Document Detail

Results of long segmental reconstruction of left anterior descending artery using left internal thoracic artery.
MedLine Citation:
PMID:  22381445     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We performed long segmental reconstruction of the left anterior descending coronary artery (LAD) using the left internal thoracic artery (LITA) in patients with diffusely diseased coronary arteries. Our study investigated short- and long-term outcomes and angiographic results after complete revascularization using this technique.
METHODS: Between March 1995 and March 2001, 112 patients (mean age 63 years) underwent long segmental LAD reconstruction (≥2 cm) with or without endarterectomy using the LITA. Of these, 68 patients (61%) had a history of old myocardial infarction, 44 (39%) had undergone prior percutaneous coronary intervention, 39 (35%) had unstable angina, and 11 (10%) required preoperative intraaortic balloon pumping.
RESULTS: The majority of patients (96%) underwent operation under cardiac arrest. All patients underwent a complete revascularization with long segmental LAD reconstruction using the LITA. The average length of arteriotomy was 3.7 cm, and 43 patients (38%) underwent extensive (≥4 cm) LAD reconstruction. Endarterectomy was performed in 37 patients (33%). The early mortality rate was 1.8% (2 of 112). Perioperative myocardial infarction in the LAD territory was 5.4%. The 5- and 10-year survival rates were 91% and 74%, respectively. Freedom from major adverse cardiac events at 10 years was 77%. Early angiography (n = 99) showed a 99% excellent patency rate of the LITA. Midterm (n = 61) and long-term (n = 23) follow-up angiography both showed 100% excellent patency rate of the LITA.
CONCLUSIONS: Long segmental LAD reconstruction with or without endarterectomy using the LITA provided excellent long-term outcomes and acceptable early operative results, even in patients with diffusely diseased coronary arteries.
Yasuyuki Kato; Toshihiko Shibata; Shuichiro Takanashi; Toshihiro Fukui; Akira Ito; Yoshihiro Shimizu
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Publication Detail:
Type:  Journal Article     Date:  2012-02-28
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  93     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-27     Completed Date:  2012-06-15     Revised Date:  2013-04-04    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1195-200     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
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MeSH Terms
Coronary Artery Bypass / methods*
Coronary Artery Disease / surgery*
Coronary Vessels / surgery*
Mammary Arteries / surgery*
Middle Aged
Retrospective Studies
Treatment Outcome
Vascular Patency
Comment In:
Ann Thorac Surg. 2013 Mar;95(3):1136   [PMID:  23438555 ]
Ann Thorac Surg. 2013 Mar;95(3):1136   [PMID:  23438554 ]
Ann Thorac Surg. 2013 Mar;95(3):1136-7   [PMID:  23438553 ]

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