scholarly journals How I deploy arterial grafts

2018 ◽  
Vol 7 (5) ◽  
pp. 690-697 ◽  
Author(s):  
David P. Taggart
Keyword(s):  
Arterial Grafts

scholarly journals How decisive is the number of distal arterial anastomoses in coronary bypass surgery?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Olivier J. L. Jegaden ◽  
Fadi Farhat ◽  
Margaux P. O. Jegaden ◽  
Amar O. Hassan ◽  
Joel Lapeze ◽  
...  
Keyword(s):  
Arterial Graft ◽  
Complete Revascularization ◽  
Prognosis Factor ◽  
Arterial Grafts ◽  
Term Survival ◽  
Late Mortality ◽  
Vessel Disease ◽  
Diabetes Status ◽  
The Impact ◽  
Late Survival

Abstract Background The benefit of arterial revascularization in coronary surgery remains controversial. The incremental value of additional grafts to the left internal thoracic artery (ITA) has been mainly assessed according to the number of arterial grafts, possibly limiting the detection of its actual impact. We analyzed the influence of the number of distal arterial anastomoses (DAA) performed on late mortality in patients having received from one to three arterial grafts. Methods Retrospective review of 3685 primary isolated coronary artery bypass grafting (CABG) performed from 1989 to 2014 was conducted with a 13-year mean follow-up. One arterial graft (SITA) was used in 969 patients, two arterial grafts, ITA or gastroepiploic artery (GEA), in 1883 patients (BITA: 1644; SITA+GEA: 239), and three arterial grafts in 833 patients (BITA+GEA). Totally, 795 patients (22%) received one DAA, 1142 patients (31%) two, 1337 patients (36%) three, and 411 patients (11%) four or more. A sub-group analysis was done in the 2104 patients with 3-vessel disease who received at least 2 arterial grafts. Results In this series the early mortality was 1.6% and it was not influenced by the surgical technique. Late mortality was significantly influenced by age, gender, heart failure, LV ejection fraction, diabetes status, complete revascularization, number of arterial grafts, number of DAA, both ITA, sequential ITA graft, GEA graft. In multivariable analysis with Cox regression model, the number of DAA was the only technical significant independent prognosis factor of late survival (p < 0.0001), predominant over both ITA, complete revascularization and number of arterial grafts. The impact of the number of DAA on survival was found discriminant from 1 to 3; after 3 there was no more additional effect. In 3-vessel disease patients who received at least 2 arterial grafts, the number of DAA remained a significant independent prognosis factor of late survival (p < 0.0001). Conclusions The number of distal arterial anastomoses is an independent predictor of long-term survival, predominant over the number of arterial grafts and the completeness of the revascularization; higher the number, better the late survival. It is a strong support of the extensive use of arterial grafting in CABG.

Attenuation of Flow Disturbances in Tapered Arterial Grafts

1989 ◽  
Vol 111 (4) ◽  
pp. 303-310 ◽  
Author(s):  
R. A. Black ◽  
T. V. How
Keyword(s):  
Pulsatile Flow ◽  
Reynolds Numbers ◽  
Axial Distance ◽  
Pulsed Ultrasound ◽  
Arterial Grafts ◽  
Vascular Prostheses ◽  
Disturbance Intensity ◽  
Flow Disturbances ◽  
Percent Area

Flow disturbances in tapered arterial grafts of angles of taper between 0.5 and 1.0 deg were measured in vitro using a pulsed ultrasound Doppler velocimeter. The increase in transition Reynolds numbers with angle of taper and axial distance was determined for steady flow. The instantaneous centerline velocities were measured distal to a 50 percent area stenosis (as a model of a proximal anastomosis), in steady and pulsatile flow, from which the disturbance intensities were calculated. A significant reduction in post-stenotic disturbance intensity was recorded in the tapered grafts, relative to a conventional cylindrical graft. In pulsatile flow with a large backflow component, however, there was an increase in disturbance intensity due to diverging flow during flow reversal. This was observed only in the 1.0 deg tapered graft. These findings indicate that taper is an important consideration in the design of vascular prostheses.

scholarly journals Infected Arterial Grafts

1970 ◽  
Vol 171 (5) ◽  
pp. 704-714 ◽  
Author(s):  
J. HAROLD CONN ◽  
JAMES D. HARDY ◽  
CARLOS M. CHAVEZ ◽  
WILLIAM R. FAIN
Keyword(s):  
Arterial Grafts

scholarly journals Structural features of arterial grafts important for surgical myocardial revascularization: Part II - Histology of the radial, inferior epigastric, and right gastroepiploic arteries

2015 ◽  
Vol 72 (12) ◽  
pp. 1111-1117
Author(s):  
Borovic Labudovic ◽  
Jelena Kostic ◽  
Sasa Borovic ◽  
Ivan Zaletel ◽  
Sanja Dzelebdzic ◽  
...  
Keyword(s):  
Myocardial Revascularization ◽  
Structural Features ◽  
Arterial Grafts

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