Key result
Off-pump LAD mammary artery patch reconstruction demonstrates safety with ~1% mortality.
Why the study?
Coronary endarterectomy for diffuse coronary disease carries high morbidity and mortality, prompting the development of patch angioplasty and reconstruction.
Does off-pump mammary artery patch reconstruction of the left anterior descending coronary artery without endarterectomy provide safe and effective revascularization in patients with diffuse coronary disease?
Cohort (n=104)
Does off-pump mammary artery patch reconstruction of the left anterior descending coronary artery without endarterectomy provide safe and effective revascularization in patients with diffuse coronary disease?
Off-pump arterial patch reconstruction of the left anterior descending coronary artery without endarterectomy is a safe and effective revascularization strategy for diffuse coronary disease, avoiding the high morbidity associated with coronary endarterectomy.
May support off-pump patch reconstruction in diffuse LAD disease; hypothesis-generating and requires randomized confirmation.
Most patients with diffuse coronary disease require endarterectomy for revascularization. In view of the high morbidity and mortality associated with coronary endarterectomy, patch angioplasty and reconstruction of the coronary artery was developed. We retrospectively evaluated 104 patients who underwent mammary artery patch angioplasty of the left anterior descending coronary artery. The procedure consisted of laying open the entire diseased segment of the coronary artery and patching it with an in-situ left internal mammary artery onlay patch, without endarterectomy, in an off-pump procedure. One (0.9%) patient died, 2 (1.8%) suffered perioperative myocardial infarction, and an intraaortic balloon pump was used in 2. The mean blood loss was 224 mL. Intensive care unit stay was 2.5 days, and hospital stay was 7.8 days. At 1-year follow-up, most patients were in New York Heart Association functional class I. Follow-up angiography was carried out in 16 patients and showed good patency of all anastomoses. Arterial patch reconstruction of the left anterior descending coronary artery can be performed safely and effectively in an off-pump procedure, with excellent early and intermediate results.
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Prabhu et al. (2008) conducted a cohort in Diffuse coronary disease (n=104). Mammary artery patch angioplasty was evaluated on Mortality. Off-pump mammary artery patch reconstruction of the left anterior descending coronary artery was safe, with 0.9% mortality and 1.8% perioperative myocardial infarction.
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