The Journal of thoracic and cardiovascular surgery · 2009
Midterm outcomes of myocardial revascularization in children.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Viola Nicola, Alghamdi Abdullah A, Al-Radi Osman O, Coles John G, Van Arsdell Glen S, Caldarone Christopher A
Аннотация
OBJECTIVE: Pediatric coronary artery bypass grafting is uncommon. Small target vessels and appropriate conduit choice are the main technical challenges.
METHODS: Fourteen patients undergoing coronary artery bypass grafting from January 1986 to December 2008 were retrospectively reviewed.
RESULTS: Median age was 10 years (range, 3-15 years); median weight was 36 kg (range, 12-71 kg). Indications included symptoms or evidence of inducible ischemia and angiographically documented coronary stenosis. Diagnoses included Kawasaki disease (5/14), anomalous left coronary artery originating from the pulmonary artery (2/14), previous stent implant (1/14), and metabolic disease (3/14). The remaining 3 patients had coronary stenosis after other cardiac operations. Preoperatively 5 patients (45%) had no symptoms and 9 (64%) had positive stress test. Single-vessel disease was demonstrated in 2 (14%), double-vessel disease in 7 (50%), triple-vessel disease in 1 (7%), and left main coronary artery involvement in 4 (29%). With standard cardiopulmonary bypass, 18 (81%) in situ internal thoracic arteries and 4 (19%) long saphenous veins were grafted. There was 1 early reoperation for graft failure. All patients survived to hospital discharge. Follow-up angiography was performed in 5 patients (36%; median, 2 years; range, 1 day-10 years), and 1 (7%) required late balloon dilatation. Median follow-up was 3.3 years (1 month-10 years), and 12 patients had no symptoms. There was 1 late death of noncardiac cause.
CONCLUSIONS: Pediatric coronary artery bypass grafting can be performed for a wide range of indications. Midterm results are excellent. Preoperative stress testing can detect silent myocardial ischemia.
METHODS: Fourteen patients undergoing coronary artery bypass grafting from January 1986 to December 2008 were retrospectively reviewed.
RESULTS: Median age was 10 years (range, 3-15 years); median weight was 36 kg (range, 12-71 kg). Indications included symptoms or evidence of inducible ischemia and angiographically documented coronary stenosis. Diagnoses included Kawasaki disease (5/14), anomalous left coronary artery originating from the pulmonary artery (2/14), previous stent implant (1/14), and metabolic disease (3/14). The remaining 3 patients had coronary stenosis after other cardiac operations. Preoperatively 5 patients (45%) had no symptoms and 9 (64%) had positive stress test. Single-vessel disease was demonstrated in 2 (14%), double-vessel disease in 7 (50%), triple-vessel disease in 1 (7%), and left main coronary artery involvement in 4 (29%). With standard cardiopulmonary bypass, 18 (81%) in situ internal thoracic arteries and 4 (19%) long saphenous veins were grafted. There was 1 early reoperation for graft failure. All patients survived to hospital discharge. Follow-up angiography was performed in 5 patients (36%; median, 2 years; range, 1 day-10 years), and 1 (7%) required late balloon dilatation. Median follow-up was 3.3 years (1 month-10 years), and 12 patients had no symptoms. There was 1 late death of noncardiac cause.
CONCLUSIONS: Pediatric coronary artery bypass grafting can be performed for a wide range of indications. Midterm results are excellent. Preoperative stress testing can detect silent myocardial ischemia.