1. The most ideal replacement for a small calibre artery segment is a similar sized autogenous arterial conduit. 2. Autogenous venous segments, although functional replacements for small calibre arteries, undergo structural changes which may prove detrimental to function. 3. At this stage of their development, fabric grafts cannot be considered as adequate replacements for small calibre arteries.

Animals↗

PubMedDate not supplied

A five year study of the incidence of valve-related complications with the Omniscience cardiac prosthesis.

A total of 228 Omniscience cardiac valve prostheses were implanted in 210 patients at two hospitals in Canada from November, 1979 to August, 1984. The 184 operative survivors were followed for a mean duration of 28.5 months (maximum 62.7 months) and for a total of 438 patient-years. Actuarial analysis for AVR, MVR, and all patients showed survival probabilities at five years of 97.2%, 98.9%, and 97.0% respectively. The five-year actuarial probabilities of remaining free of any thrombotic complications were 96.9% for AVR, 96.4% for MVR, and 95.7% overall. When considering only serious thrombotic complications (thromboembolism with deficit or valve thrombosis), the event-free rates are 100% for AVR, 98.9% for MVR, and 98.6% for the overall patient group at five years. These rates for survival and freedom from thrombotic complication demonstrate the clinical safety and effectiveness of the Omniscience prosthesis. In addition, there were no cases of structural failure or intrinsic mechanical malfunction of the prosthesis.

Anticoagulants↗

PubMedDate not supplied

Computerized database for coronary bypass surgery.

A computer-assisted system has been developed to store, retrieve and analyze medical and surgical data on patients undergoing coronary bypass surgery. The analysis ranges from a simple summary tabulation to a more advanced prognostic evaluation of the risk of coronary bypass in an individual candidate for the operation. Data can be displayed on the terminal's screen or printed in a hard copy and used for clinical or administrative purposes. The system can be operated with no knowledge of computers or programming and requires only minimal typing skills.

Aged↗

PubMedDate not supplied

The changing clinical profile of coronary artery bypass graft patients, 1970-89.

OBJECTIVE: To review the changing clinical profile of isolated coronary artery bypass graft (CABG) surgery patients at the University of Alberta Hospitals during the past two decades. DESIGN: Data were obtained retrospectively by review of patients' hospital charts and cardiologists' charts. The three patient cohorts consisted of the first 411 consecutive patients who underwent isolated CABG surgery between 1970 and 1974, 302 consecutive patients who had CABG surgery in 1984 and 346 consecutive patients who had the operation in 1989. RESULTS: Patients who underwent CABG surgery in 1984 and 1989 were older than patients undergoing the same operation in the 1970s. Emergency and/or urgent operations and the number of patients with prior myocardial infarct were increased significantly in 1984 and 1989. The incidence of patients with multiple vessel disease and left main stem stenosis increased significantly over the two decades. The number of bypass grafts per patient and the use of internal mammary grafts have increased since 1970. The endarterectomy procedure was performed less frequently in 1984 and 1989. The use of radial artery grafts has been discontinued. Perioperative mortality remained stable throughout the study period despite an increasing incidence of high risk patients. The major cause of death was pump failure. The incidence of peripostoperative myocardial infarct was higher in the 1970s. A multivariate analysis of the 1984 and 1989 cohorts was performed to identify temporal trends in risk factors. Emergency surgery, preoperative heart failure, age (older than 65 years), prior CABG surgery and preoperative renal failure are significant predictors of operative motility. CONCLUSIONS: The clinical profile of patients for isolated CABG surgery has changed over the years. The mortality rate has been stable over two decades despite the advancement of medical and surgical practices, representing a balance of increasingly high risk patients presenting for CABG surgery.

Adult↗