scholarly journals A rare case of left internal mammary artery disease before bypass surgery

2015 ◽  
Vol 36 (22) ◽  
pp. 1349-1349
Author(s):  
S. P. Tripathi ◽  
P. G. Kerkar ◽  
C. P. Lanjewar ◽  
M. S. Phadke
Keyword(s):  
Rare Case ◽  
Bypass Surgery ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Internal Mammary ◽  
Artery Disease

scholarly journals A New Current to The Armamentarium: Is the CHA2DS2-Vasc-HS Score Predictive of Low Left Internal Mammary Artery (LIMA) Flow in Patients Underwent Coronary Bypass Surgery?

2021 ◽  
Vol 24 (4) ◽  
pp. E631-E636
Author(s):  
Nihat SOYLEMEZ ◽  
Mehmet BALLI ◽  
Fatma KÖKSAL ◽  
Mahmut YILMAZ ◽  
Fazilet ERTURK SAG ◽  
...  
Keyword(s):  
Bypass Surgery ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Bypass Graft ◽  
Previous History ◽  
Estimation Method ◽  
Coronary Bypass ◽  
Internal Mammary ◽  
Flow Group ◽  
Artery Disease

Introduction: Left internal mammary artery (LIMA) grafts should be used in patients undergoing CABG. No other procedure results in patency equivalent to that of the left anterior descending coronary artery (LAD)–LIMA bypass graft. The CHA2DS2-Vasc-HS scoring system can be used to successfully predict CAD severity in stable CAD patients. We aimed to investigate the relationship between LIMA flow and the CHA2DS2-Vasc-HS score. Methods: A total of 684 patients, who underwent CABG surgery, were included in this study. Previous history of bypass surgery, emergency operations, patients with Leriche syndrome and patients with severe obstructive pulmonary and subclavian artery disease were excluded from our study. Patients with a LIMA flow that was suitable for bypass grafting, as determined during the intraoperative evaluation, were included in the low LIMA flow group, and the CHA2DS2-Vasc-HS score was calculated for all patients. Results: Patients in the low LIMA flow group (Group 1) were older. The CHA2DS2-Vasc-HS score (P < 0.001), presence of mild or moderate COPD (P = 0.022), number of severely diseased vessels (P = 0.036), and BMI (P < 0.001) were independent predictors of poor LIMA flow. The cutoff value of the CHA2DS2-VASc-HS score for the prediction of poor LIMA flow was >5.5, with a sensitivity of 92.9% and specificity of 83.4% (AUC: 0.938, 95% Cl: 0.906 – 0.970, P < 0.001). Conclusion: A preoperative high CHA2DS2-Vasc-HS score can be used to predict low intraoperative LIMA flow. The CHA2DS2-Vasc-HS score is an easy-to-use and reliable estimation method and can be used as an additional preoperative of LIMA flow in patients undergoing CABG due to severe CAD.

scholarly journals A nasty surprise: cardiogenic shock induced by extensive dissection of the left internal mammary artery graft occurring 3 months after coronary angiography—a case report

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Henning Ebelt ◽  
Peter Röhl ◽  
Andreas Schwenzky ◽  
Matthias Hoyme ◽  
Matthias Wiora
Keyword(s):  
Acute Coronary Syndrome ◽  
Bypass Surgery ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Threatening Condition ◽  
Internal Mammary ◽  
Life Threatening ◽  
Acute Dissection

Abstract Background Acute dissection of the left internal mammary artery (LIMA) graft in patients with previous cardiac bypass surgery is a rare but potentially life-threatening condition. Case summary A 58-year-old man with history of coronary artery disease and bypass surgery 15 years ago presented with acute coronary syndrome (non-ST-elevation myocardial infarction, NSTEMI). Angiography showed severe three-vessel disease with occlusion of a saphenous vein graft (SVG) to the first diagonal branch but patents grafts to left artery descendent (LIMA) and SVG to the right coronary artery. No coronary intervention was performed and the patient was treated medically (aspirin and ticagrelor) and discharged home after 6 days. Three months later, the patient again was admitted to the hospital with acute coronary syndrome (NSTEMI) and developing cardiogenic shock. Angiography now showed an extensive flow limiting dissection of his LIMA graft with the dissection starting at the ostium of the LIMA. After implantation of an Impella 2.5, percutaneous coronary intervention (PCI) of the graft was performed under guidance by optical coherence tomography (OCT) leading to implantation of a drug-eluting stent into the ostium of the LIMA and repeated balloon dilatations of the medial and distal parts of the graft. Antegrade flow was established and the patient’s condition improved so that the Impella was removed in the cath lab. After an uneventful course, the patient was discharged home after 6 days. Elective repeat angiography after 8 weeks showed an excellent functional result without persisting signs of LIMA dissection or stenosis. Discussion Acute dissection of a LIMA graft is a rare event that may lead to a life-threatening condition. According to the literature, LIMA dissection happens during coronary interventions in approximately half of the cases but it also may evolve spontaneously. However, as seen from our case, there might be a substantial delay between LIMA angiography and the clinical onset of dissection. In the vast majority of cases, dissection of LIMA can be treated by PCI. The use of Impella as reported for the first time in this case may improve the safety of the procedure. In accordance to PCI of the native coronary arteries, it seems possible to leave non-flow limiting dissections in cases of extensive disease in order to avoid the late complications of complete stenting of the graft.

Coronary Bypass Surgery in Patient with Malaria

2002 ◽  
Vol 10 (2) ◽  
pp. 160-161 ◽  
Author(s):  
Mehmet Balkanay ◽  
Denyan Mansuroğlu ◽  
Kaan Kirali ◽  
Suat Nail Ömeroğlu ◽  
Cevat Yakut
Keyword(s):  
Bypass Surgery ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Early Postoperative Period ◽  
Beating Heart ◽  
Bypass Grafting ◽  
Antimalarial Therapy ◽  
Internal Mammary

A 65-year-old man with unstable angina pectoris developed malaria prior to coronary artery bypass grafting. After 3 weeks on antimalarial therapy, left internal mammary artery-toleft anterior descending artery anastomosis was performed on the beating heart to avoid the effects of cardiopulmonary bypass. There was no complication in the early postoperative period.

scholarly journals Perioperative Avulsion of a Left Internal Mammary Artery Graft in a Patient with Syphilis

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Vasily I. Kaleda ◽  
Sergei A. Belash ◽  
Alexei V. Barsuk ◽  
Kirill O. Barbuhatti
Keyword(s):  
Rare Case ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Massive Bleeding ◽  
Bypass Grafting ◽  
Artery Graft ◽  
Internal Mammary Artery Graft ◽  
Internal Mammary ◽  
Life Threatening

Avulsion of a graft after coronary artery bypass grafting surgery is a rare but very serious complication which leads to massive bleeding and possible life-threatening cardiac tamponade. In this paper we report a very rare case of a left internal mammary artery graft avulsion on the day of surgery in a patient with syphilis.

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