RESUMO
Objective: The aim of this study is to examine the outcomes post redo CABG in patients above 70 years old
Method: This retrospective study was carried out at Liverpool Heart and Chest Hospital, for 148 patients above the age of 70 [Mean age 74.29+/-3.4 years] who underwent reoperation for Coronary Artery Bypass Graft [CABG] over 10 years period between 2001-2011. Post operative mortality and morbidity was analyzed. We used Major Adverse Vascular Events [MAVE] as in-hospital safety of treatment assessment tools
Results: The mean EURO score was 7.41+/- 2.67. Thirty-day mortality was 6% [9 out of 148], and the one-year survival was 84.4% [n=125]. MAVE show 4.7% post-operative Q-wave MI and 4% stroke. Renal impairment was noted in 14.2%. Rate of re-exploration was 12.8% mainly for bleeding and tamponade 8.1% and 2.7% respectively. Mean length of stay was 16.3 days
Conclusion: This study shows acceptable survival and post operative mortality and morbidity in this high risk group. Therefore, Redo CABG in patients over 70 alone should not deter a cardiac surgeon from offering such a potentially beneficial intervention
RESUMO
To evaluate the feasibility of semiclosed and remote endarterectomy for the treatment of occlusive superficial femoral artery disease. During 2005 and 2006, 31 patients [aged 25-81] with critical lower limb ischemia and disabling claudication whom underwent endarterectomy of the superficial femoral artery using ring stripper in the vascular surgery department at Queen Alia hospital in Amman, were reviewed. Semiclosed endarterectomy technique was performed in 21 patients and remote endarterectomy in 10 patients. The procedure with its suspected outcome and complications was discussed with the patients including other treatment options. Written Ethical Approval was obtained from all the study patients. In 29 patients clinical success in the form of restoration of blood supply with limb salvage and alleviation of rest pain and disabling claudication was achieved which was the main goal. Clinical success rate was 94%. Two patients ended up with below knee amputation with a failure rate of 6%. One patient died postoperatively with a mortality rate of 3%. During the two years follow-up period, another three patients died, which was not related to surgery. Semiclosed and remote endarterectomy using ring stripper is a useful technique in the treatment of occlusive arterial lesions of the superficial femoral artery and should be considered as one of the treatment options among selected cases