Objective To evaluate repeat coronary artery bypass grafting (CABG) in 312 patients. Methods The data of 312 patients (average age 65±9 years) who had CABG operation in Hartford hospital were collected and analyz...Objective To evaluate repeat coronary artery bypass grafting (CABG) in 312 patients. Methods The data of 312 patients (average age 65±9 years) who had CABG operation in Hartford hospital were collected and analyzed. The mean duration follow up after the first CABG was 11.8±4.5 years. A total of 1069 bypass grafts were performed. Among them, 386 were arterial grafts such as internal mammary artery, radial artery and gastroepiploic artery; 682 were venous grafts and 1 Gore-Tex graft. Results The operative mortality was 4.5%. Fifteen patients ( 4.8%) had peri-operative myocardial infarction and 46 patients (15%) had low cardiac output syndrome. Intra-aortic balloon pump (IABP) was used in 131 patients before, during and after operation. One hundred and nineteen patients weaned off IABP and recovered. Conclusion Although the difficulties and risk factors were increased, the results of redo CABG were still good.展开更多
Background and purpose Infrainguinal arterial reconstruction increases limb salvage rates, however, the fac- tors that predict time to graft failure remain ill-defined. The aim of this study was to define such predict...Background and purpose Infrainguinal arterial reconstruction increases limb salvage rates, however, the fac- tors that predict time to graft failure remain ill-defined. The aim of this study was to define such predictors. Methods A retrospective analysis of infrainguinal arterial reconstructions performed for symptomatic pe- ripheral arterial disease refractory to medical/interventional therapies over a 6 year period was performed. Demographics and adverse outcomes were analysed and statistical significance was determined using Chi-squared analysis, the Student t test and the Wilcoxon signed-rank test. Main findings 170 procedures were analysed. The male to female ratio was 4:3. The median age was 70.1 years. The post-operative com- plication rate was 12%. On univariate analysis, female gender, the use of a synthetic graft, and the presence of critical ischaemia at the time of surgery were predictive of time to graft failure (ρ ≤ 0.05, ρ ≤ 0.03, ρ ≤ 0.02 respectively). On multivariate analysis, the 3 most significant predictors were the occurrence of a post-operative complication, female gender and a high ASA grade. The presence of diabetes mellitus and smoking did not adversely affect graft outcome, (ρ ≤ 0.23, ρ ≤ 0.20 respectively). Conclusion This study suggests that female gender adversely affects graft patency while a history of smoking and the presence of diabetes mellitus do not. Our findings also suggest that the occurrence of a post-operative complication, and a high ASA grade at time of surgery are additional important predictors of early and late graft failure.展开更多
文摘Objective To evaluate repeat coronary artery bypass grafting (CABG) in 312 patients. Methods The data of 312 patients (average age 65±9 years) who had CABG operation in Hartford hospital were collected and analyzed. The mean duration follow up after the first CABG was 11.8±4.5 years. A total of 1069 bypass grafts were performed. Among them, 386 were arterial grafts such as internal mammary artery, radial artery and gastroepiploic artery; 682 were venous grafts and 1 Gore-Tex graft. Results The operative mortality was 4.5%. Fifteen patients ( 4.8%) had peri-operative myocardial infarction and 46 patients (15%) had low cardiac output syndrome. Intra-aortic balloon pump (IABP) was used in 131 patients before, during and after operation. One hundred and nineteen patients weaned off IABP and recovered. Conclusion Although the difficulties and risk factors were increased, the results of redo CABG were still good.
文摘Background and purpose Infrainguinal arterial reconstruction increases limb salvage rates, however, the fac- tors that predict time to graft failure remain ill-defined. The aim of this study was to define such predictors. Methods A retrospective analysis of infrainguinal arterial reconstructions performed for symptomatic pe- ripheral arterial disease refractory to medical/interventional therapies over a 6 year period was performed. Demographics and adverse outcomes were analysed and statistical significance was determined using Chi-squared analysis, the Student t test and the Wilcoxon signed-rank test. Main findings 170 procedures were analysed. The male to female ratio was 4:3. The median age was 70.1 years. The post-operative com- plication rate was 12%. On univariate analysis, female gender, the use of a synthetic graft, and the presence of critical ischaemia at the time of surgery were predictive of time to graft failure (ρ ≤ 0.05, ρ ≤ 0.03, ρ ≤ 0.02 respectively). On multivariate analysis, the 3 most significant predictors were the occurrence of a post-operative complication, female gender and a high ASA grade. The presence of diabetes mellitus and smoking did not adversely affect graft outcome, (ρ ≤ 0.23, ρ ≤ 0.20 respectively). Conclusion This study suggests that female gender adversely affects graft patency while a history of smoking and the presence of diabetes mellitus do not. Our findings also suggest that the occurrence of a post-operative complication, and a high ASA grade at time of surgery are additional important predictors of early and late graft failure.
