title: Rare case of proximal coronary plaque regression after distal arterial grafting.
abstract: The metabolically active endothelium of arterial grafts is reported to slow the atherosclerotic process in the distal coronary territories to which they are grafted with improved patency. The literature on arterial grafting causing proximal plaque regression is scant. We report here a case of proximal left anterior descending artery (LAD) plaque regression following distal arterial grafting with a left internal mammary arterial (LIMA) graft to LAD. This rarely documented regression resulted in "stringing" of the arterial graft, while there was a significant progression of atherosclerotic disease in the right coronary with patent venous graft and de novo lesion in circumflex territory necessitating percutaneous coronary intervention, in spite of aggressive medical therapy. The dichotomous progression of disease in two out of three coronary arterial systems and regression of the proximal plaque in LAD grafted with LIMA 12 years ago suggests the protective effect of arterial grafting in reversing the atherosclerotic process.
authors.affiliation: Rajagiri Hospital, Chunangamvely, Aluva, Kochi 683112, Kerala, India.
authors.forename: George Jose
authors.initials: GJ
authors.lastname: Valooran
authors.affiliation: Rajagiri Hospital, Chunangamvely, Aluva, Kochi 683112, Kerala, India. Electronic address: shivnairmd@gmail.com.
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Nair
authors.affiliation: Rajagiri Hospital, Chunangamvely, Aluva, Kochi 683112, Kerala, India.
authors.forename: Krishnan
authors.initials: K
authors.lastname: Chandrasekharan
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D018450:Disease Progression; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D058226:Plaque, Atherosclerotic / Q000175:diagnosis / Q000601:surgery*
keywords: Arterial graft; Coronary artery bypass grafting; Coronary plaque; Internal mammary artery; Statins