Rotational atherectomy in the distal left anterior descending coronary artery through an internal mammary artery graft.
We report the case of a 53-year-old white man who began complaining of dyspnoea and angina 19 months after coronary artery bypass graft surgery. Coronary angiography revealed the presence of a long and critical stenosis in the native left anterior descending coronary artery, shortly after distal anastomosis of the left internal mammary artery. After failed predilatations with standard or cutting balloons, we successfully used the rotablator system, which allowed us to implant a bare-metal stent in the native left anterior descending coronary artery. However, stent deployment caused long linear graft dissection, which was reduced by drug-eluting stent implantation in the proximal and distal segments of the left internal mammary artery.
Sardella
Gennaro
G
Department of Cardiovascular and Respiratory Sciences, La Sapienza University, Rome, Italy. rino.sardella@uniroma1.it
De Luca
Leonardo
L
Di Roma
Angelo
A
Fedele
Francesco
F
D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D015607:Stents