Skip to main content
NCBI home page
The Texas Heart Institute Journal logoLink to The Texas Heart Institute Journal
. 1987 Dec;14(4):389–394.

Coronary Endarterectomy Combined with Vein Patch Reconstruction and Internal Mammary Artery Grafting: Experience with 18 Patients

Pino Fundarò 1, Pietro Di Biasi 1, Carmine Santoli 1
PMCID: PMC324763  PMID: 15227295

Abstract

Over a 19-month period (from November 1985 to June 1987), 18 patients underwent open coronary endarterectomy combined with vein patch reconstruction and internal mammary artery (IMA) grafting. All 18 patients had disabling angina and severe, diffuse coronary atherosclerosis that prevented revascularization by conventional means. Thirteen underwent open endarterectomy of the left anterior descending coronary artery, and the remaining five had open endarterectomy of the right coronary artery. All patients received additional bypass grafts to other coronary arteries (2.6 grafts per patient). There was no operative mortality, but one patient had a perioperative myocardial infarction that was unrelated to the open endarterectomy. Postoperative angiography in 16 cases showed that only one of the grafts to the endarterectomized artery was occluded. After a mean follow-up of 8.7 months, all the patients but one were angina-free. No late deaths occurred.

Although the long-term clinical results and graft patency have yet to be evaluated, the early results of this series encourage us to continue using this technique in patients whose diffuse coronary artery disease is untreatable by conventional means. (Texas Heart Institute Journal 1987; 14:389-394)

Keywords: Endarterectomy, coronary

Keywords: vein patch reconstruction

Keywords: internal mammary artery grafting

Keywords: coronary artery disease

Full text

PDF
389

Images in this article

391Image
on p.391
392Image
on p.392
392Image
on p.392

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Fundarò P., Santoli C. Endoarteriectomia coronarica: stato dell'arte. G Ital Cardiol. 1986 Oct;16(10):835–844. [PubMed] [Google Scholar]
  2. Kamath M. L., Matysik L. S., Schmidt D. H., Smith L. L. Sequential internal mammary artery grafts. Expanded utilization of an ideal conduit. J Thorac Cardiovasc Surg. 1985 Feb;89(2):163–169. [PubMed] [Google Scholar]
  3. Keon W. J. Manual coronary endarterectomy and revascularization: improving techniques and results. Ann Thorac Surg. 1981 Nov;32(5):427–428. doi: 10.1016/s0003-4975(10)61773-0. [DOI] [PubMed] [Google Scholar]
  4. Livesay J. J., Cooley D. A., Hallman G. L., Reul G. J., Ott D. A., Duncan J. M., Frazier O. H. Early and late results of coronary endarterectomy. Analysis of 3,369 patients. J Thorac Cardiovasc Surg. 1986 Oct;92(4):649–660. [PubMed] [Google Scholar]
  5. Loop F. D., Lytle B. W., Cosgrove D. M., Golding L. A., Taylor P. C., Stewart R. W. Free (aorta-coronary) internal mammary artery graft. Late results. J Thorac Cardiovasc Surg. 1986 Nov;92(5):827–831. [PubMed] [Google Scholar]
  6. Parsonnet V., Gilbert L., Gielchinsky I., Bhaktan E. K. Endarterectomy of the left anterior descending and mainstem coronary arteries: a technique for reconstruction of inoperable arteries. Surgery. 1976 Dec;80(6):662–673. [PubMed] [Google Scholar]
  7. Parsonnet V., Gilbert L., Gielchinsky I., Bhaktan E. K. Endarterectomy of the left anterior descending and mainstem coronary arteries: a technique for reconstruction of inoperable arteries. Surgery. 1976 Dec;80(6):662–673. [PubMed] [Google Scholar]
  8. Qureshi S. A., Halim M. A., Pillai R., Smith P., Yacoub M. H. Endarterectomy of the left coronary system. Analysis of a 10 year experience. J Thorac Cardiovasc Surg. 1985 Jun;89(6):852–859. [PubMed] [Google Scholar]
  9. Rankin J. S., Newman G. E., Bashore T. M., Muhlbaier L. H., Tyson G. S., Jr, Ferguson T. B., Jr, Reves J. G., Sabiston D. C., Jr Clinical and angiographic assessment of complex mammary artery bypass grafting. J Thorac Cardiovasc Surg. 1986 Nov;92(5):832–846. [PubMed] [Google Scholar]
  10. Reul G. J. Present status of the internal mammary artery as a coronary artery bypass conduit at the Texas Heart Institute. Tex Heart Inst J. 1985 Sep;12(3):211–219. [PMC free article] [PubMed] [Google Scholar]
  11. Robicsek F. A simple test to determine the efficiency of mammary artery grafts during operation. Ann Thorac Surg. 1985 Apr;39(4):388–388. doi: 10.1016/s0003-4975(10)62643-4. [DOI] [PubMed] [Google Scholar]
  12. Sauvage L. R., Wu H. D., Kowalsky T. E., Davis C. C., Smith J. C., Rittenhouse E. A., Hall D. G., Mansfield P. B., Mathisen S. R., Usui Y. Healing basis and surgical techniques for complete revascularization of the left ventricle using only the internal mammary arteries. Ann Thorac Surg. 1986 Oct;42(4):449–465. doi: 10.1016/s0003-4975(10)60557-7. [DOI] [PubMed] [Google Scholar]
  13. Singh R. N., Beg R. A., Kay E. B. Physiological adaptability: the secret of success of the internal mammary artery grafts. Ann Thorac Surg. 1986 Mar;41(3):247–250. doi: 10.1016/s0003-4975(10)62763-4. [DOI] [PubMed] [Google Scholar]
  14. Vucinić M., Radovancević B., Huskić R., Nezić D. A new efficient method of topical cooling and rewarming of the myocardium. Tex Heart Inst J. 1985 Dec;12(4):323–332. [PMC free article] [PubMed] [Google Scholar]

Articles from Texas Heart Institute Journal are provided here courtesy of Texas Heart Institute

RESOURCES