title: Angiographic characteristics of major intramural coronary arteries and their effect on coronary bypass surgery.
abstract: OBJECTIVE
  Dissection of intramyocardial coronary arteries can cause technical problems in coronary bypass surgery, including bleeding and inadvertent ventricular perforation, which can prolong the operation time. The goal of this study was to assess the effects of intramural coronary arteries on coronary bypass surgery and to define the angiographic characteristics of these coronary arteries.
  
  
  RESULTS
  We studied 112 patients (60.12 +/- 10.23 y, 98 M) who underwent coronary bypass surgery, half of whom had intramural coronary arteries. Coronary angiographies were revised just after surgery, and characteristics of intramural coronary arteries were documented by combining surgical findings and angiographies. In angiographic examinations, studied intramural segments of the coronary arteries had less angulations in contrast to matched segments of control groups (mean 1.1 +/- 0.3 vs. 2.46 +/- 1.04, P < 0.001), and the angles were significantly smaller (13.25 +/- 1.28 degrees vs. 24.11 +/- 11.0 degrees P < 0.001). During surgery the intramural portions of the coronary arteries appeared to be free of atherosclerotic plaques. Mean cross clamp time of patients with intramural coronary arteries was longer than that in control patients (58.86 +/- 19.65 vs. 48.29 +/- 16 68, P < 0.01).
  
  
  CONCLUSIONS
  Major intramural coronary arteries can be diagnosed preoperatively by angiographic examination. Overlying myocardial bands play a protective role against coronary artery atherosclerosis.
authors.affiliation: TDV 29 Mayis Hospital, Cardiovascular Surgery Dept., Istanbul, Turkey. canerkvc@yahoo.com
authors.forename: Caner
authors.initials: C
authors.lastname: Arslan
authors.forename: Bekir
authors.initials: B
authors.lastname: Kayhan
authors.forename: Emir
authors.initials: E
authors.lastname: Cantürk
authors.forename: Ahmet Kürşat
authors.initials: AK
authors.lastname: Bozkurt
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies