Revascularización miocárdica versus angioplastía coronaria transluminal percutánea para el tratamiento de la cardiopatía isquímica / Myocardial revascularization versus percutaneous transluminal coronary angioplasty in the treatment of ischemic cardiopathy

BACKGROUND AND OBJECTIVE: Ischemic heart disease affects a high number of patients, and may be treated by surgery or coronary angioplasty. The objective of this study is to compare the middle term results of both procedures. MATERIAL AND METHODS: Between January and March of 1999, 59 patients with a mean age of 65 years old ranging 46 to 79, were treated with myocardial revascularization (group I) and 57 patients with a mean age of 59 years old ranging 33 to 88 were submitted to coronary angioplasty (group II). It was evaluated and compared risk factors, morbidity, mortality, evolution in two years after the procedures, presence of symptoms, freedom of events. RESULTS: In group I a higher number of diabetic patients was found. The 89.8 of patients was asymptomatic two years after the procedure in group I against 52.6 in group II (p = 0.03). One patient in group I presented angina six months after the procedure and 27 patients in group II (47.3), presented angina between the first seven months after the procedure (p = 0.034). Morbidity affects in special to diabetic patients and was higher in group I. Mortality was similar in both groups: 6.7 for group I and 6 in group II. The length of stay in hospital was lower in group II (p = 0.03). CONCLUSION: In a middle time, coronary artery bypass grafting offers better results related to freedom of angina and better quality of life.

Derivación extracorpórea izquierda transoperatoria para la corrección de un aneurisma de aorta torácica / Intraoperative left heart bypass for correction of a thoracic aorta aneurysm

Se presenta el caso de un paciente masculino de 26 años de edad en quien se utilizó una derivación izquierda con canulación en la aurícula izquierda y la aorta descendente para perfusión distal con bomba centrífuga, durante el tratamiento quirúrgico de un aneurisma de la aorta torácica, el cual se efectuó sin complicaciones mediante plastia con parche de dacrón. La evolución postoperatoria fue satisfactoria, sin complicaciones ni daño a órganos y estructuras distales.Se puede concluir que la derivación izquierda es una alternativa de protección intraoperatoria durante la cirugía de la aorta torácica.