[Surgical osteoplasty of the left main coronary artery using the right internal thoracic artery].
A 39-year-old female with a history of progressive refractory angina required medical treatment. A coronary angiography showed 75% left coronary ostial stenosis without any other atherosclerotic lesions. The isolated ostial stenosis of the left main coronary artery was reconstructed by patch angioplasty, using a proximal segment of the right internal thoracic artery. The transaortic patch angioplasty was performed using a superior approach, which allowed a good exposure of the left coronary artery to the aorta without difficulty. A postoperative coronary angiography showed satisfactory patency, and a small biopsy of the ostial tissue demonstrated findings compatible with fibromuscular dysplasia. Based on this outcome, a proximal segment of the internal thoracic artery appears to provide a suitable patch material for enlarging the left coronary ostium.
Shimanuki
T
T
Department of Cardiovascular Surgery, Yamagata Prefectural Nihonkai Hospital, Sakata, Japan.
Uchino
H
H
Toyama
S
S
Abiko
M
M
D000328:Adult; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D006801:Humans; D008323:Mammary Arteries; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods