Myocardial revascularization with both internal thoracic arteries 25 years after delayed repair for aortic
Mario Gaudino1, Piero Farina2, Federico Cammertoni2
1Division of Cardiac Surgery, Department of Cardiovascular Sciences, Catholic University, Rome, Italy mgaudino@tiscali.it.
Insights
This study reports the first successful bilateral internal thoracic artery grafts for myocardial revascularization in a patient with a history of aortic coarctation repair. It demonstrates the viability of these grafts despite prior aortic repair.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Grafting
Background:
- Aortic coarctation can alter internal thoracic arteries, potentially precluding their use in myocardial revascularization.
- Previous adult repair of aortic coarctation may further compromise internal thoracic artery suitability for grafts.
Observation:
- A patient with a history of aortic coarctation repair 25 years prior underwent myocardial revascularization.
- Bilateral internal thoracic arteries were utilized as grafts for the procedure.
Findings:
- This represents the first documented case of bilateral internal thoracic artery grafting for myocardial revascularization in a patient with a history of aortic coarctation repair.
- The successful use of these grafts suggests they can be viable conduits even after extensive delay post-aortic repair.
Implications:
- This case challenges previous assumptions about the unsuitability of internal thoracic arteries in patients with a history of aortic coarctation.
- It expands potential graft options for myocardial revascularization in this specific patient population.
- Further research may be warranted to evaluate long-term outcomes of such grafts.
Abstract:
Aortic coarctation has been reported to cause alterations in the internal thoracic arteries that make these vessels unsuitable to be used as grafts for myocardial revascularization, especially if coarctation repair was performed in adulthood. This is the first reported bilateral internal thoracic grafting for myocardial revascularization in a patient who had undergone aortic coarctation repair 25 years earlier.
