[Reimplantation of the right internal mammary artery into the left internal mammary artery. The Y anastomosis--25 cases].
Distal latero-circumflex arteries (DLCA) and posterior descending artery (PDA) are anatomically too far and cannot be revascularized with internal mammary artery (IMA) by a conventional procedure. The reimplantation of the right IMA into the left IMA in situ increases (2 times) the length of right IMA graft available. Fifty-five patients underwent this technique. Their preoperative status was: 22 males, 3 females; mean age: 57 years, 38% myocardial infarction (MI). Coronary angiography showed: stenosis of the left main coronary artery: 3; stenosis of 3 vessels: 15; 2 vessels: 10; 2.3 anastomoses by patient were performed with Y right and left IMA procedure: 24 LDA, 8 diagonals, 25 DLCA and 1 PDA anastomosis. No deaths were observed in this short series. Morbidity was: 1 MI, 2 sternal sepsis, 1 bilateral phrenic paralysis (all were cured without sequelae). To date (March 90) 15 patients have been followed for 3 to 12 months, 12 are angina-free, 3 are significantly improved, 11 have a negative exercise test. Thallium test is normal in the revascularized area in 14 patients. Seven angiographies have been performed (6 months to 1 year) and all Y right IMA are patent.
Barra
J A
JA
Service de Chirurgie Thoracique, Cardiaque et Vasculaire, Centre Hospitalier Régional et Universitaire, Brest.
Mondine
P
P
Mahlab
A
A
Bezon
E
E
Rukbi
I
I
Slimane
A K
AK
Terky
A K
AK
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D003326:Coronary Circulation / Q000502:physiology; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery; D009204:Myocardial Revascularization / Q000009:adverse effects / Q000379:methods*; D014654:Vascular Patency / Q000502:physiology
Réimplantation de l'artère mammaire interne droite dans l'artère mammaire interne gauche. Montage en Y--vingt-cinq cas.