RESUMO
In order to expand the revascularization of the left anterior descending coronary artery, we have applied the inverted left internal thoracic artery (left internal thoracic artery [LITA] transected near its origin, thus supplied by retrograde flow from superior epigastric and musculophrenic arteries) in carefully selected cases (four patients). The 64-slice multidetector row computed tomographic scans performed postoperatively (range, 6 to 40 days), as well as the scans performed in the follow-up period (range, 18 to 35 months) showed preserved inverted LITA conduits with thrombolysis in myocardial infarction (TIMI) 3 flow in all patients.
Assuntos
Vasos Coronários/cirurgia , Artéria Torácica Interna/fisiologia , Artéria Torácica Interna/transplante , Revascularização Miocárdica/métodos , Grau de Desobstrução Vascular , Idoso , Seguimentos , Humanos , Masculino , Artéria Torácica Interna/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Infarto do Miocárdio/cirurgia , Seleção de Pacientes , Fatores de Tempo , Resultado do TratamentoRESUMO
Cardiac surgeons are treating an increasing number of patients with diffuse coronary artery disease that requires the use of alternative surgical techniques. We present a patient who had a technically unsatisfactory endarterectomy of the left anterior descending coronary artery. We were left with only 3 segments of properly endarterectomized coronary bed areas, separated with totally disintegrated coronary bed portions. These 3 segments were incorporated into the venous graft, with the inflow obtained from the left internal thoracic artery. We believe that this approach may be the rescue technique for complicated coronary artery endarterectomy.
