Touch the Plaque Open Technique of LAD Endarterectomy During CABG Surgery Guarantees Fair Postoperative Outcome and Preserved LV Functional Performance
Notice bibliographique
Résumé
Background: The rising number of severely diffused diseased left anterior descending (LAD) coronary artery (which is the most important target) met during coronary artery bypass grafting (CABG) surgeries represents a chal-lenging test to the cardiac surgeon and requires a more complex maneuvers rather than simple distal segment arteriotomy anastmosis in order to secure complete myocardial revascu-larization which is the main goal of the surgery. Touch the plaque open technique of LAD endarterectomy combined with left internal thoracic (mammary) artery (LIMA) patch plasty is one of the available solutions.Aim of Study: Impact of application of touch the plaque open technique of LAD endarterectomy combined with LIMA patch plasty on the postoperative outcome, left ventricular (LV) function and clinical status of the patients is evaluated.Patients and Methods: This retrospective observational non-randomized study included 21 patients who presented with ischemic heart disease (IHD) requiring primary surgical myocardial revascularization (primary CABG surgery). In-cluded patients are those with multi-vessel coronary artery disease, left main or left main-equivalent coronary artery disease and one or two coronary artery disease. They had anginal pain grade III according to Canadian Cardiovascular Society (CCS) grading of angina pectoris. Intraoperatively they had long segment-diffusely diseased LAD that was dealt with touch the plaque open technique of LAD endarterectomy combined with LIMA patch plasty. Postoperative mortality, morbidity outcomes, LV function, overall hospital complica-tions, haemodynamic and functional clinical status, and overall one-year survival were evaluated.Results: Mean age was 58.23±7.54 years. Female patients represented 42.85%. The overall hospital complication rate was 28.57%. No mortality happened during the follow-up period (overall one-year survival rate was 100%). Preoperative mean LVEF% was 46.3±3.7% (range 37-59%). Evident im-provement in both clinical status and LVEF% was observed. Prior-to-hospital discharge LVEF% showed mild improvement with a mean 50.1±1.3% (p>0.05) and at one-year follow-up showed significant improvement with a mean 57.5±3.4% (p<0.05). 85.71% were in CCS grade I at one-year follow-up (p<0.01).Conclusion: Touch the plaque open technique of LAD endarterectomy combined with LIMA patch plasty provides satisfactory operative and postoperative results without adding more burden to the surgery. It secures complete revasculari-zation of the LAD myocardial territory and improvement of the LV function and resultant improvement of the clinical and haemodynamic status of the patients. Utilization of LIMA patch plasty and strict anticoagulation management postoper-atively is highly recommended.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».