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Extensive Endarterectomy, Onlay Patch, and Internal Mammary Bypass of the Left Anterior Descending Coronary Artery
Author(s) -
Sankar Nainar Madhu,
Satyaprasad Velivela,
Rajan Sethurathinam,
Bashi Vellayikodath Velayudhan,
Cherian Kotturathu Mammen
Publication year - 1996
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.1540-8191.1996.tb00009.x
Subject(s) - medicine , endarterectomy , surgery , myocardial infarction , incidence (geometry) , artery , coronary artery disease , cardiology , carotid arteries , physics , optics
A bstract The incidence of diffuse disease requiring multiple endarterectomies is high among the Oriental population. The technique of LAD endarterectomy and reconstruction is difficult, and often it is a challenging problem. From June 1987 to September 1994, 2376 patients from seven countries underwent coronary artery bypass graft surgery, among whom 610 patients had endarterectomy. One hundred thirty‐six patients underwent LAD endarterectomy, and among them, 69 had extensive endarterectomy. The LAD was reconstructed with IMA onlay patch in 41 patients and with saphenous vein onlay patch in 28 patients. Three patients had evidence of postoperative myocardial infarction and seven patients died in the postoperative period. Twelve patients were postoperatively restudied and in all of them, the graft to LAD was patent. Use of internal mammary artery onlay patch after endarterectomy is advantageous since it may be associated with higher long‐term patency and low incidence of reoperation. To our knowledge, this has not been reported anywhere.