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Endovascular approach in chronic aortoiliac disease in patient undergoing coronary artery bypass surgery

Fotini Ampatzidou1, Charilaos-Panagiotis Koutsogiannidis1, Aggelos Megalopoulos2

  • 1Department of Cardiothoracic Surgery, General Hospital "G. Papanikolaou," Thessaloniki, Greece.

Annals of Cardiac Anaesthesia
|January 17, 2019
PubMed

Insights

Internal thoracic artery (ITA) is a key vessel for coronary artery bypass grafting (CABG). Preoperative identification of Winslow

Area of Science:

  • Cardiovascular Surgery
  • Vascular Anatomy

Background:

  • Coronary artery bypass grafting (CABG) frequently utilizes the internal thoracic artery (ITA) as a preferred conduit.
  • Aortoiliac disease can present complex challenges in patients requiring CABG.

Observation:

  • A patient with known preoperative aortoiliac disease and an anterior collateral pathway was evaluated for elective coronary bypass.
  • The potential for lower limb ischemia due to ITA use in such patients was noted.

Findings:

  • The anterior collateral pathway, specifically Winslow's anastomotic pathway, is crucial for maintaining lower limb perfusion when the ITA is used.
  • Failure to recognize this pathway can lead to adverse outcomes.

Implications:

  • Preoperative assessment for Winslow's anastomotic pathway is critical in patients with aortoiliac disease undergoing CABG.
  • This assessment ensures the safe utilization of the ITA and prevents potential lower limb ischemia.

Keywords:
Aortoiliac diseasecollateral blood flow' ischemiacoronary artery bypass surgery

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