Basrah Journal of Surgery (Dec 2019)

CORONARY ENDARTERECTOMY AND PATCH ANGIOPLASTY FOR DIFFUSE CORONARY ARTERY DISEASE. A PROSPECTIVE ANALYSIS OF 22 CASES

  • Shkar Saed,
  • Hisham Hasan,
  • Abdulsalam Taha

DOI
https://doi.org/10.33762/bsurg.2019.164514
Journal volume & issue
Vol. 25, no. 2
pp. 47 – 53

Abstract

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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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