References of "Defraigne, Jean-Olivier"
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See detailDirect Evidence of Free Radical Production after Ischaemia and Reperfusion and Protective Effect of Desferrioxamine: Esr and Vitamin E Studies
Defraigne, Jean-Olivier ULg; Detry, Olivier ULg; Pincemail, Joël ULg et al

in European Journal of Vascular Surgery (1994), 8(5), 537-43

After surgical renal revascularisation, warm renal ischaemia due to renal artery cross-clamping contributes to postoperative renal dysfunction. After reperfusion, free radicals are thought to be a ... [more ▼]

After surgical renal revascularisation, warm renal ischaemia due to renal artery cross-clamping contributes to postoperative renal dysfunction. After reperfusion, free radicals are thought to be a significant cause of injury. Nevertheless, indisputable proof of free radical production is scarce, partly because of their transient nature. In this study, electron paramagnetic resonance and vitamin E levels were used to demonstrate the free radical production after renal ischaemia and reperfusion. Rabbit kidneys were submitted either to 15 or 60 minutes of ischaemia followed by reperfusion. A spin trap agent (alpha-phenyl-N-tert-butyl nitrone (PBN), 20mg/ml, 1 ml/min) was infused during reperfusion directly into the left renal artery via an aortic catheter before declamping. Blood samples were selectively drawn from the left renal vein for ESR analysis (Varian spectrometer E109) of lipidic residues extracted from blood samples. The vitamin E content of the left renal cortex was determined by HPLC procedure. The right renal cortex was used as a control for the vitamin E values. In the venous effluent, ESR analysis revealed the formation of a spectrum consisting of a triplet of asymmetric doublets. This signal resulted from the spin trapping by PBN of a mixture of both oxygen- and carbon- centred lipidic radicals. The amplitude of the signal which is proportional to the amount of free radicals was significantly higher after 60 minutes ischaemia than after 15 minutes.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailTransplantations de tumeurs malignes insoupçonnées lors de greffes d'organes
Detry, Olivier ULg; Detroz, Bernard ULg; D'Silva, M. et al

in Revue Médicale de Liège (1994), 49(1), 23-31

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See detailEvidence for Free Radical Formation During Human Kidney Transplantation
Pincemail, Joël ULg; Defraigne, Jean-Olivier ULg; Franssen, Christine ULg et al

in Free Radical Biology & Medicine (1993), 15(3), 343-8

Fourteen patients undergoing kidney transplantation were studied for evidence of the production of free radicals as assessed by the measurement of vitamin E (an index of lipid peroxidation) and of ... [more ▼]

Fourteen patients undergoing kidney transplantation were studied for evidence of the production of free radicals as assessed by the measurement of vitamin E (an index of lipid peroxidation) and of myeloperoxidase (a marker of neutrophil activation) in the systemic blood. Early (2 min) and late revascularization (30 min) of the kidney were respectively associated with a significant decrease of 35.5 and 40% of the initial level of plasma vitamin E. This consumption paralleled to the decrease of the vitamin E/total lipids ratio, a better indicator of vitamin E status. Heparin administration preceding renal artery clamping resulted in a twofold significant increase of baseline plasma myeloperoxidase (MPO) level (523 +/- 214 ng/ml). At kidney reperfusion, MPO concentration rose again and reached a maximum value of 1,653 +/- 882 ng/ml, indicating the presence of considerable neutrophil activation. A return to the baseline value was observed after 30 min of reperfusion. A short discussion about the possible origin of this MPO increase is given. Taken together, these data strongly suggest that free radical production, leading to lipid peroxidation phenomena, can occur within the early phase of kidney revascularization. Preliminary data using electron spin resonance with the spin-trapping technique strengthen this hypothesis. [less ▲]

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See detailMisdiagnosed Malignancy in Transplanted Organs
Detry, Olivier ULg; Detroz, Bernard ULg; D'Silva, M. et al

in Transplant International (1993), 6(1), 50-4

The case reports of three patients who received cancer-bearing organs at this institution are presented. A fourth recipient, who was to be transplanted with a cancerous kidney, was spared this disastrous ... [more ▼]

