Total arterial anaortic off-pump coronary artery bypass grafting for diffuse coronary disease - A case report
Kamales Kumar Saha1, Mandar M Deval1, Shekhar Ambardekar1
1Fortis S L Raheja Hospital, Raheja Rugnalaya Marg, Mahim West Mumbai, Maharashtra, India.
Insights
This study details a diabetic patient with diffuse coronary artery disease successfully treated with total arterial anaortic off-pump coronary artery bypass grafting. The patient remained asymptomatic with excellent graft patency after two years, showcasing a promising surgical approach.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Vascular Biology
Background:
- Diffuse coronary artery disease presents significant surgical challenges.
- Coronary artery bypass grafting (CABG) is a common treatment, but outcomes vary.
- Minimizing stroke risk and maximizing graft longevity are key goals in CABG.
Observation:
- A diabetic patient with diffuse coronary artery disease underwent total arterial anaortic off-pump CABG.
- Nine distal arterial grafts were utilized, including internal mammary and radial arteries.
- The patient remained asymptomatic with patent grafts at over two years post-surgery.
Findings:
- Anaortic off-pump CABG demonstrated a low incidence of stroke.
- Total arterial grafts showed excellent long-term patency rates.
- This case represents the first report of nine arterial grafts performed off-pump.
Implications:
- Total arterial anaortic off-pump CABG is a viable and effective strategy for diffuse coronary artery disease.
- The use of multiple arterial grafts may improve long-term outcomes.
- This surgical technique offers a promising alternative for complex coronary revascularization.
Abstract:
Surgical treatment of diffuse coronary artery disease remains challenging. We present here a diabetic patient, with diffuse coronary disease, revascularized using total arterial anaortic off-pump coronary artery bypass grafting. He received total nine distal grafts. He continues to be asymptomatic after more than 2 years. CT angiography follow-up shows eight out of nine grafts are patent. Anaortic off-pump coronary artery bypass grafting has the least incidence of stroke and arterial grafts have the best long-term patency rate. This is the first case report of nine arterial bypass graft performed off-pump using both internal mammary and both radial arteries. Anaortic total arterial off-pump coronary artery bypass grafting has achieved excellent intermediate term result in this patient of diffuse coronary artery disease.
