Evaluation of different surgical modalities for coronary reconstruction of diffusely diseased left anterior descending artery

Abstract

How to cite this article: Elsayed MH, Hassanein WM, Keshk SA, Zidan M, Etman WG. Evaluation of different surgical modalities for coronary reconstruction of diffusely diseased left anterior descending artery. Vessel Plus 2018;2:39. http://dx. AbstractAim: Endarterectomy has been shown to be an effective adjunct in treating diffusely diseased coronary arteries. Reconstruction of endarterectomized coronaries has been done by various techniques. We compare early results of left internal mammary artery (LIMA) patch to saphenous vein patch in left anterior descending artery (LAD) reconstruction. Methods:We prospectively followed 30 patients with diffusely diseased LAD from January 2016 to January 2018. Patients were followed up clinically, by echocardiogram and CT coronary angiography.Results: Twenty-seven patients were males (90%). The mean age was 59.23 ± 7.98. Twenty-two patients (73.3%) had a LIMA onlay patch. The mean length of patch reconstruction was greater in the saphenous vein group than LIMA group (8.31 ± 1.16 cm vs. 5.64 ± 0.73 cm, P < 0.001). Postoperative myocardial infarction occurred in 1 patient from the LIMA group (4.5%) and 1 patient in the saphenous vein patch group (12.5%). Operative mortality occurred in 1 patient belonging to the LIMA group. Mean time of follow up was 17.59 ± 6.34 months. CT coronary angiography showed a patency rate of 93.1%. Conclusion:Results of reconstruction by LIMA and saphenous vein patch are comparable in short-term follow up.

Reconstruction of a Diffusely Diseased Left Anterior Descending Coronary Artery with Left Internal Thoracic Artery Patch: One year follow up

“…LAD reconstruction was done with a LITA patch in all cases because this long segment anastomosis necessitates CPB for a more secure anastomosis with adequate cardiac protection. Similarly, numerous studies used on-pump CABG for all their cases [17][18][19][20]. However, due to strong collaterals in patients with extensive CAD, the offpump CABG can be successfully conducted by a surgeon with good surgical experience, as demonstrated in a study by Fukui and associates [7] and others [3,6,21].…”