title: The Comparison Between Two Surgical Methods for Left Internal Mammary Artery (LIMA) Anastomosis on Left Anterior Descending (LAD) Artery in Patients with Severe Diffuse Lesions: Short to Mid-Term Results.
abstract: Coronary artery disease is the leading cause of death worldwide. In this study, we compared two surgical methods of left internal mammary artery (LIMA) anastomosis on left anterior descending (LAD) artery in patients with severe diffuse lesions. A total of 40 patients were included in our study and randomly assigned into two groups. In group A, after a long arteriotomy on LAD, the posterior surface of left internal mammary artery (LIMA) was opened by the same length and was anastomosed along the LAD course through normal and diseased parts. In group B instead of complete opening of LAD, a small arteriotomy was done only in areas where the wall of the vessel was nearly normal (especially the anterolateral wall), and LIMA was anastomosed to these areas in a sequential (Jump) method. The patients were then followed for post-operation results. The two groups showed equal results regarding early mortality, post-operation bleeding, and infection, pleural and pericardial effusion. There were two cases of myocardial infarction (MI) in group A with one mortality after 18 months, while no MI was reported in group B. Group B demonstrated significantly superior results regarding the rise in ejection fraction and the improvement in functional class. In this study it was demonstrated that diffuse coronary artery lesions of LAD should be preferably operated using LIMA with the sequential-jump anastomoses method and the surgeon should avoid long arteriotomy with single long anastomosis because of lower chance of long-term patency.
authors.affiliation: Department of Cardiac Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. zarrabisx@gmail.com.
authors.forename: Khalil
authors.initials: K
authors.lastname: Zarrabi
authors.affiliation: Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. p.dehghani@gmail.com.
authors.forename: Pooyan
authors.initials: P
authors.lastname: Dehghani
authors.affiliation: Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. ayat.dr@yahoo.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Abdi Ardekani
authors.affiliation: Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. aminz487@gmail.com.
authors.forename: Mohammad Amin
authors.initials: MA
authors.lastname: Zarrabi
authors.affiliation: Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. abdolali.zolghadr@gmail.com.
authors.forename: Abdoali
authors.initials: A
authors.lastname: Zolghadrasli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000601:surgery*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D016037:Single-Blind Method