Long-term left internal mammary artery graft patency for coronary artery disease associated with pseudoxanthoma
Howard K Song1, Erez Sharoni, Byron Williams
1Section of Cardiothoracic Surgery and Division of Cardiology, Emory University, Atlanta, Georgia, USA.
Insights
Pseudoxanthoma elasticum (PXE) patients with coronary artery disease benefit from coronary artery bypass grafting (CABG). Long-term patency of left internal mammary artery (LIMA) grafts in PXE patients is demonstrated, supporting arterial conduit suitability.
Area of Science:
- Cardiology
- Genetics
- Vascular Surgery
Background:
- Pseudoxanthoma elasticum (PXE) is a rare inherited disorder affecting connective tissue.
- PXE commonly leads to premature coronary artery disease (CAD).
- Coronary artery bypass grafting (CABG) is a treatment for PXE-related CAD, but arterial conduit suitability is debated.
Observation:
- A patient with PXE and CAD underwent off-pump CABG.
- The procedure utilized left internal mammary artery (LIMA) and bilateral radial artery grafts.
- Graft patency was assessed over the long term.
Findings:
- The left internal mammary artery (LIMA) graft demonstrated long-term patency.
- Bilateral radial artery grafts also remained patent.
- This case supports the use of arterial conduits in PXE patients undergoing CABG.
Implications:
- The findings suggest that arterial conduits, including LIMA, are suitable for CABG in PXE patients.
- This may improve long-term outcomes for patients with this rare condition.
- Further research into arterial graft use in PXE is warranted.
Abstract:
Pseudoxanthoma elasticum (PXE) is a rare, inherited connective tissue disorder with numerous systemic manifestations that include premature coronary artery disease. Coronary artery bypass grafting (CABG) is known to be beneficial in patients with PXE-related coronary artery disease. In these patients, however, the suitability of arterial conduits, including the internal mammary artery, has been controversial. We present a patient with PXE-related coronary artery disease who has had long-term patency of a left internal mammary artery (LIMA) graft after an off-pump CABG procedure in which LIMA and bilateral radial artery conduits were used.
