Vein patch angioplasty with internal mammary artery grafting of the left anterior descending coronary artery

Objective@#To describe the treatment outcomes of patients who underwent coronary artery bypass grafting (CABG) with vein patch angioplasty with internal mammary artery (IMA) grafting of the diffusely diseased left anterior descending (LAD) coronary artery.@*Methods@#This is a retrospective observational study of 26 patients who have undergone vein patch angioplasty of the LAD coronary artery with IMA grafting in three centers by a single surgeon from January 2012 to August 2017. The demographic profile, intraoperative data, and postoperative outcome (including in-hospital mortality and morbidity, perioperative myocardial infarction, and NYHA functional classification) were recorded. Continuous variables were expressed as means with standard deviation and categorical variables summarized as frequencies and percentages. Student’s t-test was used to compare the preoperative versus postoperative mean NYHA functional class.@*Results@#There were 22 (85%) males and 4 (15%) females with a mean age of 62 years (range: 34 to 82). Twentyfive patients (96%) had a three-vessel disease, and one (4%) had a two-vessel disease. Nine patients (35%) had a preoperative myocardial infarction. The mean cardiopulmonary bypass and aortic-cross clamp times were 156 and 118 minutes, respectively. The mean number of vessels grafted was 4.12. Multiple arterial grafting was used in seven patients (27%). There were two in-hospital mortalities (7.7%) and three morbidities (11.5%), including reoperation for bleeding, acute kidney injury, and leg wound infection. Six patients (23%) developed postoperative atrial fibrillation. No patient developed perioperative myocardial infarction. The mean ICU stay was three days, and the mean hospital stay was 10.27 days. The mean NYHA functional class improved from 2.85 preoperatively to 1.5 postoperatively (p<0.00001). Among patients with improvement, postoperative NYHA improved by two functional classes in 38% and by one functional class in 62%. @*Conclusion@#Vein patch angioplasty is a valuable technique for diffuse coronary stenosis of the LAD artery with acceptable early results.

Early outcomes of the bird-cage chest wall reconstruction in the Philippine General Hospital

Objective@#To describe the treatment outcomes of patients with chest wall tumors undergoing resection and Birdcage chest wall reconstruction in the local setting. @*Methods@#Data were obtained from 13 patients who underwent chest wall resection and Bird-cage (methylmethacrylate neo-rib, mesh, soft tissue, and skin) reconstruction in the Philippine General Hospital from January 2008 to September 2019. Demographics, operative procedures, 30-day operative morbidity, and mortality were evaluated using means and frequencies.@*Results@#We included 13 (77% female) patients with a mean age of 44.5 years. The most common indication for chest wall resection was recurrent neoplasm (5/13, 38.46%). The most extensive chest wall defect was 600 cm2. The average length of ICU stay was 5.15 days, and two patients had prolonged intubation (>3 days). The graft infection rate was 38%, pneumonia 23%, and the operative mortality rate was zero.@*Conclusion@#Bird-cage reconstruction is a safe, reliable, and cheap method of providing rigid chest wall reconstruction for chest wall tumor resection.

Early outcomes of the bird-cage chest wall reconstruction in the Philippine General Hospital

Objective@#To describe the treatment outcomes of patients with chest wall tumors undergoing resection and Birdcage chest wall reconstruction in the local setting. @*Methods@#Data were obtained from 13 patients who underwent chest wall resection and Bird-cage (methylmethacrylate neo-rib, mesh, soft tissue, and skin) reconstruction in the Philippine General Hospital from January 2008 to September 2019. Demographics, operative procedures, 30-day operative morbidity, and mortality were evaluated using means and frequencies. @*Results@#We included 13 (77% female) patients with a mean age of 44.5 years. The most common indication for chest wall resection was recurrent neoplasm (5/13, 38.46%). The most extensive chest wall defect was 600 cm2. The average length of ICU stay was 5.15 days, and two patients had prolonged intubation (>3 days). The graft infection rate was 38%, pneumonia 23%, and the operative mortality rate was zero.@*Conclusion@#Bird-cage reconstruction is a safe, reliable, and cheap method of providing rigid chest wall reconstruction for chest wall tumor resection.