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Y Wanibuchi

Publications and source records attributed to Y Wanibuchi.

129 records · Page 8Linked to original sources
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Bovine internal thoracic artery graft. Successful use at urgent coronary bypass surgery.

Bovine internal thoracic artery grafts (Bioflow) were successfully utilized in two patients for emergency coronary artery bypass grafting (CABG). One patient was an 80-year-old man with severe varicose veins and a calcified ascending aorta. Heart failure occurred after triple CABG with bilateral internal thoracic and gastroepiploic arteries. The addition of a Bioflow graft to the circumflex artery restored good cardiac function. The second case was a 54-year-old man whose patent old saphenous vein graft was accidentally injured at reoperation. Emergency use of the Bioflow to bypass the right coronary artery in combination with the right gastroepiploic artery graft to the anterior descending artery resulted in an excellent outcome. The two Bioflow grafts were patent at the 20th and 10th postoperative days, respectively. These cases strongly suggest the efficacy of Bioflow during emergency situations in CABG.

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[Outcome of coronary angioplasty and coronary artery bypass grafting in patients over 75 years old].

Mortality, morbidity, and 3-year survival rates were evaluated in patients aged over 75 years undergoing initial revascularization by percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG). The groups of 74 patients undergoing PTCA and 27 undergoing CABG had similar clinical characteristics including age, sex, emergency operation, prior myocardial infarction, and ejection fraction. The PTCA group contained significantly more patients with single vessel disease (44% vs 8%, p < 0.01) while the CABG group had more three-vessel or left main trunk disease (30% vs 70%, p < 0.01). The patients in the PTCA group demonstrated more prior cerebral vascular events, renal insufficiency, and abdominal aortic aneurysms. Angiographic revascularization was achieved in 112 of 130 lesions (86%) and in 63 of the 74 (84%) patients in the PTCA group. Hospital mortality for the PTCA group was 5.4% (two cardiac deaths and two non-cardiac deaths), but 0% for the CABG group. Myocardial infarction occurred in 1.3% and 3.7%, respectively (p = NS). Three-year survival, excluding hospital deaths, was 90% for patients with PTCA and 96% for those with CABG (p = NS). All these deaths were of non-cardiac origin. Both PTCA and CABG are safe and effective for selected patients over the age of 75 years.

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