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1.
Transplant Proc ; 40(10): 3554-7, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19100436

RESUMO

Patients with coronary artery disease (CAD) who undergo liver transplantation (OLT) have been previously identified as a high-risk group. Since that identification, the management of CAD has undergone significant changes as has the cardiovascular screening and selection of patients for OLT. We retrospectively identified 42 patients with known CAD who underwent OLT to compare outcomes with a control group of 42 patients without CAD who were matched for gender, age, and primary liver disease. Mortality rates were higher in the CAD than the control group at 1 year (5 vs 1) and 3 years (11 vs 3; P < .05) although lower than previously reported (at 3 years, 26% vs 50%). New cardiovascular morbidity was also more frequent among the CAD than control group at 1 year (11 vs 3; P < .05) and 3 years (16 vs 4; P < .05). Although outcomes for patients with CAD undergoing OLT are improved from historical levels, they are still worse than those in patients without CAD despite current management and selection strategies.


Assuntos
Doença das Coronárias/epidemiologia , Transplante de Fígado/efeitos adversos , Ponte de Artéria Coronária , Doença das Coronárias/mortalidade , Doença das Coronárias/cirurgia , Estenose Coronária/cirurgia , Feminino , Seguimentos , Humanos , Transplante de Fígado/mortalidade , Masculino , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Fumar/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
2.
J Vasc Surg ; 31(3): 450-5, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10709056

RESUMO

OBJECTIVE: The superficial femoral popliteal vein (SFPV) has been used as an alternative conduit for both arterial and venous reconstructive surgery. Its popularity continues to grow, despite concern about the potential for venous morbidity after harvest. The purpose of this study was to determine an anatomic "safe" length of SFPV for harvest, assuming that the preservation of at least one valve and one significant collateral vein in the remaining popliteal vein (PV) segment can minimize venous morbidity. METHODS: Forty-four SFPVs were harvested from 39 cadaveric specimens. The length of both the superficial femoral vein (SFV) and PV was measured, and the number and location of valves and significant side branches (more than 2 mm in diameter) of the PV were measured. The Student two-tailed t test was used as a means of comparing vein lengths between the sexes. Correlation coefficients were determined for the effect of patient height on vein length, stratified by means of sex. RESULTS: Vein length (SFV mean, 24.4 +/- 4 cm; PV mean, 18.8 +/- 4 cm) varied with sex (male SFV mean, 28.1 +/- 5 cm; male PV mean, 21. 5 +/- 3 cm; female SFV mean, 22.6 +/- 4 cm; female PV mean, 18.4 +/- 3 cm; P =.01). Valve number (mean, 1.8 +/- 0.5) and location and collateral vein number (mean, 5 +/- 1.8) and location were variable and independent of height or sex. CONCLUSION: An anatomic "safe" length of SFPV for harvest to minimize venous morbidity would include all the SFV and 12 cm of PV in 95% of women and 15 cm of PV in 95% of men. We found that the male sex was a significant determinant for a longer safe length of vein that can be harvested.


Assuntos
Veia Femoral/anatomia & histologia , Veia Poplítea/anatomia & histologia , Cadáver , Dissecação , Feminino , Humanos , Masculino , Fatores Sexuais
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