The case reports of three patients who received cancer-bearing organs at this institution are presented. A fourth recipient, who was to be transplanted with a cancerous kidney, was spared this disastrous complication. The relevant data regarding the donors is also alluded to, with special reference to the type and site of the primary malignancy. Following these case reports, the implications of these issues, their possible prevention, and further management are discussed. [less ▲]

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See detailAneurysm of the Ascending Aorta after Cardiac Transplantation
Defraigne, Jean-Olivier ULg; Vahdat, Olivier; LAVIGNE, Jean-Paul ULg et al

in Annals of Thoracic Surgery (1992), 54(5), 983-4

We report the case of a 57-year-old female cardiac transplant patient in whom an aneurysm of the recipient side of the ascending aorta developed 1 year after transplantation. Although a mycotic origin was ... [more ▼]

We report the case of a 57-year-old female cardiac transplant patient in whom an aneurysm of the recipient side of the ascending aorta developed 1 year after transplantation. Although a mycotic origin was the likely cause, histologic examination diagnosed an atherosclerotic aneurysm. [less ▲]

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See detailBrachiocephalic Arterial Reconstruction
VAN DAMME, Hendrik ULg; Caudron, D.; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1992), 92(1), 37-45

From 1980 to 1990, 18 patients underwent trans-sternal repair for occlusive disease of the brachiocephalic artery. The mean age was 57 years (43-72). Most of the patients were women (n = 10). All but two ... [more ▼]

From 1980 to 1990, 18 patients underwent trans-sternal repair for occlusive disease of the brachiocephalic artery. The mean age was 57 years (43-72). Most of the patients were women (n = 10). All but two patients had one or more symptoms related to the stenosis of the brachiocephalic trunk: right-sided upper limb ischemia (n = 7), transient ischemic attacks (n = 8), vertebrobasilar insufficiency (n = 6), left sided minor stroke (n = 1). Only two patients were asymptomatic before operation. Angiography revealed a tight stenosis (n = 14) or an occlusion (n = 3); in one patient it concerned an ulcerated non-stenotic plaque of the brachiocephalic artery. Eleven patients had coexistent involvement of other supraaortic vessels. Angiographically, clinically and intraoperatively, there was evidence of Takayasu arteritis in three female patients. All patients had direct repair by trans-sternal approach. Six patients with short lesions had thromboendarterectomy with patch angioplasty of the innominate artery. In eleven cases, aorto-brachiocephalic bypass grafting was performed. In one patient, aortic calcification precluded proximal anastomosis, and a carotid-to-carotid bypass was done. In five patients, simultaneous revascularization of subclavian (n = 3), left common carotid (n = 2) or internal carotid artery (n = 2) completed the procedure. In one patient, concomitant coronary revascularization was done. There was no operative mortality. Postoperative morbidity was limited to pulmonary infection (n = 2), transient neurologic deficit (n = 1) and renal insufficiency (n = 1). All patients had relief of symptoms. Duplex echo scan confirmed patency of all reconstructions at a mean follow-up of 46 months.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailEvidence for free radical generation in ischemia-reperfusion
Franssen, Colette ULg; Pincemail, Joël ULg; Defraigne, Jean-Olivier ULg et al

in Teaching and research in intensive care medicine - Proceeding book (1992)

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See detailAxillounifemoral and Axillobifemoral Bypasses. Retrospective Study of 85 Cases
DUJARDIN, P.; LAVIGNE, Jean-Paul ULg; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1991), 91(4), 155-60

From 1983 to 1990, 65 axillobifemoral and 20 axillofemoral bypasses have been performed in 85 patients (77 men and 8 women), with a mean age of 69 +/- 9 years. Indications for surgery were: severe ... [more ▼]

