Angiographic characteristics of major intramural coronary arteries and their effect on coronary bypass surgery.
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.
Arslan
Caner
C
TDV 29 Mayis Hospital, Cardiovascular Surgery Dept., Istanbul, Turkey. canerkvc@yahoo.com
Kayhan
Bekir
B
Cantürk
Emir
E
Bozkurt
Ahmet Kürşat
AK
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