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Integrated coronary revascularization with drug-eluting stents: immediate and seven-month outcome


, : Integrated coronary revascularization with drug-eluting stents: immediate and seven-month outcome. Journal of Thoracic and Cardiovascular Surgery 131(5): 956-962

We sought to demonstrate the safety and feasibility of an integrated coronary revascularization strategy that combines minimally invasive left internal thoracic artery to left anterior descending coronary artery anastomosis with drug-eluting stent implantation to non-left anterior descending coronary artery lesions. Over 18 months, 47 consecutive patients with multivessel coronary artery disease underwent thoracoscopic harvesting of the left internal thoracic artery to graft the left anterior descending coronary artery. Anastomoses were constructed by hand, off-pump, and under direct vision through a 4-cm non-rib-spreading, muscle-sparing chest incision. Non-left anterior descending coronary artery lesions were then treated percutaneously using sirolimus- or paclitaxel-eluting stents. Angiographic follow-up was performed in all patients. Within the first 90 days of hospitalizations, there were no deaths, myocardial infarctions, neurologic events, or wound complications. Forty patients underwent left internal thoracic artery to left anterior descending coronary artery grafting, and 7 patients underwent left internal thoracic artery to left anterior descending coronary artery/diagonal sequential grafting for a total of 54 anastomoses. Angiographic patency scores were FitzGibbon A 96.2% (52/54) and FitzGibbon A + B 100% (54/54). A total of 65 drug-eluting stents were implanted in 61 non-left anterior descending coronary artery coronary lesions of which 49.1% (30/61) were type B2 or C lesions, including 5 left main lesions. Diabetes was present in 53.2% of patients (25/47). At a mean follow-up time of 7.0 +/- 4.8 months, the target lesion or vessel repeat revascularization rate was 6.6% (4/61) for drug-eluting stents and 1.9% (1/54) for left internal thoracic artery to left anterior descending coronary artery grafting. One anastomosis required balloon dilation, but no patients have required repeat coronary artery bypass grafting. Integrated coronary revascularization using drug-eluting stents is feasible and safe. There are sufficient data to justify a randomized comparison of integrated coronary revascularization with standard coronary artery bypass grafting.

US$19.90

PMID: 16678575

DOI: 10.1016/j.jtcvs.2005.10.058


Other references

Ochoa E.; Puente F.; Cervantes F.; Hinojosa O.; Avila R., 1981: Suture obliteration of ductus arteriosus in premature children surgical considerations. Surgical treatment of patent ductus arteriosus in 10 premature newborn patients with cardiac insufficiency and/or respiratory distress syndromes studied. Technical factors including the use of local anesthesia are discussed. The post-operative car...

Honaramooz, A.; Cook, S.J.; Beard, A.P.; Bartlewski, P.M.; Rawlings, N.C., 1999: Nitric oxide regulation of gonadotrophin secretion in prepubertal heifers. Mechanisms responsible for the pulsatile release of gonadotrophin secretion in prepubertal heifers are not fully known. We have shown that an excitatory amino acid agonist, N-Methyl-D,L-aspartic acid (NMA), induces an immediate release of luteiniz...

Body, S.; Couper, G., 2015: You can't get there from here without more robust data. Journal of Thoracic and Cardiovascular Surgery 148(6): 3125-3126

Gordon, N., 1994: Ophthalmoplegia in childhood. Developmental Medicine and Child Neurology 36(4): 370-374

Spuler, Arnold., 1907: Die Schmetterlinge Europas. 3. Aufl. von E. Hofmanns gleichnamigem Werke. Lfg 33-37. Unknown

Gehrz, R.C.; Peterson, E.S.; Liu, Y.N., 1988: Immune mechanisms in congenital cytomegalovirus infection: activation of CMV-specific T helper cells (CMV-Th) by exogenous IL-2. Infants with congenital CMV infection have a specific defect in CMV-induced lymphocyte proliferation, providing a model for investigation of mechanisms of viral immune recognition and immune response. In the present study the possible role of a de...

Gustafson, S.J.; Ricketts, T.A.; Tharpe, A.Marie., 2017: Hearing Technology Use and Management in School-Age Children: Reports from Data Logs, Parents, and Teachers. Consistency of hearing aid and remote microphone system use declines as school-age children with hearing loss age. One indicator of hearing aid use time is data logging, another is parent report. Recent data suggest that parents overestimate their...

Bragazza, L.; Gerdol, R., 2002: Are nutrient availability and acidity-alkalinity gradients related in Sphagnum-dominated peatlands?. Gradients in acidity-alkalinity and nutrient availability were studied in 2 Sphagnum-dominated peatlands on the southeastern Italian Alps, province of Bolzano. Decreasing concentrations of most mineral elements (Ca2+, Mg2+, Mn2+, Al3+ and Si4+) in...

Rajan, A.R., 1995: Relative utilisation of different zinc carriers in wetland rice (Oryza sativa). In a greenhouse experiment rice cv. IR 50 was grown in Madukkur series (Udic Haplustalf) and Nedumbalam series (Entic Chromustert) soils and given ZnSO4 (23% Zn), ZnSO4 + ammonium polyphosphate (APP), zincated urea (2% Zn) or zincated diammonium p...

Kojis, T.L.; Heinzmann, C.; Flodman, P.; Ngo, J.T.; Sparkes, R.S.; Spence, M.A.; Bateman, J.B.; Heckenlively, J.R., 1996: Map refinement of locus RP13 to human chromosome 17p13.3 in a second family with autosomal dominant retinitis pigmentosa. In order to elucidate the genetic basis of autosomal dominant retinitis pigmentosa (adRP) in a large eight-generation family (UCLA-RP09) of British descent, we assessed linkage between the UCLA-RP09 adRP gene and numerous genetic loci, including e...