Surgical Revascularization of the Left Anterior Descending Artery with Multiple Failed Overlapping Stents
Autor: | Nursen Tanrikulu, Ahmet Yasar Cizgici, Tolga Demir, Ergun Demirsoy, Kemal Ilker Yildirim, Ismet Dindar, Mehmet Umit Egrenoglu |
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Rok vydání: | 2015 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Stent Arteriotomy Canadian Cardiovascular Society medicine.disease Surgery surgical procedures operative medicine.anatomical_structure Internal medicine Angiography Cardiology Medicine cardiovascular diseases Myocardial infarction Cardiology and Cardiovascular Medicine business Elective Surgical Procedure Endarterectomy Artery |
Zdroj: | Journal of Cardiac Surgery. 30:877-880 |
ISSN: | 0886-0440 |
Popis: | 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. |
Databáze: | OpenAIRE |
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