A new bridge bypass technique for multisegmental left anterior descending coronary artery disease

There is an increase in cases with complex, multisegmental left anterior descending (LAD) coronary artery lesions in coronary artery bypass graft (CABG) surgery. In these cases, further reconstructive surgical procedures are needed for complete revascularization. In four cases (3 males, 1 female, mean age 58±3.3 years) with multisegmental LAD lesions, extra surgical intervention was employed to the LAD artery in conjunction with standard coronary surgical procedures between January 2008 and September 2010. All cases presented with class 3 or 4 stable angina pectoris. In all cases, the surgical procedure consisted of standard cannulation followed by CABG under cardiopulmonary bypass. In cases with complex multisegmental LAD lesions, a short saphenous vein graft was bridged between the mid and distal portions of the LAD as a new technique. The prepared left internal mammarian artery was anastomosed to this bridge which was created over the LAD. The remaining coronary anastomoses were performed with the standard technique. The postoperative period passed without any problem in all patients. We believe that this is a successful technique for providing complete revascularization in patients with complex, multisegmental LAD lesions.