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COMPLETE ARTERIAL REVASCULARISATION IN ELDER PATIENTS

Year 2005, Volume: 9 Issue: 1, 18 - 24, 01.01.2005

FARUK Cıngöz CELALETTIN Günay ALPER Ucak M. ERIN Tüysüz ERKAN Kuralay HARUN Tatar

Abstract

Aim: The aim of this study was to evaluate the early and mid-term results of total arterial myocardial revascularization in elderly patients. Material and Method: 65 patients aged 60 years and older (mean 64.8+5.4, range 60-78 years) who underwent total arterial myocardial revascularization between January 2002 and June 2004 were evaluated prospectively. 41 patients (63.1%) had three-vessel coronary artery disease, 18(27.7%) had two-vessel disease and 6(9.2%) with left main lesion. 22 patients had an old myocardial infarction and 11 unstabile angina pectoris. Mean EF was 55%. All patients underwent TAMR. In total 167 distal anastomoses were constructed (2.6 per patient) Pedicled LITA and RITA, free RITA and Radial arter were used as single or composite T-or Y- graft. Results: Patient were followed-up in a mean period of 17.6+7.3 months (range 1-28 month). There was no ocluded grafts in the early postoperative period (less than 90 days) patency 100%. Late(mean 16+2 month) LITA patency was 98.1% (one graft ocluded), RITA patency was 93.4% (one graft ocluded) and RA patency was 93.2% (three grafts ocluded).One patient died in this period (1.5%) one underwent PTCA (1.5%) two suffered angina pectoris (3.1%), there was no reoperation in this period. Conclusion: This study showed that using only arterial conduits in coronary bypass surgery in elderly (patient aged over 60 years) were clearly evident with respect to higher patency rate, surgical reintervention and freedom from cardiac events.

Keywords

FARUK CINGÖZ

References

  • Dallan LA, de Oliveira SA, Lizboa LA et all: Complete myocardial revascularization using arterial grafts. 2000; 4: 179-183
  • Favoloro R: Saphenous vein graft in the surgical treatment of coronary artery disease: Operative technique. J Thorac Cardiovasc Surg 1969; 58: 178-85.
  • Kolesov VI: Mammary artery-coronary artery anastomosis as a method of treatment for angina pectoris. J Thorac Cardiovasc Surg 1967; 54: 535.
  • Lytle BW, Loop FD, Cosgrove DM: Longterm (5–12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts. J Thorac Cardiovasc Surg 1985; 89: 248-58.
  • Calafiore AM, di Giammarco G, Teodori G, et al: Radial artery and inferior epigastric arteryas composite graft with internal mammary artery: Improved midterm angiographic results. Ann Thorac Surg 1995; 60: 517-23.
  • Campeau L, Enjalbert M, Lesperance J, et al: Atherosclerosis and late closure of aortocoronary saphenous vein grafts: Sequential angiographic studies at 2 weeks, 1 year, 5 to 7 years and 10 to 12 years after surgery. Circulation 1983; 68:1-7.
  • Barner HB: The continuing evolution of arterial conduits. Ann Thorac Surg 1999; 68:1-8
  • Galbut DL, Traad EA, Dorman MJ, et al: Seventeen-year experience with bilateral internal mammary artery grafts. Ann Thorac Surg 1990; 49: 195-201.
  • Dewar LR, Jamieson WR, Janusz MT, et al. Unilateral versus bilateral internal mammary revascularization. Survival and event-free performance. Circulation. 1995;92:8-13.
  • Naik MJ, Abu-Omar Y, Alvi A, ey al.Total arterial revascularisation as a primary strategy for coronary artery bypass grafting. Postgrad Med J. 2003;79:43-8.
  • Carpentier A, Guermonprez JL, Deloche A, et al: The aorta-to-coronary radial artery bypass graft. Ann Thorac Surg 1973; 16: 111-21.
  • Acar C, Jebara VA, Portoghese M, et al: Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 1992; 54: 652-9.
  • Calafiore A.M.,Teodori G, Di Giammarco G.et al Coronary revascularization with the radial artery:new interes for an old conduit J Card Surg 1995;10:140-6
  • Hersh S. Barner M, Bailey MS Radial artery patency: are aortocoronary conduits superior to composite grafting?. Ann Thorac Surg 2003;77:794-9
  • Possati G, Gaudino M, Prati F, Long-term results of the radial artery used for myocardial revascularization.Circulation. 2003;108:1350-4
  • Lemma M, Mangini A, Gelpi G et al. Is it better to use the radial artery as a composite graft? Clinical and angiographic results of aorto-coronary versus Y-graft Eur J Cardiothorac Surg 2004; 26 :110–117.
  • Tatoulis J, Buxton BF,Completeer JA et al. Bilateral radial artery grafts in coronary reconstruction:technique and early resalts in 261 patients.Ann Thorac Surg 1998;66:714-9
  • Loop FD, Lytle BW, Cosgrove DM, et al: Free (aorta-coronary) internal mammary artery graft: Late results. J Thorac Cardiovasc Surg 1986; 92: 827-31.
  • Calafiore A.M.; Di Giammarco G.; Luciani N et al.Composite arterial conduits for a wider arterial myocardial revascularization Ann Thorac Surg 1994;58:185-90
  • Cosgrove DM, Lytle BW, Loop FD et all. Does bilateral internal mammary artery grafting increse surgical risk? J Thorac Cardiovasc Surg 1988; 95: 850-6.

COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS

Year 2005, Volume: 9 Issue: 1, 18 - 24, 01.01.2005

FARUK Cıngöz CELALETTIN Günay ALPER Ucak M. ERIN Tüysüz ERKAN Kuralay HARUN Tatar

Abstract

Aim: The aim of this study was to evaluate the early and mid-term
results of total arterial myocardial revascularization in elderly
patients.
Material and Method: 65 patients aged 60 years and older (mean
64.8+5.4, range 60-78 years) who underwent total arterial myocardial revascularization between January 2002 and June 2004 were
evaluated prospectively. 41 patients (63.1%) had three-vessel coronary artery disease, 18(27.7%) had two-vessel disease and 6(9.2%)
with left main lesion. 22 patients had an old myocardial infarction
and 11 unstabile angina pectoris. Mean EF was 55%. All patients
underwent TAMR. In total 167 distal anastomoses were constructed
(2.6 per patient) Pedicled LITA and RITA, free RITA and Radial
arter were used as single or composite T-or Y- graft.
Results: Patient were followed-up in a mean period of 17.6+7.3
months (range 1-28 month). There was no ocluded grafts in the
early postoperative period (less than 90 days) patency 100%.
Late(mean 16+2 month) LITA patency was 98.1% (one graft ocluded), RITA patency was 93.4% (one graft ocluded) and RA patency
was 93.2% (three grafts ocluded).One patient died in this period
(1.5%) one underwent PTCA (1.5%) two suffered angina pectoris
(3.1%), there was no reoperation in this period.
Conclusion: This study showed that using only arterial conduits in
coronary bypass surgery in elderly (patient aged over 60 years) were
clearly evident with respect to higher patency rate, surgical reintervention and freedom from cardiac events.

