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Surgical Revascularization of the Left Anterior Descending Artery with Multiple Failed Overlapping Stents
Author(s) -
Demir Tolga,
Egrenoglu Mehmet Umit,
Tanrikulu Nursen,
Cizgici Ahmet Yasar,
Yildirim Kemal Ilker,
Dindar Ismet,
Demirsoy Ergun
Publication year - 2015
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/jocs.12657
Subject(s) - medicine , arteriotomy , artery , endarterectomy , myocardial infarction , surgery , stent , revascularization , cardiology , vein , radiology , stenosis
A BSTRACT Background Multiple stents make standard coronary artery bypass techniques difficult. We describe our surgical approach, in patients undergoing coronary artery bypass grafting (CABG), in left anterior descending arteries (LAD) with multiple failed overlapping stents. Methods We retrospectively reviewed the data of six patients undergoing CABG with multiple failed overlapping stents in the LAD. All patients were operated on electively. After removal of the stents with an open endarterectomy, the long segmental arteriotomy of the LAD was reconstructed with a saphenous vein patch. Afterwards the left internal mammary artery was anastomosed to the vein patch. Results The mean age was 61.5 ± 7.9 years. Five patients (83.3%) were in Canadian Cardiovascular Society Class III or IV. Four patients (66.6%) had suffered a remote myocardial infarction (>1 month). The average hospital stay was 6.5 ± 1.1 days. Postoperative electrocardiograms showed no specific changes and no myocardial enzyme elevations were noted. Early postoperative angiography showed that all grafts including the endarterectomized LAD were patent. There was no mortality within the 30 days. Patients’ mean follow‐up time was 35.6 ± 36.7 months. Conclusions CABG with open stent endarterectomy is a valuable alternative option for patients with “full‐metal jacket“ diseased LAD that are not graftable using standard surgical techniques. doi: 10.1111/jocs.12657 (J Card Surg 2015;30:877–880)