Journal of the American College of Surgeons
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Malignant cutaneous adnexal tumors (MCATs) are rare and their natural history is poorly understood. Available literature indicates aggressive behavior with a significant risk of metastasis. ⋯ Despite the historical impression that MCATs have a high metastatic potential, most patients have low recurrence rates and excellent 5-year survival rates. Lymphatic disease identified after SLNB in early-stage tumors is rare and the value of this staging procedure in MCAT remains unclear.
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Use of multiple arterial grafts (MAGs) provides superior patency and long-term survival benefit compared with venous grafts during coronary artery bypass grafting (CABG). However, MAGs are used infrequently for CABG. We hypothesized that specific measures introduced at our institution would lead to an increase in the use of MAGs. ⋯ A programmatic emphasis on the use of MAGs for CABG is an effective method to increase its use.