Document Detail


Left internal mammary elongation with inferior epigastric artery in minimally invasive coronary surgery.
MedLine Citation:
PMID:  9332917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  1997-11-06     Completed Date:  1997-11-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  393-6; discussion 397-8     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery G. D'Annunzio University, S. Camillo de Lellis Hospital, Chieti, Italy.
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MeSH Terms
Descriptor/Qualifier:
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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