Objective: To assess the 20-year results of emergency coronary artery bypass grafting (eCABG) for failed percutaneous coronary angioplasty (fPTCA). Methods: Between 1977 and 1997, 101 patients, (56±5)years (32 to 78 years), underwent eCABG (8.5±25) hours (1 to 168 hours) after fPTCA. The mean preoperative left-ventricular ejection fraction was (57±9)% (30 to 75%). Single-vessel disease (SVD) was found in 55%, two-vessel disease (TwVD) in 39% and triple-vessel disease (TrVD) in 15% of patients, with the left anterior descending coronary artery (LAD) being affected in 74%. 15% of patients had full cardiopulmonary resuscitation prior to eCABG. Results: The incidence of eCABG for fPTCA dropped from 29% (1977-82) to 6% (1983-87), 0.02% (1988-92) and to 0.004% (1993-97) (P=0.000). Patients mean age increased from (50±10) (1977-82) to (62±10) years (1993-97) (P=0.0001). The incidence of TrVD increased from 4% (1977-82) to 68% (1993-97) (P=0.0001), the LAD being dilated in 76% of patients between 1977-82 and in 36% between 1993-97 (P=0.009). Hospital mortality for eCABG was 5% and was stable over time. The use of the left internal mammary artery increased from 8% (1977-82) to 54% (1993-97) (P=0.006). After (14±4) years (1 to 20 years), the actuarial survival was (84±8)%, freedom from myocardial infarction (70±11)% and freedom from reoperation (58±17)%. Conclusion: PTCA has become a safe procedure despite the higher incidence of older patients with TrVD. eCABG for fPTCA carries an acceptable mortality with off-pump coronary artery surgical techniques already applie two decades ago. Patients surviving surgery have an excellent long-term survival.

Objective:To analyze the feasibility of detecting Ph1 in leukemia patients in the Kinshasa University Clinics in the Democratic Republic of Congo,at KU Leuven,Belgium.Methods:Bone marrow and peripheral blood samples with chronic myeloid leukemia,acute myeloid leukemia or acute leukocytes leukemia were obtained from 32 patients in Kinshasa University clinics in the Democratic Republic of Congo and transferred to KU Leuven in Belgium for iFISH feasibility.Ph1 was detected by using a remote analysis of interphase fluorescence in situ hybridization (iFISH).Results:Out of the 32 patients involved in this study,65.6％ (n =21) of the cases were successfully tested,of which 52.4％ (n =11) were iFISH positives for the variant t(9;22)(presence of Ph1) in chronic myeloid leukemia samples and 47.6％ (n =10) negatives in all subtypes of hematological malignancies.However,there was a female predominance in chronic myeloid leukemia samples Phi-positives by iFISH,whereas no sexual influence was observed on acute subtypes of leukemia.Conclusions:iFISH analysis is feasible on samples obtained from remote sites in the Democratic Republic of Congo.However,the optimization of the sample storage is necessary to further improve iFISH's performance.

Objective To analyze the feasibility of detecting Ph