Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Reconstruction of Injured or Inadquate Left Internal Thoracic Artery in Cornonary Artery bypass Graft

관상동맥우회술시 부적절한 좌내흉동맥의 변형 활용에 대한 경험

  • 이영탁 (부천세종병원 흉부외과)
  • Published : 1999.10.01
Download PDF
⟨ Previous Next ⟩

Abstract

Use of the left internal thoracic artery(ITA) to bypass the left anterior descending(LAD) coronary artery has become the standard of care based on its superior graft patency, reduced cardiac events, and enhanced survival. But rarely we encountered with injury to the artery during harvesting which leads to loss of the merits of surgery. We reconstructed inadequate ITAa with other arterial conduits so proximal stump to be a blood source if possible. Maternal and method: Between January 1996 and March 1999, 12 patients received bypass with the reconstructed left internal thoracic artery grafts to left anterior descending artery because of an injury(n=8), short or small(n=4). Right or left ITA was used to LAD as a free graft(n=2). And the other 10 left ITAs were extended with radial artery(n=6), right ITA(n=3), saphenous vein(n=1). Composite "T" graft was made with other arterial conduits in these extended graft(n=5). Result: There was only one morbidity of minor would problem, and no mortality. The patency of extended graft to LAD was complete in 5 patients who received angiography during the period of 2wks to 2 years postoperative, but one of side branch of "T" graft occluded. All of these patients were well. Conclusion: Reconstructive extension with the use of other arterial conduit for the injured proximal ITA is warranted in any patients with acceptable results. acceptable results.

Keywords

References

  1. Semin Thorac Cardiovasc Surg v.8 Complete revascularization with internal thoracic artery grafts Tector AJ;Kress DC;Downey FX
  2. Ann Thorac Srug v.58 Complete arterial conduits for a wider arterial myocardial revascularization Calafiorc AM;DiGiammarco F;Luciani N(et al.)
  3. Semin Thorac Cardiovasc Surg v.8 Optimal use of the gastroepiploic artery Suma H
  4. Semin Thorac Cardiovasc Surg v.8 Current status of the inferior epingastric artery Buthe M;Dion R
  5. Semin Thorac Cardiovasc Surg v.8 Definng the role of the radial artery Barner HB
  6. 대흉외지 v.30 요골동맥을 이용한 관상동맥우회술 나찬영;이영탁;박국양 (등)
  7. J Thorac Cardiovasc Surg v.99 Comparative anatomic studies of various arterial conduits for myocardial revoscularization Van Son JAM;Smedts F;Vincent JG(et al.)
  8. Ann Thorac Surg v.67 Pharmacology of coronary artery bypass graft Rosenfeldt FC;He GW;Buxton BF(et al.)
  9. Ann Thorac Surg v.64 Single versus bilateral internal mamary artery grafts: 10 year outcome analysis Pick AW;Orszulak TA;Aderson BJ(et al.)
  10. Ann Thorac Surg v.52 Internal mammary artery graft at reoperation risk. benefita and methods of preservation Coltharp WH;Decker MD;Lea JWIV(et al.)
  11. Ann Thorac Surg v.67 Injury to a patent left internal thoaic artery graft at coronary reoperation Gillinov AM;Casselman FP;Lytle BW(et al.)
  12. Ann Thorac Surg v.67 Recycling of arterial grafts during reoperative coronary artery operations Noirhomme PH;Underwood MJ;EL khoury GA(et al.)
  13. Ann Thorac Surg v.64 Results of 1454 free right internal thoacic artery to coronary grafts Tatoulis J;Buxton BF;Fuller JA
  14. Ann Thorac Surg v.54 Reivival of the radial artery for coronary artery bypass grafting Acar C;Jebra VA;Portoghese M(et al.)