[Coronary artery bypass grafting to total occlusion of all three coronary vessels].
We studied total occlusion of all three coronary arteries. From 1975 to 1992, a total of 4,100 patients underwent coronary arteriography at Show University Hospital. Of these, four patients (0.1%) had complete occlusion of all three coronary arteries and all of them underwent coronary artery bypass grafting (CABG). The mean numbers of coronary risk factors were only 2.3 but history of angina of effort were long-standing such as 4 to 29 years (mean 16.3 yr). All cases had previous episodes of myocardial infarction. Three cases (75%) had aortic aneurysm. One case was also diagnosed as Leriche syndrome besides coexisting aneurysm. Coronary arteriogram showed total occlusion of right coronary artery, left anterior descending artery and left circumflex artery in the segment of 1.6 or 7 and 11 respectively. All cases had intracoronary anastomosis and intercoronary anastomosis. Among 12 occluded coronary arteries of all four cases, 11 were distally visualized with contrast medium via collateral flow but good opacification of the distal coronary trees were not seen. Also proper assessments of cardiac performance including viability of myocardium were not established because all cases were in the state of C.C.S grades IV. But significant clinical recovery were obtained in all cases after CAGB of three or four bypass. We conclude that these results might be a useful suggestion for the treatment of total occlusion of all three coronary arteries.
Yamada
M
M
Department of Surgery, School of Medicine, Showa University.
Narisawa
T
T
Kazuma
H
H
Tanaka
H
H
Inoue
K
K
Takaba
T
T
D000368:Aged; D003251:Constriction, Pathologic / Q000601:surgery; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged