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Page 4 of 11 Elsayed et al. Vessel Plus 2018;2:39 I http://dx.doi.org/10.20517/2574-1209.2018.65

Table 1. Preoperative characteristics
Preoperative characteristics No. (%), mean ± SD, or median (range) (n = 30)
Age (years) 59.23 ± 7.98
Males 27 (90)
Cardiac profile
Unstable angina 26 (86.7)
Left main 5 (16.7)
Previous MI 18 (60)
Ejection fraction 51.23 ± 9.02
Risk factors
Hypertension 27 (90)
Smoking 16 (53.3)
Dyslipidemia 10 (33.3)
Diabetes mellitus 19 (63.3)
Insulin use 4 (14.3)
Comorbidities
COPD 9 (30)
Renal impairment 0 (0)
Previous CVA 1 (3.3)
PVD 2 (6.7)
NYHA class
II 15 (50)
III 15 (50)

MI: myocardial infarction; COPD: chronic obstructive pulmonary disease; CVA: cerebrovascular accident; PVD: peripheral vascular
disease; NYHA: New York Heart Association

MI: elevation of biomarkers (creatine kinase-MB or troponin) to more than 5 times the 99th percentile of
the normal reference range during the first 72 h after a CABG plus: (1) new pathologic Q waves or left bundle
branch block; or (2) angiographically documented new graft or native coronary artery occlusion; or (3)
imaging evidence of new loss of viable myocardium.

Statistical analyses were performed using IBM SPSS Statistics 22.0 software (IBM Corp, Armonk, NY).
Normally distributed continuous variables are expressed as the mean ± SD, and skewed continuous variables
are expressed as the median with the range. For comparison of the 2 groups, t test, Wilcoxon signed rank
test, or Fisher’s exact test was used as deemed appropriate.

RESULTS
Baseline clinical characteristics and demographic data are summarized in Table 1. The endarterectomized
LAD was reconstructed using LIMA onlay patch in 22 patients (73.3%). Postoperative MI occurred in 2
patients, one of them only in the reconstructed LAD territory. There was one mortality occurring 5 days
postoperative in the ICU due to MI and refractory ventricular arrhythmias resulting in operative mortality
of 3.3%. Intraoperative and postoperative data are summarized in Table 2.

At least 6 months after surgery all patients except for one case of mortality had a coronary CT angiogram
done and showed 93.1 percent patency rate with 2 patients found to have stenotic LIMA-LAD anastomosis
[Table 3, Figure 1]. One patient belonged to the LIMA group and the other to the saphenous patch group.
In addition to the CT angiography echocardiogram was done and the patients were followed up clinically
regarding any chest pain and dyspnea. Angina occurred in 4 patients and they belonged to Canadian
Cardiovascular Society (CCS) class I. Tables 4 and 5 showed the improvement in New York Heart
Association (NYHA) class and ejection fraction postoperatively.

Tables 6 and 7 showed comparison between both methods of reconstruction using LIMA or LIMA and
saphenous vein patch in relation to the baseline demographics, intraoperative and postoperative events.