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Intraoperative Coronary Angioscopy— Technique and Results: A Study of 38 Patients
Author(s) -
Bessou Jean Paul,
Melki Jean,
Bouchart Francois,
MoutonSchleifer Dominique,
Tabley Alfred,
Arrig Jean,
Redonnet Michel,
Berland Jacques,
Letac Brice,
Soyer Robert
Publication year - 1993
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1993.tb00398.x
Subject(s) - medicine , angioscopy , anastomosis , coronary arteries , artery , surgery , revascularization , mammary artery , internal thoracic artery , radiology , cardiology , myocardial infarction , bypass grafting
A bstract Over a period of 11 months, 38 patients submitted to coronary artery revascularization underwent intraoperative angioscopy of the coronary arteries and internal thoracic arteries. Fifty‐nine lesions were observed, but only 31 stenoses responsible for coronary insufficiency were observed (33%). Forty‐four distal anastomoses were explored (47%) but ten of these explorations were incomplete. None revealed technical failure of the anastomosis. Thirteen harvested left internal mammary arteries were explored. One of the explorations led to rejection of the graft due to an intimal fracture. Some tiny intimal flaps were observed in our experience, as in others. Although the iatrogenic origin of these lesions in relation to the introduction of the angioscope is obvious, it does not seem to influence the outcome of the operation. In our opinion, two main fields appear to be developing in coronary angioscopy: preoperative assessment of the quality of internal thoracic artery grafts, and control of distal graft anastomoses. The flexibility of the angioscopes and of the leading catheters must be improved to minimize the risk of arterial wall traumatic lesions. (J Card Surg 1993; 8:483–487)