Coronary artery bypass grafting for Fabry's disease: veins more suitable than arteries?
Coronary artery bypass grafting was performed in a 54-year-old man affected by untreated Fabry's disease. Left internal mammary artery (LIMA) and saphenous vein grafts were implanted. Surgical samples of LIMA revealed diffuse glycosphyngolipid infiltration of smooth muscle cells, whereas SV was normal. After surgery, the patient received antithrombotic and enzyme replacement therapy. At 1-year follow-up, LIMA graft occluded, whereas saphenous vein graft remained patent. In Fabry's disease, veins, probably because of a low pressure load, seem to be spared from glycosphingolipid accumulation and are more suitable than arteries for grafting. A preventive histology of conduits is suggested before graft selection.
Department of Heart and Great Vessels Attilio Reale, La Sapienza University, 00161 Rome, Italy.
Cristina
C
Chimenti
Emanuela
E
Morgante
Giuseppe
G
Critelli
Matteo A
MA
Russo
Andrea
A
Frustaci
D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000209:etiology / Q000601:surgery; D000795:Fabry Disease / Q000150:complications / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000473:pathology*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D012501:Saphenous Vein / Q000473:pathology* / Q000601:surgery