By Ludwig K. von Segesser M.D., F.A.C.S. (auth.)

With an enormous heritage of private event and a evaluate of greater than three hundred references, Dr. Segesser has written a ebook to shut the space among the idea and perform of coronary artery revascularization. particularly, he indicates the probabilities and obstacles of inner mammary artery grafting during this surgery. The chapters consultant you to a radical figuring out of the topic, from anatomy and pathology, to experimental reviews and the historical past of first surgical makes an attempt, to medical program and effects. The dialogue of long term follow-up, issues and re-operations aspect to parts of luck in addition to topics for destiny study. the main points supplied the following approximately operative techniques and their results provide the cardiovascular surgical crew very important suggestions approximately current practices with a view to support bring about better scientific effects.

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Additional info for Arterial Grafting for Myocardial Revascularization: Indications, Surgical Techniques and Results

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1967) and Urschel and Morales (1967). 1 Free Internal Mammary Artery Grafts (Canine Experiments) Free internal mammary artery grafts as canine femoral artery substitutes have been analyzed by Aarnio (1988). Both left and right internal mammary arteries were dissected free in six dogs, the left together with 2 cm wide surrounding tissue and the right as a naked artery. Free internal mammary artery grafts (3 cm long) were anastomosed end-to-end to the femoral arteries as femorofemoral graft. At 6 months all grafts were patent.

Rings with and without endothelium were suspended in organ chambers and isometric tension was recorded. 005). In the internal mammary artery, the relaxations were greatest with acetylcholine (98 % ± 2 %). The maximal response to thrombin was 44 % ± 7 % and to adenosin diphosphate 39 % ± 8 %. In the saphenous vein, the relaxations were below 15% with either agonist. 01 respectively) and hemoglobin, indicating that the response was mediated by endothelium derived relaxing factor. Endothelium-independent relaxations to sodium nitroprusside were comparable in the mammary artery and the saphenous vein.

1 Autologous Alternative Graft Materials Besides the greater saphenous veins which have been used in thousands of patients for successful coronary artery revascularizations (Collins et al. 1973; Cameron et al. 1979; Loop et al. 1979; Kennedy et al. 1980; Braunwald 1983; Hahn 1983) and the lesser saphenous veins which have been used as complementarily, armveins have been used in the absence of sufficient saphenous veins. However, armveins have a much thinner vessel wall than saphenous veins and are known for accelerated attrition in the arterial environment (Schulman and Bradhey 1982).

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