scholarly journals Intraoperative Validation of Left Internal Mammary Artery Graft by Flourescence Imaging Technique

2018 ◽  
Vol 10 (2) ◽  
pp. 145-149
Author(s):  
AM Asif Rahim ◽  
MAH Pervez ◽  
MG Kibria ◽  
MSH Talukder ◽  
A Zaman ◽  
...  
Keyword(s):  
Gold Standard ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Graft Patency ◽  
Conventional Angiography ◽  
Mortality And Morbidity ◽  
Internal Mammary ◽  
Operative Assessment

Background: In coronary artery bypass surgery (CABG) left internal mammary artery (LIMA) is considered gold standard conduit of choice for myocardial revascularization. Graft failure following CABG reduces cardiac mortality and morbidity both in short and long term. Although conventional angiography is gold standard for assessing graft patency but rarely available in same operating room. So intraoperative florescence imaging could be an efficient and reliable method of assessing the patency of graft.Methods: This study was conducted between July 2013 to June 2014 in the Department of Cardiac Surgery of National Institute of Cardiovascular Diseases (NICVD). Thirty six LIMA grafts were assessed by using IFI system .ICG administered through CVP line and imaging acquired during pass of the ICG through field of view graft flow. Quality of anastomosis was intra operatively to validate graft.Results: Mean age of study population was 54±8.38 years. Per operative assessment of LIMA to left anterior descending artery revealed 32 (88.8%) patent anastomosis, narrowing of anastomosis was found in 2 (5.55% ) patients.Conclusion: Intraoperative fluorescence imaging is an effective and inexpensive way to validate patency of LIMA graft.Cardiovasc. j. 2018; 10(2): 145-149

Left Internal Mammary Artery Graft Retransplantation from the Recipient to the Donor Heart: A Case Report

2000 ◽  
Vol 10 (1) ◽  
pp. 18-20
Author(s):  
Andras Kollar ◽  
Terri Donaldson ◽  
Elaine Greer ◽  
Renee Howser ◽  
Stacy F. Davis ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Myocardial Revascularization ◽  
Donor Heart ◽  
Artery Graft ◽  
Internal Mammary Artery Graft ◽  
Internal Mammary ◽  
History Of

A case of heart transplantation with concomitant coronary artery bypass graft is reported. The patient was an alternate transplant list candidate with a history of bilateral below-knee amputation and 2 previous myocardial revascularization procedures. The previously used and patent left internal mammary artery graft was successfully removed and retransplanted from the recipient to the donor heart.

Side-Branch of Internal Mammary Artery Bypass Graft Causing Coronary Steal

1998 ◽  
Vol 6 (3) ◽  
pp. 219-220 ◽  
Author(s):  
Pasquale Mastroroberto ◽  
Massimo Chello ◽  
Saverio Zofrea ◽  
Roberto Ceravolo ◽  
Francesco Perticone
Keyword(s):  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Stress Test ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Myocardial Revascularization ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Internal Mammary ◽  
Coronary Steal

A case of coronary steal syndrome caused by a large unligated branch of the left internal mammary artery in a patient who had undergone myocardial revascularization is described. The presence of recurrent angina, a positive exercise stress test, and repeat angiography showing a lateral branch of the mammary artery led to a diagnosis of the coronary steal phenomenon. Surgical ligation of the branch was performed and the patient became symptom-free with a negative exercise stress test.

scholarly journals Angiographic patency after robotic beating heart totally endoscopic coronary artery bypass grafting facilitated by automated distal anastomotic connectors

2020 ◽  
Vol 31 (4) ◽  
pp. 467-474
Author(s):  
Husam H Balkhy ◽  
Sandeep Nathan ◽  
Gianluca Torregrossa ◽  
Hiroto Kitahara ◽  
Sarah Nisivaco ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Clinical Outcomes ◽  
Coronary Artery Bypass ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Graft Patency ◽  
Beating Heart ◽  
Internal Mammary

