Page 378 - Read Online

Elsayed et al. Vessel Plus 2018;2:39 Vessel Plus
DOI: 10.20517/2574-1209.2018.65

Original Article Open Access

Evaluation of different surgical modalities for
coronary reconstruction of diffusely diseased left
anterior descending artery

Mohamed H. Elsayed , Wael M. Hassanein , Samir A. Keshk , Mamdouh Zidan , Waheed G. Etman 1
1
1
2
1
1 Department of Cardiothoracic Surgery, University of Alexandria, Alexandria 21111, Egypt.
2 Department of Radiology, University of Alexandria, Alexandria 21111, Egypt.
Correspondence to: Dr. Mohamed H. Elsayed, Department of Cardiothoracic Surgery, University of Alexandria, Champollion
Street, Khartoum Square, Azarita, Alexandria 21111, Egypt. E-mail: moh.hassanein@gmail.com
How to cite this article: Elsayed MH, Hassanein WM, Keshk SA, Zidan M, Etman WG. Evaluation of different surgical modalities
for coronary reconstruction of diffusely diseased left anterior descending artery. Vessel Plus 2018;2:39.
http://dx.doi.org/10.20517/2574-1209.2018.65
Received: 13 Sep 2018 First Decision: 26 Oct 2018 Revised: 30 Oct 2018 Accepted: 1 Nov 2018 Published: 12 Nov 2018

Science Editor: Mario F. L. Gaudino Copy Editor: Cui Yu Production Editor: Zhong-Yu Guo

Abstract
Aim: Endarterectomy has been shown to be an effective adjunct in treating diffusely diseased coronary arteries.
Reconstruction of endarterectomized coronaries has been done by various techniques. We compare early results of left
internal mammary artery (LIMA) patch to saphenous vein patch in left anterior descending artery (LAD) reconstruction.

Methods: We prospectively followed 30 patients with diffusely diseased LAD from January 2016 to January 2018.
Patients were followed up clinically, by echocardiogram and CT coronary angiography.

Results: Twenty-seven patients were males (90%). The mean age was 59.23 ± 7.98. Twenty-two patients (73.3%)
had a LIMA onlay patch. The mean length of patch reconstruction was greater in the saphenous vein group than LIMA
group (8.31 ± 1.16 cm vs. 5.64 ± 0.73 cm, P < 0.001). Postoperative myocardial infarction occurred in 1 patient from the
LIMA group (4.5%) and 1 patient in the saphenous vein patch group (12.5%). Operative mortality occurred in 1 patient
belonging to the LIMA group. Mean time of follow up was 17.59 ± 6.34 months. CT coronary angiography showed a
patency rate of 93.1%.

Conclusion: Results of reconstruction by LIMA and saphenous vein patch are comparable in short-term follow up.

Keywords: Endarterectomy, reconstruction, left internal mammary artery patch

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.vpjournal.net