Arterial patch angioplasty for reconstruction of proximal coronary artery stenosis

Surgical angioplasty of the left main coronary artery and/or proximal segment of the right coronary artery by pulmonary autograft patch

“…The encouraging results have been achieved with the use of autoarterial patches harvested from the distal segment of the left internal mammary artery [22] or proximal segment of the right internal mammary artery [5,23] but the number of these cases is small and the follow-up results are not yet assessed. At the same time, the width of the internal mammary artery patch may be insufficient to perform a safe extensive patch angioplasty of LMCA.…”

“…There are still controversial opinions about the expediency of the performance of this procedure in rare cases of isolated lesion of LMCA/RCA or with limited involving distal coronary branches [3,4]. One of the fears giving doubt in the possibility of a reliable performance of the surgical angioplasty is the uncertainty in longevity of patch materials [5]. It is supposed that the autovein has tendency to proliferative degeneration similar to that in case of coronary artery bypass grafting (CABG) [6] or to dilating because of its natural elasticity [7].…”

Pediatric Applications of Surgical Patch Angioplasty of the Main Coronary Trunks

“…Most recently, Liska et al proposed their transaortic approach in which the aorta is divided and mobilized anteriorly, again with the aim of improving visualization and facilitating patch reconstruction. 5 These techniques have had limited modification in their application to the pediatric population. After median sternotomy, bicaval cardiopulmonary bypass (CPB) is established and cardioplegic arrest achieved.…”

Re-implant of the right coronary artery: a surgical technique for the treatment of ostial lesions

“…Surgical techniques for the treatment of ostial lesions of the coronary arteries, with the exception of endarterectomy [1], utilize patches of autologous tissue (bovine pericardium) [2,3] or homologous (saphenous vein [4] or internal thoracic artery [5]) to reconstruct the affected ostium. The utilization of homologous or autologous tissue patches helps intimal hyperplastia, thrombosis and calcification, compromising the immediate and / or late results.…”