The Annals of thoracic surgery
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Comparative Study
Comparison of late coronary artery bypass graft survival effects of radial artery versus saphenous vein grafting in male and female patients.
This study aimed to compare the survival benefit derived from using radial artery (RA) as a second arterial conduit in combination with internal thoracic artery (ITA), as opposed to ITA plus saphenous vein (SV) in men and women. ⋯ Late survival results suggest that male and female CABG patients benefit appreciably from use of RA as a second arterial conduit in combination with ITA. Yet, the late survival advantage derived from RA use was relatively less for women. This sex variance in benefit likely reflects differences in risk profiles of male and female CABG patients.
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Penetrating trauma has increased in developed and urban environments. Pulmonary artery injury is rare, but can be associated with significant morbidity. ⋯ The patient had active great vessel bleeding and required extensive surgical intervention. Clinicians should have a high index of suspicion for life-threatening thoracic injuries following a stab injury to the chest, despite initial clinical stability or negative baseline radiological findings.
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Arch reconstruction is a key part of the Norwood operation for hypoplastic left heart syndrome and is related to late morbidity. Since 2003, our surgical technique has been standardized to a right ventricle to pulmonary artery conduit, arch reconstruction with homograft patch, and Damus-Kaye-Stansel anastomosis onto homograft patch, with partial or complete resection of any coarctation ridge. We studied the impact of the surgical approach on arch reinterventions and outcome. ⋯ Our standard technique for the Norwood operation has good results but further intervention for recoarctation is common. Size of ascending aorta and incomplete resection of coarctation tissue were risk factors for recoarctation. Complete resection of coarctation tissue may reduce the incidence of recoarctation. A small ascending aorta may predict late arch problems.