From 1983 to 1990, 65 axillobifemoral and 20 axillofemoral bypasses have been performed in 85 patients (77 men and 8 women), with a mean age of 69 +/- 9 years. Indications for surgery were: severe aortoiliac occlusive disease (87%), sepsis of previous aortoiliac prosthesis, abdominal aorta aneurysm. Anatomic bypass was precluded for general (81%) or local (19%) conditions. In the last group, 9 patients have had previous laparotomy. Four patients presented with aortoenteric fistulas. Eighteen patients were operated on in emergency. The operative mortality was 12%, with 50% cardiac related deaths. Early primary patency was 98%. Early secondary patency was 100%. The mean follow-up is 28 +/- 15 months. The 3 years survival is 77%. The cumulative patency rates at 1 and 3 years are 89% and 76% respectively. Although axillobifemoral bypasses achieve poor long-term results when compared with aortoiliac bypasses, they can be considered in high risk patients. In this group of patients, the cumulative patency rate and the survival curves tend to be parallel. [less ▲]

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See detailSurgical Management of Left Atrial Myxoma
RADERMECKER, Marc ULg; LAVIGNE, Jean-Paul ULg; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1991), 91(1), 27-31

Although rare, left atrial myxoma is an entity from anatomopathological and clinical aspects. Seven cases of left atrial myxoma operated on the last ten years were reviewed. We also report a rare ... [more ▼]

Although rare, left atrial myxoma is an entity from anatomopathological and clinical aspects. Seven cases of left atrial myxoma operated on the last ten years were reviewed. We also report a rare presentation of right atrial myxoma, where the tumor was responsible of a dramatic hemodynamic shock due to right ventricular inflow obstruction. Six patients were female, with a mean age of 53 years. All but one consulted for exertional dyspnea of recent onset. Two patients with left atrial myxoma and the patient with right atrial myxoma had experienced embolism. Five patients had systemic symptoms. Echocardiography was the most performant diagnostic procedure. All but the patient with right atrial myxoma were operated by the left atrial access. The mitral valve was replaced in two patients. The histological aspect of this benign tumor is illustrated but the lack of frank border between the tumor and the myocardium is emphasized. We conclude that surgical management is primordial. We give anatomopathological rationale for resection of implantation pedicle. The operative mortality was nul in this series of 8 patients; major improvement of cardiac status was constant. No recurrence has occurred during the follow-up period. [less ▲]

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See detailTruncal Vagotomy and Pyloroplasty Combined with Valvular Replacement in Patients with Ulcer Disease
Defraigne, Jean-Olivier ULg; Innocenti, C.; DEKOSTER, Guy ULg et al

in Journal of Cardiovascular Surgery (The) (1991), 32(1), 42-5

In 1988, 5 patients (3 men and 2 women) with ulcer disease (mean age 56 +/- 8 years) underwent valvular replacement for aortic (No. = 4) or mitral disease (No. = 1). All patients had had gastroduodenal ... [more ▼]

In 1988, 5 patients (3 men and 2 women) with ulcer disease (mean age 56 +/- 8 years) underwent valvular replacement for aortic (No. = 4) or mitral disease (No. = 1). All patients had had gastroduodenal ulcers. Preoperative gastroscopy demonstrated active ulcers (No. = 4) and a healed pyloric ulcer with pyloric stenosis (No. = 1). Despite the presence of ulcers, a non-biologic prosthesis was preferred in each patient because of their young age (No. = 3), chronic atrial fibrillation requiring anticoagulant therapy (No. = 1), and refusal of the eventuality of subsequent reoperation (No. = 1). In each patient, a truncal vagotomy with pyloroplasty was performed simultaneously with the valvular procedures by the same incision. The postoperative courses were uneventful. With a mean follow-up of 15 +/- 3 months, no gastrointestinal bleeding was observed during anticoagulant therapy. With anticoagulant drugs, bleeding may occur with a frequency of 4% per patient treatment-year, half of which are gastrointestinal in origin. Nevertheless, in selected patients with gastroduodenal ulcers, performing a vagotomy-pyloroplasty simultaneously with valvular replacement allows implantation of a non-biologic prosthesis, with greater durability than bioprosthesis. [less ▲]

