Alternative option in patients with multisegmental left anterior descending coronary artery disease for providing complete myocardial revascularization.
OBJECTIVE
The basic aim of surgical interventions in patients with coronary artery disease is to complete myocardial revascularization. In such patients, however, complementary revascularization techniques may require in patients with multisegmental left anterior descending disease. Among the different procedures, we performed an alternative option in patients with multisegmental lad disease for providing complete myocardial revascularization.


METHODS
This study consists of retrospective analysis of consecutive eight patients between january 2008 and august 2013. In all patients, the surgical procedure consisted of standard aortic and right atrial cannulations followed by coronary artery bypass grafting with cardiopulmonary bypass. At the lesions of non-lad vessels distal anastomoses were performed with saphenous vein graft. After that lad arteriotomies were performed at the proximal and the distal segment of coronary stenosis, and a bridge was formed with a short segment valveless svg. The left internal mammary artery was anastomosed on the bridge.


RESULTS
This innovative technique was performed successfully in all the patients. There were no morbidity and in-hospital mortality. At follow-up 1 year control, all the patients have no complications. In 2 patients, control angiogram showed a patent lima to a bridge anastomosis.


CONCLUSIONS
Although our series has a small group population, we advocate that this is a safe, easy, and efficient technique for providing complete revascularization in multisegmental lad disease. This technique could be performed with the good result and easy implementation. It perfuses both the proximal and the distal segments of the multisegmental lad stenoses.
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training & Research Hospital Bursa, Turkey.
Arif
A
Gucu
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training & Research Hospital Bursa, Turkey.
Tuğrul
T
Goncu
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training & Research Hospital Bursa, Turkey.
Senol
S
Yavuz
Department of Cardiology, Bursa Yuksek Ihtisas Training & Research Hospital Bursa, Turkey.
Ozlem Arican
OA
Ozluk
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training & Research Hospital Bursa, Turkey.
Cuneyt
C
Eris
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training & Research Hospital Bursa, Turkey.
Tamer
T
Turk
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training & Research Hospital Bursa, Turkey.
Ahmet
A
Ozyazıcıoglu
Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Training & Research Hospital Bursa, Turkey.
Hakan
H
Vural
Coronary artery bypass grafting; complete myocardial revascularization; revascularization techniques