“Y” Graft Bypass for Bilateral Coronary Ostial Aortoarteritis

2002 ◽  
Vol 10 (2) ◽  
pp. 162-164 ◽  
Author(s):  
Sushil K Singh ◽  
Deepak Kumar ◽  
Ram D Yadave ◽  
Asha R Khanna ◽  
Subhash K Sinha

A case of bilateral coronary ostial aortoarteritis, which presented with angina pectoris, is reported. Emergency total arterial revascularization was performed using the bilateral mammary artery and radial artery, and the radial artery was hanged “Y” on the left internal mammary artery. The patient was discharged on low-dose steroid. He was asymptomatic at 1-year follow-up.

2016 ◽  
Vol 23 (05) ◽  
pp. 583-588
Author(s):  
Tayyab Pasha ◽  
Rafaqat Ahmed ◽  
Muhammad Amir ◽  
Amir Iqbal ◽  
Ayesha Siddiqa

Objectives: Off pump TACR/MACR performed in experienced hands hascomparable results to on pump TACR/MACR. Period: January-2012 to December-2015.Material and method: 405 patients with two and three vessel coronary artery disease (two &three VCAD) underwent OPCAB at the department of cardiac surgery, Jinnah hospital, Lahore.73 of them got total or multiple arterial coronary revascularizations. 34 patients (41%) hadtwo VCAD and 47 (59%) had three VCAD. Total arterial revascularization was performed in 70(95.8%) patients using right internal mammary artery and left internal mammary artery and/orradial artery. 3 (4.10%) patients got multiple arterial grafts using BITA, RA and SVG. Results:There was no death reported in first 30 days post operatively. Deep sternal wound infectionoccurred in only one patient. The rate of perioperative stroke and renal failure was zero. Two(2.46%) patients had acute MI and 1 patient was reopened due to bleeding. Conclusion: Weconclude that early outcome of OPCAB total or multiple arterial coronary revascularizations, inexperienced hands, are as safe and effective as ONCAB.


2001 ◽  
Vol 72 (4) ◽  
pp. 1275-1281 ◽  
Author(s):  
Edvin Prifti ◽  
Massimo Bonacchi ◽  
Giacomo Frati ◽  
Piero Proietti ◽  
Gabriele Giunti ◽  
...  

2019 ◽  
Vol 29 (2) ◽  
pp. 179-186 ◽  
Author(s):  
Shruti Jayakumar ◽  
Marisa Gasparini ◽  
Tom Treasure ◽  
Clare Burdett ◽  
Felix Jozsa ◽  
...  

Abstract OBJECTIVES Conduits used in coronary artery bypass grafting may have significant impact on outcomes, but evidence is mixed and there is large variation in practice. This study provides insights into the opinions of the UK surgeons on conduit use and their decision-making processes. METHODS A questionnaire was created using the Ottawa Decision Support Framework to elicit the importance that surgeons placed on bilateral internal mammary artery grafting, skeletonization, total arterial revascularization and sequential anastomoses on a scale of 1–10. Scores ≥8 were deemed ‘important’ and ≤3 ‘not important’. Surgeons were asked to specify changes to practice in frail patients or emergencies. Additional questions included conduit type used, factors affecting decision-making and vein harvesting methods. Questionnaires were administered in person with data analysed centrally. RESULTS Ninety-seven consultant cardiac surgeons from 25 centres responded. Thirty-two percent surgeons routinely used radial arteries and 36% used right internal mammary artery. High-quality evidence contributed most to decision-making receiving a total of 328/960 points, with consultant experience being the second (255/960 points). There was a bimodal distribution of perceived importance of bilateral internal mammary artery use, with 29 (30%) ‘important’ and ‘not important’ scores each. 23% of surgeons found total arterial revascularization important. Most surgeons (64%) preferred pedicled mammary arteries. Twenty-six percent of surgeons considered sequential grafting to be important. CONCLUSIONS Low uptake of total arterial revascularization and bilateral internal mammary artery among the UK consultants may be due to the lack of high-quality evidence demonstrating a significant benefit. It is also possible that reluctance to use certain conduits may stem from low levels of exposure to conduits or inadequate training, particularly given the importance of consultant experience on decision-making.


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