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See detailCardiac Transplantation in Patients Older Than 55 Years
Defraigne, Jean-Olivier ULg; Demoulin, J.C.; VAN DAMME, Hendrik ULg et al

in Acta Chirurgica Belgica (1991), 91(1), 38-42

From 1985 to 1990, 27 patients older than 55 years (extremes 55-65 years; 21 men and 6 women) received a cardiac transplant. The cause of cardiopathy was ischemic in 70%. Postoperative immunosuppressive ... [more ▼]

From 1985 to 1990, 27 patients older than 55 years (extremes 55-65 years; 21 men and 6 women) received a cardiac transplant. The cause of cardiopathy was ischemic in 70%. Postoperative immunosuppressive therapy consisted of Cyclosporin A, steroids, azathioprine and antilymphocytic serum. Rejection episodes were monitored by endomyocardial biopsies and treated by pulses of steroids or monoclonal antibodies (OKT3). The operative mortality is 7.4% (n = 2). The one and two year survivals are 71% and 62% respectively. The incidence of infection and/or rejection were 0.71 +/- 0.4 and 1.4 +/- 0.7 episodes/patient year. Age beyond 55 years does not contraindicate heart transplantation. This change in recipient selection policy should lead to parallel changes in donor selection criteria. [less ▲]

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See detailOstéite sternale et médiastinite après chirurgie de pontage aorto-coronaire
DETROZ, B.; Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Annales de Chirurgie (1991), 45(2), 128-35

Between 1980 and 1987, 31 cases of osteitis (n = 9) and/or mediastinitis (n = 22) were observed after 2,801 consecutive aorto-coronary bypasses (1.1%). Three types of treatment were used: 1) sternal ... [more ▼]

Between 1980 and 1987, 31 cases of osteitis (n = 9) and/or mediastinitis (n = 22) were observed after 2,801 consecutive aorto-coronary bypasses (1.1%). Three types of treatment were used: 1) sternal debridement with osteosynthesis and continuous mediastinal irrigation (n = 25); 2) sternal and mediastinal debridement with open drainage without osteosynthesis (n = 2); 3) incision and debridement of sternal abscesses (n = 4). The overall mortality was 26% (8/31), i.e. 11% (1/9) for isolated osteitis and 32% (7/22) for mediastinitis. Four factors were statistically associated with infection: reoperation for hemorrhage (19.4%, p less than 0.001); preoperative diabetes (25%, p less than 0.001), postoperative low cardiac output (55%, p less than 0.001), postoperative respiratory insufficiency (45%, p less than 0.001). [less ▲]

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See detailIndications actuelles de la greffe hétérotopique en transplantation cardiaque
RADERMECKER, Marc ULg; Defraigne, Jean-Olivier ULg; Limet, Raymond ULg

in Revue Médicale de Liège (1990), 45(12), 614-9

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See detailCardiac Transplantation Beyond 55 Years of Age
Defraigne, Jean-Olivier ULg; Demoulin, J. C.; Beaujean, M. A. et al

in Transplant International (1990), 3(2), 59-61

Between January 1985 and December 1988, 20 patients over the age of 55 years (extremes 56-63 years; 15 men and 5 women) underwent cardiac transplantation. The cause of cardiopathy was ischemic in 70% of ... [more ▼]

Between January 1985 and December 1988, 20 patients over the age of 55 years (extremes 56-63 years; 15 men and 5 women) underwent cardiac transplantation. The cause of cardiopathy was ischemic in 70% of the cases. The immunosuppressive regimen consisted of cyclosporin A, corticoids, and azathioprine. Rejection episodes were monitored by endomyocardial biopsies and treated by pulses of corticoids or monoclonal antibodies (OKT3). The operative mortality was 10% (n = 2). The 1-year survival rate was 70%. The 1-year incidence of infection and/or rejection episodes was 1 and 1.53 episodes/patient, respectively. One patient was successfully retransplanted after 9 months because of intractable rejection. Age beyond 55 years is no longer a contraindication to cardiac transplantation. This change in recipient selection policy should lead to parallel changes in donor selection criteria. [less ▲]

