CORONARY ENDARTERECTOMY AND PATCH ANGIOPLASTY FOR DIFFUSE CORONARY ARTERY DISEASE. A PROSPECTIVE ANALYSIS OF 22 CASES
Basrah Journal of Surgery,
2019, Volume 25, Issue 2, Pages 47-53
10.33762/bsurg.2019.164514
Abstract
Diffusecoronaryarterydisease(CAD)isasurgicalchallengeinwhichconventionalcoronary arterybypassgrafting(CABG)maynotachieveadequatemyocardialrevascularizationunless adjuvantproceduressuchascoronaryendarterectomyandcoronarypatchangioplasty(CPA) areadded.Theaimofthisprospectivestudyistoevaluatetheoutcomeoftheseproceduresin ourinstitution in viewofthe relevantliterature.DataofallpatientswhounderwentCPA±CABGbyonesurgeoninourinstitution (n=22) betweenApril2018andApril2019werecollected.Patientsunderwentopencoronary endarterectomyandonlaypatchofleftinternalmammaryartery(LIMA)oravenouspatchunder cardiopulmonarybypass(CPB).
Of167CABGprocedures,22werecombinedwithCPA.Therewere15(68.2%)males.Age rangedbetween43-72yearswithameanof59.patientsincluded19isolatedleftanterior descendingarteries(LADs),tworightcoronaryarteriesandoneobtusemarginalbranch.The CPBtimewas88-198minutesandtheaorticcrossclamptimewas40-125minutes.The patientshad(includingLAD)2-4vesseldiseases.TheaverageICUstaywas29±14hoursand meanhospitalstaywas5dayswithnocomplicationsapartfromatrialfibrillation(n=4,18.2%). Thefollow-upperiodrangedfrom4to14months.Onthe40thpostoperativeday,coronaryCT angiographyrevealedpatentgrafts.Nopatientdied duetoCAD.
Inconclusion,coronaryendarterectomyandangioplastyisasafeandhighlyrewarding procedure in potentiallyinoperable patients with diffusecoronaryartery disease.
Keywords:Coronaryarterydisease,endarterectomy,angioplasty,venous,patch,leftanterior descending, left internal mammaryartery.
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