency rate of the RA was comparable to that of ITA (p=0.912). The patency rate of sequential SVGs was higher than that of single SVG (40.3% vs 31.8%, p=0.478) and the patency rate of proximal segments in sequential anastomosis was higher than that in single anastomsis (55.6% vs 31.8%, p=0.097), but statistically not significant. CONCLUSION: Arterial grafts have markedly superior patency rates than SVGs, so consideration should be given to the vigorous use of arterial grafts. The patency rate of the RA was comparable to that of ITA.
Subject(s)
Female , Humans , Male , Angiography , Coronary Angiography , Coronary Artery Bypass , Mammary Arteries , Radial Artery , Saphenous Vein , TransplantsABSTRACT
In an extremely enlarged right heart, the repeated midline sternotomy was considered to involve the risk of massive hemorrhage. A right thoracotomy provides a convenient and safe way to approach the tricuspid valve in patient who have had previous heart surgery through a midline sternotomy.
Subject(s)
Humans , Heart , Hemorrhage , Reoperation , Sternotomy , Thoracic Surgery , Thoracotomy , Tricuspid ValveABSTRACT
Intravenous leiomyomatosis is a rare neoplasm characterized by intravenous growth of histologically benign smooth muscle cell tumor. We report a case of intravenous leiomyomatosis with right atrial extension in a 19-year-old woman. Various surgical techniques and approaches have been previously reported. In this case, the tumor was removed with a single-stage approach via laparotomy without cardiopulmonary bypass.
Subject(s)
Female , Humans , Young Adult , Cardiopulmonary Bypass , Heart Atria , Laparotomy , Leiomyomatosis , Myocytes, Smooth Muscle , Vascular NeoplasmsABSTRACT
Spindle cell lipoma is a relatively rare adipocytic neoplasm that is easily mistaken for a liposarcoma, and is histologically characterized by a mixture of uniform spindle cells and mature fat cells. It occurs predominantly in male patients aged 45~65 years, and in most cases it arises in the subcutaneous tissue of the neck or shoulder. We report a case of a 45-year-old woman with spindle cell lipoma arising from the left pleural cavity.