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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 February;40(1):15-20

VASCULAR PAPERS 

    ORIGINAL ARTICLES

Trans­tho­racic recon­struc­tions of the innom­i­nate ­artery ­with ath­e­ros­cle­rotic occlu­sions

Guirov K., Lazarov Z., Topalov I., Magaev B.

From the ­Clinic of Vas­cular Sur­gery and Angi­ology Mil­i­tary Med­ical ­Academy, ­Sofia, Bul­garia

Back­ground. Lit­er­a­ture ­reports con­cerning trans­tho­racic recon­struc­tive oper­a­tions of the innom­i­nate ­artery (IA) are ­rare.
­Methods. Six men and one ­woman ­aged ­from 48 to 64 ­years ­were oper­ated on - all of ­them had ath­e­ros­cle­rotic IA ­lesions. ­Some of ­them had addi­tional vas­cular dis­ease ­such as cor­o­nary ath­e­ros­cle­rotic ­lesions in one ­patient, ­another one had ­chronic arte­rial ­ischemia (CM) of the ­lower extrem­ities and one ­patient under­went a ­stroke. All the ­patients had ­some neu­ro­log­ical symp­toms (head­ache, diz­zi­ness) and ­chronic arte­rial insuf­fi­ciency of the ­right arm, ­five ­patients had clin­i­cally and arte­ri­o­graph­i­cally ­detected sub­cla­vian ­steal syn­drome (SSS) ­with ver­teb­ro­bas­ilar symp­toms (­ataxia and syn­cops). Periph­eral arte­rial pres­sure (PAP) of ­both ­arms ­gave a dif­fer­ence ­from 30 to 80 ­mmHg. Aor­toar­ter­i­o-graphy ­showed one sten­osis and 6 throm­boses of the IA, the ­left ­common ­carotid ­artery (­LCCA) was ­affected in two ­cases. All oper­a­tions ­were ­done ­through a lon­gi­tu­dinal ster­notomy con­tinued by cer­vi­cotomy. In one ­patient an endar­te­rec­tomy (EA) of IA was ­done. In six ­patients a ­bypass oper­a­tion was performed. The ­ascending ­aorta was ­used for ­inflow. The ­distal anas­to­moses ­were ­with the ­distal ­part of the IA, in two ­patients, ­with the ­right sub­cla­vian ­artery (RSA) and the ­right ­common ­carotid ­artery (­RCCA) in two ­patients and ­with RSA, ­RCCA and ­LCCA in two ­cases.
­Results. ­There was no oper­a­tive or post­op­er­a­tive mor­tality, the post­op­er­a­tive com­pli­ca­tions ­were per­i­car­ditis and pneu­monia. The ­patients ­were ­observed for a ­period of 18 ­months to 10 ­years. The use of Dop­pler-con­trol pro­vided ­patency ­data of arte­rial ­grafts in all the ­patients. One ­patient ­died of a ­heart ­attack ­five ­years ­after sur­gery, ­another had an ­ischemic ­stroke of the ­left hem­i­sphere ­four ­years ­after sur­gery.
Con­clu­sions. The ­authors con­sider ­that trans­tho­racic IA recon­struc­tions, ­although ­being trau­matic, ­give ­good ­early and ­long-­term ­results.

language: English


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