ABSTRACT
The main cause of the Bland-White-Garland (BWG) syndrome is usually an anomalous origin of the left coronary artery, however, the right coronary artery can be affected as well. We report on the surgical treatment of an adult type BWG syndrome in a 59-year-old male patient. The reason for angiography was anginal pain which occurred 7 years prior to the operation. At that time patient did not agree to undergo surgery, however, symptom aggravation brought him to the hospital again. Because of the vessel anatomy the operator decided to implant a vein graft.
Subject(s)
Angioplasty/methods , Coronary Vessel Anomalies/surgery , Coronary Vessels/surgery , Atrial Fibrillation/etiology , Atrial Fibrillation/surgery , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures/methods , SyndromeABSTRACT
The aim of the study was to analyze perioperative risk factors, with special attention to cardioprotective techniques. Additionally we compared effectiveness of standard risk scales (Cleveland and Canadian) and own risk scale (modified by inclusion Graham, Chambers, Davies classification of distal coronary arteries) in investigated group. The obtained data indicate that cardioprotective techniques have no impact on clinical results but there are some important factors which influence surgical treatment: age (over 75 years), ejection fraction less than 20% and poor distal parts of coronary vessels. The regression model results were used to calculate predictive value of Cleveland or Canadian risk scale (measured area under ROC curve). Effectiveness of anticipation: mortality (Cleveland and Canadian), complications, ICU and hospital stay in patients with severely depressed left ventricular function achieved 71%, 70%, 70%, 71%, 69%, respectively. After including Graham, Chambers, Davies classification of distal coronary arteries predictive value improved 3-4% and thereby raised to 74%, 73%, 74%, 74% and 72%.
