RESUMO
A clot in the left atrial appendage (LAA) is an important cause of cardio-embolic stroke. Concomitant occlusion of the LAA during cardiac surgery is found to have reduced postoperative stroke. A study was designed to observe the results of LAA occlusion in 17 patients undergoing coronary artery bypass graft surgery (CABG) and aortic valve replacement (AVR). The LAA was occluded epicardially with a SIRONIX 60-mm linear noncutting stapler (Healthium Medtech Pvt limited, Peenya, Bengaluru). The effectiveness of occlusion was confirmed by trans-esophageal echocardiography and at 2 years of follow-up with trans-thoracic echocardiography. There was no re-canalization of the LAA, and the patients remained in sinus rhythm. Concomitant LAA occlusion with a linear stapler during cardiac surgery is a safe, feasible, and reproducible option.
RESUMO
Congenital atresia of the left main coronary ostium is a rare coronary anomaly presenting in adulthood. A 48-year-old man presented with unstable angina. Coronary angiography showed an absent left coronary ostium with a super-dominant right coronary artery retrogradely filling the left system. Computed tomography-angiography with 3-dimensional reconstruction confirmed the absence of the left main coronary artery. In view of ongoing chest pain, the patient was offered coronary artery bypass surgery. Total arterial revascularization was performed with a left internal mammary artery-left radial artery Y-graft.
