Challenges associated with treatment of left internal mammary artery graft thrombosis

Xenogiannis, Iosif; Vemmou, Evangelia; Nikolakopoulos, Ilias; Brilakis, Emmanouil S.

doi:10.1002/ccd.28322

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Основными причинами возврата стенокардии в общей группе были: дисфункция шунта (77%) и прогрессирование атеросклероза в нативных коронарных артериях (КА) (23%) [5]. По данным литературы, основными причинами развития дисфункции маммарного шунта являются тромбоз, прогрессирование атеросклероза, разрыв шунта, а также его сдавление опухолью, искусственным водителем ритма, посттравматической гематомой [6][7][8][9][10].…”

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“…В настоящем сообщении описывается случай развития повторного инфаркта миокарда передней стенки левого желудочка (ЛЖ) в связи с окклюзией маммарного шунта к ПМЖВ ЛКА. [6][7][8]11]. Проведение повторной открытой реваскуляризации показано в случае ранней недостаточности шунта (свежий анастомоз, сложная анатомия или извилистый ход шунта, а также выполнение рестернотомии по некоронарным причинам) [12].…”

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A clinical case of myocardial infarction after coronary artery bypass grafting using the internal mammary artery

Zakharyan,

Shatov,

Grigoriev

et al. 2023

Bûll. sib. med.

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Coronary artery bypass grafting (CABG) is the most preferred method of myocardial revascularization in multivessel coronary artery disease and severe progressive forms of the disease. The material of choice for CABG of the left anterior descending artery (LADA) is the internal mammary artery (IMA). However, even when using IMA as a conduit for CABG, one should be aware of a possibility of graft failure, which indicates a need for constant vigilance in this category of patients. Endovascular interventions on coronary arteries make it possible to efficiently and safely revascularize an occluded bypass graft, minimizing existing risks and improving both the quality of life of patients and their subsequent survival. The article considers a clinical case of the development of recurrent anterior myocardial infarction in the patient due to occlusion of the mammary graft to the LADA.

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A clinical case of myocardial infarction after coronary artery bypass grafting using the internal mammary artery

Zakharyan,

Shatov,

Grigoriev

et al. 2023

Bûll. sib. med.

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Current challenges and prevention strategies for chronic total occlusion (CTO) complications

Karácsonyi

Vemmou

Nikolakopoulos

et al. 2021

Expert Review of Cardiovascular Therapy

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Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

Zhuo¹,

Zhang²,

Shen³

et al. 2022

WJCC

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BACKGROUND Myocardial infarction is one of the most common types of coronary heart disease. It is mainly caused by the rupture of coronary atherosclerotic plaque, which leads to platelet agglutination and thrombosis. The occlusion of coronary arteries and vessels leads to insufficient myocardial blood supply, subsequently causing cardiac interstitial fibrosis, gradual enlargement of ventricles, and heart failure, which affects the quality of life and safety of patients. AIM To investigate the effects of emergency percutaneous interventional therapy (PCI) and delayed stenting in acute myocardial infarction with high thrombotic load and identify factors related to major adverse cardiovascular events (MACE). METHODS A total of 164 patients with acute myocardial infarction and high thrombotic load who received PCI were included. Of them, 92 patients were treated with delayed stent implantation (delayed group) and 72 patients received emergency PCI (immediate group). Myocardial perfusion after stent implantation was compared between the two groups. Patients were followed up for 12 mo, and the occurrence of MACE was used as the endpoint. Univariate and multivariate models were used to analyze the factors affecting MACE occurrence. RESULTS After stent implantation, 66 (71.74%) patients in the delayed group and 40 (55.56%) patients in the immediate group had thrombolysis in myocardial infarction (TIMI) flow grade 3 ( P < 0.05), while 61 (66.30%) patients in the delayed group and 39 (54.17%) patients in the immediate group reached TIMI myocardial perfusion grade 3 ( P > 0.05). MACE occurred in 29 patients. There were statistically significant differences between the MACE and non-MACE groups in diabetes rate, TIMI grading, stent implantation timing, intraoperative use of tirofiban, and the levels of white blood cells (WBC), neutrophils, red blood cell distribution width (RDW), and uric acid, and high-sensitivity C-reactive protein (hs-CRP) at admission ( P < 0.05). Logistic regression analysis showed that TIMI grade 3 and intraoperative use of tirofiban effectively reduced the risk of MACE ( P < 0.05), while immediate stent implantation, increased WBC, hs-CRP and RDW on admission increased the risk of MACE ( P < 0.05). CONCLUSION Delayed stent implantation outweighs emergency PCI in improving postoperative myocardial perfusion in acute myocardial infarction with high thrombotic load, and effectively reduces MACE in these patients.

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Challenges associated with treatment of left internal mammary artery graft thrombosis

Cited by 3 publications

References 15 publications

A clinical case of myocardial infarction after coronary artery bypass grafting using the internal mammary artery

A clinical case of myocardial infarction after coronary artery bypass grafting using the internal mammary artery

Current challenges and prevention strategies for chronic total occlusion (CTO) complications

Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

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