Objectives To assess the early and midterm postoperative outcomes of left anterior descending (LAD) artery reconstruction using the left internal mammary artery (LIMA) or venous patch in coronary artery bypass graft (CABG) operation. Background Treatment of patients with diffuse LAD atherosclerosis is a challenge due to its complexity. So those patients are potentially inoperable by conventional CABG. Reconstruction of the severely diseased LAD by the LIMA patch or venous patch is considered as a surgical option. Patients and methods The study was a prospective observational study and was conducted on 40 patients diagnosed to have extensive diffuse LAD atherosclerosis between April 2019 and April 2022. These patients underwent elective CABG with LAD artery reconstruction. Results The mean age of the patients was 59.078.79 years; 82.5% were male; 50% were operated off-pump. The mean length of the reconstructed patch was 4.341.57 cm. LIMA on-lay patch was used in 33 (82.5%) patients. There were two (5%) patients with postoperative myocardial infarction. Five (12.5%) patients had low cardiac output syndrome. Three (7.5%) patients had typical chest pain postoperatively. There was one (2.5%) mortality after 2 months of discharge of hospital. Analysis of multislice coronary computed tomography revealed a full patent reconstructed LAD patch in 39 (100%) lived patients. Conclusion Reconstruction of diffuse LAD atherosclerosis with LIMA patch or venous patch is a safe surgical option with accepted early and midterm clinical outcomes.
Ahmed, Hesham H.; Sha’aban, Khaled A.; Dokhan, Ahmed L.; Soliman, Rafik F.; and Abdellatif, Mohammed G.
"Early and midterm outcomes of left anterior descending coronary artery reconstruction in extensive coronary artery atherosclerosis,"
Menoufia Medical Journal: Vol. 36:
2, Article 22.