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See detailTumeurs cardiaques primitives: myxomes de l'oreillette gauche
RADERMECKER, Marc ULg; LAVIGNE, Jean-Paul ULg; Defraigne, Jean-Olivier ULg et al

in Revue Médicale de Liège (1990), 45(3), 99-104

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See detailLe remplacement valvulaire mitral pour rupture de pilier mitral post-infarctus. A propos de 13 cas opérés à la phase aigue de l'infarctus
Defraigne, Jean-Olivier ULg; LAVIGNE, Jean-Paul ULg; Remy, D. et al

in Archives des Maladies du Coeur et des Vaisseaux (1990), 83(3), 377-82

Between 1983 and 1988, thirteen patients (12 men and 1 women, average age 63 years) were operated in the acute phase of myocardial infarction for papillary muscle rupture (PMR). The rupture involved the ... [more ▼]

Between 1983 and 1988, thirteen patients (12 men and 1 women, average age 63 years) were operated in the acute phase of myocardial infarction for papillary muscle rupture (PMR). The rupture involved the posterior papillary muscle in 12 cases. The average left ventricular ejection fraction was 47 +/- 9 per cent (range 34 to 63%). Pulmonary capillary pressures ranged from 76 to 41 mmHg (average 35 mmHg). Eleven patients presented with acute pulmonary oedema and 7 had cardiogenic shock. Coronary arteriography showed triple vessel disease in 3 cases, double vessel disease in 7 cases and single vessel disease in 3 cases. Surgery was carried out on average 2.7 days after the rupture and 10 days after the initial infarct. In addition to mitral valve replacement (N = 13), 11 patients underwent a myocardial revascularisation procedure. The operative mortality was 15 per cent (N = 2). Papillary muscle rupture in the acute phase of myocardial infarction causes cardiac failure which is related more to the mechanical abnormality than to an alteration of left ventricular function. Considering the operative mortality and the natural history of PMR treated medically, the authors recommend early surgery as the only management which can improve the precarious haemodynamic status of patients with this complication. [less ▲]

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See detailIntérêts et limites du bypass de l'ileon distal dans le traitement de l'hypercholestérolémie
Defraigne, Jean-Olivier ULg; Pirenne, J.; Swinnen, J. C. et al

in Journal de Chirurgie (1990), 127(2), 76-82

Partial ileal bypass (PIB) was performed in 8 young adults (5 males and 3 females, mean age 37 +/- 5 years) with a history of vascular surgery (aorto-coronary bypass, ACB, n = 6; stroke, n = 2 ... [more ▼]

Partial ileal bypass (PIB) was performed in 8 young adults (5 males and 3 females, mean age 37 +/- 5 years) with a history of vascular surgery (aorto-coronary bypass, ACB, n = 6; stroke, n = 2), presenting with hyperlipidemia (II B: n = 7; IIA: n = 1). None of the patients had diabetes, 2 had mild hypertension, and all were cigarette smokers. Hypolipidemic drugs were discontinued prior to PIB. Following bypass surgery, patients received vitamin B12 injections twice monthly. Total plasma cholesterol (TPC) and total plasma triglycerides (TPT) were assayed at 3 months and 1 year after surgery. The mean follow-up period was 84 months. Mean TPC level was significantly lower (3.96 +/- 0.57 preoperatively vs 2.19 +/- 0.79 (p less than 0.001) and 2.54 +/- 0.76 (p less than 0.01) 3 months and 1 year postsurgery, respectively. Mean TPT level was significantly lower 3 months after the intervention (4.85 +/- 2.37 vs 2.33 +/- 0.62, p. less than 0.02), but not after one year. Similar trends were observed throughout the follow-up period. One of the ACB patients died of drowing, while three others had recurring angina pectoris symptoms. Coronary angiography showed that, despite low TPC levels, coronary artery disease had extended either to other vessels not included in the former bypass, or beyond the anastomoses. Patients with a history of stroke were asymptomatic. PIB is effective in normalizing TPC. Nonetheless, this isolated procedure is insufficient to prevent the evolution of multifactorial atherosclerosis. [less ▲]

