Avtor/Urednik		Takach, Thomas J; Reul, George J; Duncan, J Michael; Krajcer, Zvonimir; Livesay, James J; Gregorič, Igor D; Cervera, Roberto D; Ott, David A; Frazier, OH; Cooley, Denton A
Naslov		Concomitant brachiocephalic and coronary artery disease: outcome and decision analysis
Tip		članek
Vir		Ann Thorac Surg
Vol. in št.		Letnik 80, št. 2
Leto izdaje		2005
Obseg		str. 564-9
Jezik		eng
Abstrakt		Background: In patients with coronary artery disease, concomitant brachiocephalic disease may affect outcome and influence decision making regarding operative staging, technique, and choice of conduit. Methods: Eighty consecutive patients (mean age, 59.3 years; 60.0% male) with concomitant brachiocephalic and coronary artery disease were identified either before (group A, n = 48) or after (group B, n = 32) coronary artery bypass grafting. Patients who had symptomatic brachiocephalic and coronary artery disease before surgery underwent concomitant brachiocephalic reconstruction and coronary artery bypass grafting using either all-vein coronary conduits (n = 41) or vein-and-internal mammary artery conduits (n = 7). Patients who had coronary-subclavian steal syndrome after coronary artery bypass (group B, n = 32) underwent either surgical (n = 5) or endovascular (n = 27) brachiocephalic reconstruction only. Results: All patients were asymptomatic after intervention. Operative mortality was 4.2% for group A and 3.1% for group B. The perioperative stroke rate was 2.1% for group A and 0% for group B. Actuarial 10-year freedom from specific events for group A was as follows: death 59.9 +/- 12.8%, brachiocephalic restenosis 100%, coronary-subclavian steal syndrome 100%, myocardial infarction 83.5 +/- 10.5%, stroke 82.1 +/- 9.9%, redo coronary artery bypass grafting 95.8 +/- 4.1%, other vascular operation 82.2 +/- 8.9%, and adverse cardiac outcome (death, redo coronary artery bypass grafting, or myocardial infarction) 52.9% +/- 13.2% (for patients with all-vein conduits) or 100% (for patients with vein-and-internal mammary artery conduits). At midterm follow-up (mean, 2.92 years), both the surgical and the endovascular treatment subgroups of group B had 100% brachiocephalic patency. (Abstract truncated at 2000 characters)
Deskriptorji		ADULT AGED AGED, 80 AND OVER ARTERIAL OCCLUSIVE DISEASES BRACHIOCEPHALIC TRUNK CORONARY ARTERY BYPASS DECISION SUPPORT TECHNIQUES RETROSPECTIVE STUDIES TREATMENT OUTCOME