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Published on: March 27, 2018
Coronary artery bypass grafting using an abdominal artery as an inflow
Kenji Takahashi1, Kazuyuki Daitoku, Masahito Minakawa
1Department of Cardiovascular Surgery, Aomori Municipal Hospital, Katta, Aomori City, Japan. takaken@r66.7-dj.com
Insights
Utilizing abdominal arteries for inflow in coronary artery bypass grafting offers a viable alternative when the ascending aorta is unusable. This surgical technique demonstrated excellent graft patency and symptom resolution in all patients.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Cardiac Anesthesia
Background:
- Ascending aorta unusable for inflow in multiple bypass surgery necessitates alternative inflow sites.
- Abdominal arteries serve as a viable inflow option when ascending aorta cannulation is contraindicated.
- This technique is crucial for reoperations to avoid damaging patent grafts and in cases where the gastroepiploic artery is unsuitable.
Purpose of the Study:
- To evaluate the efficacy and safety of using abdominal arteries as an inflow source in coronary artery bypass grafting.
- To assess graft patency and clinical outcomes in patients undergoing bypass surgery with abdominal artery inflow.
Main Methods:
- Seventeen patients underwent coronary artery bypass grafting using an abdominal artery for inflow.
- Gastroduodenal, common hepatic, left gastric, right gastric, and middle colic arteries were utilized as inflow sources.
- Target coronary arteries included the right posterior descending, atrioventricular, and circumflex arteries.
Main Results:
- No intraoperative mortality was observed in the study cohort.
- All patients experienced symptom resolution postoperatively.
- Postoperative angiography confirmed 100% graft patency in all treated patients.
Conclusions:
- Abdominal artery inflow is a safe and effective alternative for coronary artery bypass grafting when the ascending aorta is not suitable.
- This technique is particularly beneficial for complex cases requiring bypass to large perfusion areas or in reoperative settings.
- Successful utilization of various abdominal arteries demonstrates the versatility of this approach in cardiovascular surgery.
Background:
In multiple bypass surgery, when the ascending aorta cannot be used as an inflow, it is sometimes necessary to use an abdominal artery. This technique is useful when a re-median sternotomy might damage a patent graft in patients undergoing reoperations or when the gastroepiploic artery is unsuitable for use as a graft.
Methods:
The subjects were 17 patients in whom an abdominal artery was used as an inflow. In these 17 patients, 9 underwent surgery for the first operation, while 8 underwent surgery for the reoperation. As an inflow, the gastroduodenal artery was used in 8 patients, the common hepatic artery in 4 patients, the left gastric artery in 3 patients, the right gastric artery in 1 patient, and the middle colic artery in 1 patient. The target coronary artery was the right posterior descending artery in 13 patients, the atrioventricular artery in 2 patients, and the circumflex artery in 4 patients. Sequential bypass was performed on 2 patients.
Results:
None of the patients died during surgery. Symptoms disappeared postoperatively in all patients; postoperative angiography showed that all grafts were patent.
Conclusions:
The present technique is useful when the ascending aorta cannot be used as an inflow or when a bypass to a region with a large perfusion area is needed in multiple bypass surgery.
