Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2018
Review Case ReportsWhat is the optimal target for the second arterial graft in patients undergoing coronary bypass surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the anterolateral or the inferior wall served as a better location for the 2nd arterial graft in a 3-system coronary artery bypass grafting procedure. In total, more than 1800 papers were found, of which 6 represented the best evidence to answer the clinical question. ⋯ All studies demonstrated similar or better mid- and long-term outcomes and patency rates when using the 2nd arterial graft to revascularize left-sided targets when compared with the right. However, all outcomes were similar when comparing non-left anterior descending left-sided targets with non-right coronary artery right-sided targets. Therefore, the right coronary artery itself should probably be avoided as the 2nd arterial target.
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Interact Cardiovasc Thorac Surg · Oct 2018
Outcomes of aortic valve replacement via partial upper sternotomy versus conventional aortic valve replacement in obese patients.
Excellent outcomes after minimally invasive aortic valve replacement (mini-AVR) have been reported. Therefore, mini-AVR has become a popular treatment option in many cardiac surgery centres. However, whether obese patients particularly benefit from mini-AVR remains unclear. The aim of the present study was to evaluate outcomes of AVR performed through partial upper sternotomy compared to AVR through a full sternotomy (full-AVR) in obese patients. ⋯ Patient safety was not affected by mini-AVR. Significant benefits in terms of decreased transfusion requirements, ventilator times and ICU times were found in the mini-AVR group. Consequently, mini-AVR, performed through partial upper sternotomy, should also be routinely offered to obese patients.
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Interact Cardiovasc Thorac Surg · Oct 2018
Observational StudyRisk factors for limb surgical site infection following coronary artery bypass graft using open great saphenous vein harvesting: a retrospective cohort study.
Our goal was to define risk factors for limb (leg) surgical site infections (SSIs) following coronary artery bypass grafting (CABG) with open saphenous vein grafting and to estimate their consequences for patients. ⋯ Leg SSIs following coronary artery bypass surgery are common and associated with morbidity. We suggest reconsidering open saphenous vein harvesting in obese female patients with peripheral vascular disease.