ABSTRACT
The authors present their first experience with rigid osteosynthesis of the sternum using the SternaLock system, used in a 61-year old male patient with a complete sternal dehiscence, diagnosed eight years following his aortocoronary bypass. The authors give a brief overview of the methodology and technique of the system implantation, the discussion deals with pros of the rigid fixation procedures and the commonest risk factors resulting in postoperative sternal instability.
Subject(s)
Internal Fixators , Sternum/surgery , Surgical Wound Infection/surgery , Cardiac Surgical Procedures/adverse effects , Humans , Male , Middle AgedABSTRACT
INTRODUCTION: The use of arterial grafts in the myocardial revascularization procedures has grown more popular due to their long-term patency compared with that of the great saphenous vein. The aim of this retrospective study was to assess our experience and first results in the group of patients who had underwent revascularization procedures using their radial artery. MATERIAL AND METHODOLOGY: Between 7/2000-2/2004, 51 patients of acceptable age, aged 69.0 +/- 9.0 (42-82), underwent the revascularization procedure using the radial artery in combination with the left or right arteria mammaria interna. The angiographic examinations were conducted in 44 patients (86.3%), 5 patients refused to undergo their control angiographic examinations. Two patients exited a few months following their surgery, however there was no obvious connection with the use of the radial artery graft. RESULTS: Out of 44 patients (86.3%), who had their control angiographic examination completed, 9.4 +/- 9.8 months later, on average, (1-38 months), 5 patients (11.4%) suffered from the RA occlusion. In 4 patients, the occlusion was located at the branching site off the aorta, in 1 patient the occlusion was located at the site of the anastomosis with the left arteria mammaria interna. The total patency of the radial artery grafts reached 89%. CONCLUSION: The use of the radial artery in myocardial revascularization procedures has proven safe, associated with lower complication rates connected with its collection. Furthermore, the procedures result in a good short and mid-term graft patency confirmed also on the control angiographic examinations.
Subject(s)
Coronary Artery Bypass , Radial Artery/transplantation , Adult , Aged , Coronary Artery Bypass/adverse effects , Coronary Artery Bypass/methods , Female , Humans , Male , Middle Aged , Postoperative ComplicationsABSTRACT
BACKGROUND: Either stented or stentless bioprostheses can be used for aortic valve replacement (AVR) in aged patients. However the choice of the valve type remains controversial. The implantation technique of the stentless valves is more complex but the haemodynamic performance supposed to be superficial to the stented ones. The aim of the study was to review our experience with stented bioprostheses implanted in the last year. MATERIAL AND METHODS: The study reviews retrospectively 35 patients who underwent AVR with Biocor fy St Jude Medical from May 2000 to May 2001. The mean age was 73 years (65-81). Associated procedures were CABG in 17, aortoplasty in 3 and Bentall procedure in 1. Thirty-two patients had aortic stenosis, the mean preoperative gradient was 44.2 mmHg. Nineteen implanted valves were 23 mm and smaller in diameter. All patients were examined by a cardiologist (including ECHO) one month after surgery. RESULTS: There was no early mortality (30 days) and no sign of structural valve deterioration or valve thrombosis. Mean hospital stay was 10.2 days (5-30). Mean postoperative gradient one month after surgery was 14.1 mmHg (6-24). CONCLUSIONS: The AVR with a stented bioprosthesis is a standard procedure with excellent results, the postoperative gradient is comparable to the gradient of the stentless valves.