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See detailCarotid-Subclavian Bypass with or without Carotid Endarterectomy
Defraigne, Jean-Olivier ULg; Remy, D.; CREEMERS, Etienne ULg et al

in Acta Chirurgica Belgica (1990), 90(5), 248-54

From 1981 to 1987, 29 patients (14 women and 15 men, with a mean age of 56 +/- 15 years) underwent a carotid-subclavian bypass for occlusive lesion of the subclavian artery (or of the left common carotid ... [more ▼]

From 1981 to 1987, 29 patients (14 women and 15 men, with a mean age of 56 +/- 15 years) underwent a carotid-subclavian bypass for occlusive lesion of the subclavian artery (or of the left common carotid artery). The symptomatology included vertebrobasilar insufficiency, arm ischemic symptoms, or combination of both symptoms. Twelve patients (42%) have had a previous transient ischemic attack, or a cerebrovascular accident. There were 22 stenoses or occlusions of the left subclavian artery, and 6 of the right subclavian artery. On arteriography, 9 patients had significant associated lesions on the internal carotid artery, either homolateral (n = 7), or heterolateral, or bilateral. Carotid to subclavian bypasses were performed either with autogenous saphenous vein (n = 15), or with prosthetic graft (n = 14). In 5 cases, a carotid endarterectomy was done simultaneously to the bypass. Operative mortality was 3.4% (1/29). Early patency (less than 1 month) was 97% and late patency 89%, with a mean follow-up of 40 +/- 24 months. The patency rates were not significantly different whether a prosthesis or a vein was used for the bypass. All patients were improved and complete relief of symptoms was achieved in 92%. No patient experienced symptoms of carotid steal after the bypass. We concluded that carotid-subclavian bypass is a safe and efficient method for revascularization of the subclavian artery of of the left common carotid artery in selected cases. [less ▲]

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See detailChirurgie coronarienne et carotidienne en simultané: à propos de 73 cas
VAN DAMME, Hendrik ULg; CREEMERS, Etienne ULg; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1990), 90(4), 185-96

A series of 73 simultaneous carotid and coronary revascularizations (Group I) is presented (January 1980-December 1988). Age, sex, risk factors, severity of angina, coronarography, neurological symptoms ... [more ▼]

A series of 73 simultaneous carotid and coronary revascularizations (Group I) is presented (January 1980-December 1988). Age, sex, risk factors, severity of angina, coronarography, neurological symptoms, angiographic carotid lesions and operative outcome of these 73 patients are compared with the aspects of 3544 coronary bypass patients (Group II) and 1001 carotid endarterectomized patients (Group III) during the same period. The angina in Group I is more severe, with 22% belonging to NYHA class IV and 26% having a stenosis of the left main coronary artery, vs 14% and 13% in Group II. Seventy percent of the carotid lesions in Group I are asymptomatic vs 33% in Group III. Group I patients had more problems in the perioperative period, with 16.4% needing prolonged high-doses analeptics and 5.4% intraaortic counterpulsation balloon. Operative mortality is higher (7%) in Group I compared with Group II (2.3%) and Group III (1.7%). These results permit to define a population of polyvascular patients with concomitant coronary and carotid disease, characterized by a more diffuse atherosclerosis and a higher operative risk. Operative morbidity and mortality after combined myocardial and cerebral revascularization remains nevertheless inferior to the cumulated surgical risk of the sequential procedures (74 patients with coexistant coronary and carotid lesions operated in two sessions before 1986). [less ▲]

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