LITA-LAD revascularization without cardiopulmonary bypass

ABSTRACT

Two male patients with post-infarction angina and positive exercise test were submitted to left Internal Thoracic Artery-Left Anterior Descending corollary artery [LITA-LAD] without cardiopulmonary bypass [CPB]. Their ages were 43 and 47 years. The angiographic lesion was total obstruction of the left anterior descending artery that was visualized retrogradely from septal branches of PDA of right coronary artery. Their blood groups was A2B Rh-ve and O Rh-ve. The two cases were done as first case in day and CPB was in stand-by with clear fluid priming to be used for the second case in day. The exposure of the LAD was as usual and the LITA-LAD anastomosis was done using 7/0 Prolene. The immediate postoperative course was smooth, no blood transfusion was used, no perioperative myocardial infarction. Patients were extubated after 8 and 9 hours and discharged from ICU in 24 hours. In hospital control showed complete disappearance of the anginal pain, no new Q wave in resting ECG, CK level was within normal and no new abnormal wall motions by echocardiography. This technique has the advantage to avoid using CPB that may cause cerebral, pulmonary and renal complications, no blood transfusion, least heparin and protamine use, smooth postoperative course, early extubation and low cost wise