| Left internal mammary elongation with inferior epigastric artery in minimally invasive coronary surgery. | |
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MedLine Citation:
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PMID: 9332917 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Sometimes the left internal mammary artery (LIMA) is not long enough to reach a too lateral LAD when a left anterior small thoracotomy (LAST operation) is the surgical approach to graft the LAD. LIMA elongation with an inferior epigastric artery (IEA) can be an useful surgical option. METHODS: From November 1994 to June 30, 1996, out of 289 patients who underwent LAST operation; 28 patients had a LIMA elongation with an IEA, 20 patients had single vessel disease, 4 had two vessel disease, and 4 three vessel disease. Mean age was 62 +/- 22 (48-84) and mean EF was 57 +/- 86. The IEA was used only when the LAD was totally or nearly occluded with no transmural myocardial infarction (high expected run off). RESULTS: All patients had an uneventful recovery. After 315 +/- 104 days from surgery all were asymptomatic. A late doppler flow assessment, performed in 28 patients, showed a high velocity diastolic flow in 27. One patient was reoperated on because of graft occlusion 84 days after surgery. An angiography was performed after 87.5 +/- 23.3 days in 22 patients. All conduit and anastomoses were patent but one, (patency rate 21/22, 95.4%); another showed mild anastomotical stenosis at the LIMA-IEA junction without clinical signs (perfect patency rate 20/22, 90.9%). CONCLUSIONS: IEA elongation of LIMA is an alternative strategy to reach a lateral LAD in selected cases; a satisfying patency rate can be expected, when correct surgical indications are used. |
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Authors:
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A M Calafiore; G Teodori; G Di Giammarco; G Vitolla; M Contini; N Maddestra; L Paloscia; A Iacò; S Gallina |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 12 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 1997 Sep |
Date Detail:
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Created Date: 1997-11-06 Completed Date: 1997-11-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: NETHERLANDS |
Other Details:
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Languages: eng Pagination: 393-6; discussion 397-8 Citation Subset: IM |
Affiliation:
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Division of Cardiac Surgery G. D'Annunzio University, S. Camillo de Lellis Hospital, Chieti, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Blood Flow Velocity Coronary Angiography Coronary Disease / diagnosis, surgery* Echocardiography, Doppler Epigastric Arteries / transplantation* Female Follow-Up Studies Humans Internal Mammary-Coronary Artery Anastomosis / methods* Length of Stay Male Middle Aged Reoperation Severity of Illness Index Surgical Procedures, Minimally Invasive / methods* Thoracotomy / methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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