Keywords

COMPLETE ARTERIAL REVASCULARISATION

References

  • Dallan LA, de Oliveira SA, Lizboa LA et all: Complete myocardial revascularization using arterial grafts. 2000; 4: 179-183
  • Favoloro R: Saphenous vein graft in the surgical treatment of coronary artery disease: Operative technique. J Thorac Cardiovasc Surg 1969; 58: 178-85.
  • Kolesov VI: Mammary artery-coronary artery anastomosis as a method of treatment for angina pectoris. J Thorac Cardiovasc Surg 1967; 54: 535.
  • Lytle BW, Loop FD, Cosgrove DM: Longterm (5–12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts. J Thorac Cardiovasc Surg 1985; 89: 248-58.
  • Calafiore AM, di Giammarco G, Teodori G, et al: Radial artery and inferior epigastric arteryas composite graft with internal mammary artery: Improved midterm angiographic results. Ann Thorac Surg 1995; 60: 517-23.
  • Campeau L, Enjalbert M, Lesperance J, et al: Atherosclerosis and late closure of aortocoronary saphenous vein grafts: Sequential angiographic studies at 2 weeks, 1 year, 5 to 7 years and 10 to 12 years after surgery. Circulation 1983; 68:1-7.
  • Barner HB: The continuing evolution of arterial conduits. Ann Thorac Surg 1999; 68:1-8
  • Galbut DL, Traad EA, Dorman MJ, et al: Seventeen-year experience with bilateral internal mammary artery grafts. Ann Thorac Surg 1990; 49: 195-201.
  • Dewar LR, Jamieson WR, Janusz MT, et al. Unilateral versus bilateral internal mammary revascularization. Survival and event-free performance. Circulation. 1995;92:8-13.
  • Naik MJ, Abu-Omar Y, Alvi A, ey al.Total arterial revascularisation as a primary strategy for coronary artery bypass grafting. Postgrad Med J. 2003;79:43-8.
  • Carpentier A, Guermonprez JL, Deloche A, et al: The aorta-to-coronary radial artery bypass graft. Ann Thorac Surg 1973; 16: 111-21.
  • Acar C, Jebara VA, Portoghese M, et al: Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 1992; 54: 652-9.
  • Calafiore A.M.,Teodori G, Di Giammarco G.et al Coronary revascularization with the radial artery:new interes for an old conduit J Card Surg 1995;10:140-6
  • Hersh S. Barner M, Bailey MS Radial artery patency: are aortocoronary conduits superior to composite grafting?. Ann Thorac Surg 2003;77:794-9
  • Possati G, Gaudino M, Prati F, Long-term results of the radial artery used for myocardial revascularization.Circulation. 2003;108:1350-4
  • Lemma M, Mangini A, Gelpi G et al. Is it better to use the radial artery as a composite graft? Clinical and angiographic results of aorto-coronary versus Y-graft Eur J Cardiothorac Surg 2004; 26 :110–117.
  • Tatoulis J, Buxton BF,Completeer JA et al. Bilateral radial artery grafts in coronary reconstruction:technique and early resalts in 261 patients.Ann Thorac Surg 1998;66:714-9
  • Loop FD, Lytle BW, Cosgrove DM, et al: Free (aorta-coronary) internal mammary artery graft: Late results. J Thorac Cardiovasc Surg 1986; 92: 827-31.
  • Calafiore A.M.; Di Giammarco G.; Luciani N et al.Composite arterial conduits for a wider arterial myocardial revascularization Ann Thorac Surg 1994;58:185-90
  • Cosgrove DM, Lytle BW, Loop FD et all. Does bilateral internal mammary artery grafting increse surgical risk? J Thorac Cardiovasc Surg 1988; 95: 850-6.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

FARUK Cıngöz This is me

CELALETTIN Günay This is me

ALPER Ucak This is me

M. ERIN Tüysüz This is me

ERKAN Kuralay This is me

HARUN Tatar This is me

Publication Date January 1, 2005
Published in Issue Year 2005 Volume: 9 Issue: 1

Cite

APA Cıngöz, F. ., Günay, C. ., Ucak, A. ., Tüysüz, M. E. ., et al. (2005). COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS. Koşuyolu Kalp Dergisi, 9(1), 18-24.
AMA Cıngöz F, Günay C, Ucak A, Tüysüz ME, Kuralay E, Tatar H. COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS. Koşuyolu Kalp Dergisi. January 2005;9(1):18-24.
Chicago Cıngöz, FARUK, CELALETTIN Günay, ALPER Ucak, M. ERIN Tüysüz, ERKAN Kuralay, and HARUN Tatar. “COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS”. Koşuyolu Kalp Dergisi 9, no. 1 (January 2005): 18-24.
EndNote Cıngöz F, Günay C, Ucak A, Tüysüz ME, Kuralay E, Tatar H (January 1, 2005) COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS. Koşuyolu Kalp Dergisi 9 1 18–24.
IEEE F. . Cıngöz, C. . Günay, A. . Ucak, M. E. . Tüysüz, E. . Kuralay, and H. . Tatar, “COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS”, Koşuyolu Kalp Dergisi, vol. 9, no. 1, pp. 18–24, 2005.
ISNAD Cıngöz, FARUK et al. “COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS”. Koşuyolu Kalp Dergisi 9/1 (January 2005), 18-24.
JAMA Cıngöz F, Günay C, Ucak A, Tüysüz ME, Kuralay E, Tatar H. COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS. Koşuyolu Kalp Dergisi. 2005;9:18–24.
MLA Cıngöz, FARUK et al. “COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS”. Koşuyolu Kalp Dergisi, vol. 9, no. 1, 2005, pp. 18-24.
Vancouver Cıngöz F, Günay C, Ucak A, Tüysüz ME, Kuralay E, Tatar H. COMPLETE ARTERIAL REVASCULARISATION IN FARUK CINGÖZ, MD, ELDER PATIENTS. Koşuyolu Kalp Dergisi. 2005;9(1):18-24.