Abstract OBJECTIVES Robotic totally endoscopic coronary artery bypass (TECAB) on the beating heart has been facilitated in our experience using distal coronary anastomotic connectors. In this study, we retrospectively reviewed graft patency in all robotic TECAB patients who underwent formal angiography at our current institution over a 5-year period. METHODS Between July 2013 and June 2018, 361 consecutive patients underwent robotic beating-heart TECAB. Of these patients, 121 had a follow-up angiogram, which assessed graft patency. Eighty-four patients had an angiogram as part of planned hybrid procedures and 37 patients underwent an unplanned angiogram for clinical indications. Retrospective analysis of angiographic patency and clinical outcomes was performed. RESULTS The mean Society of Thoracic Surgeons predicted risk of mortality was 1.8%. Single-vessel bypass was performed in 40 (33%) patients and multivessel grafting in 81 (67%). Average flow (ml/min) and pulsatility index in the grafts was 74.7 ± 39.1 and 1.42 ± 0.52, respectively. The number of grafts evaluated was 204 (130 left internal mammary artery and 74 right internal mammary artery grafts). The median time to angiography was 1.0 and 16.0 months and graft patency was 98% and 91% in the hybrid and non-hybrid groups, respectively. Overall graft patency was 95.6% (left internal mammary artery = 96%; right internal mammary artery = 93%). Left internal mammary artery to left anterior descending artery graft patency was 97%. Clinical follow-up was available for 316 (88%) patients at mean 22.5 ± 15.1 months. Freedom from major adverse cardiac events at 2 years was 92%. CONCLUSIONS In this consecutive series of patients undergoing formal angiography after robotic single and multivessel TECAB, we found satisfactory graft patency and 2-year clinical outcomes. Longer-term follow-up is warranted.

scholarly journals Iatrogenic Aortocoronary Arteriovenous Fistula following Coronary Artery Bypass Surgery: A Case Report and Complete Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Jonathan D. Gardner ◽  
William R. Maddox ◽  
Joe B. Calkins
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Rare Complication ◽  
Artery Bypass ◽  
Coronary Vein ◽  
Arteriovenous Fistulas ◽  
Asymptomatic Patients ◽  
Internal Mammary

The case of a patient who presented with angina following a coronary artery bypass (CABG) operation during which the left internal mammary artery was inadvertently anastomosed to a cardiac vein is presented. The literature concerning previously reported cases of aortocoronary arteriovenous fistulas (ACAVF) due to inadvertent grafting of a coronary vein is reviewed and the significance of this complication is discussed. ACAVF due to inadvertent grafting of a coronary vein is a rare complication of CABG and may be a more common cause of graft failure than has previously been recognized. Distortion of cardiac anatomy, the presence of epicardial fat, and an intramyocardial course of the artery intended for grafting are predisposing factors. Some patients present with angina pectoris and heart failure whereas others have no symptoms. The diagnostic test of choice is coronary angiography. Cardiac MRI and CT have a limited role due to the smaller size and the more clearly defined course of these fistulas. Asymptomatic patients are simply observed since spontaneous closure of these fistulas is reported. Symptomatic patients can be treated with combined medical management and percutaneous methods.

scholarly journals Refractory Angina Secondary to Large Unligated Side Branch of Internal Mammary Artery

2019 ◽  
Vol 14 ◽  
Author(s):  
Zachary Oman ◽  
Lucas Gu ◽  
Nauman Khalid ◽  
Rahil Rafeedheen ◽  
Hassan Alkhawam ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Medication Management ◽  
Side Branch ◽  
Current Data ◽  
Refractory Angina ◽  
Common Diagnosis ◽  
Internal Mammary

Coronary artery disease (CAD) has become a common diagnosis. Managing the symptoms of CAD continues to be an ongoing dilemma requiring optimal medication management or potential revascularization with either percutaneous coronary interventions or coronary artery bypass grafting (CABG). We present a case of debilitating refractory angina in a patient with severe CAD after optimal medical therapy and CABG secondary to coronary steal phenomenon via the left internal mammary artery conduit supplying a large unligated side branch to the internal chest wall. While current data are inconclusive on this phenomenon, our patient had complete resolution of angina following coil embolization of unligated side branch of the internal mammary artery.   

scholarly journals On pump harvesting of Left Internal Mammary Artery (LIMA) in unstable patients undergoing coronary artery bypass grafting (CABG) is a safe operative strategy: A pilot study

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Muhammad Sher-i-Murtaza ◽  
Mirza Ahmad Raza Baig
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Hemodynamic Instability ◽  
Bypass Grafting ◽  
Operative Strategy ◽  
Internal Mammary

Objective: To evaluate the clinical safety of left internal mammary artery (LIMA) harvesting in hemodynamically unstable patients after establishing cardiopulmonary bypass (CPB) in isolated coronary artery bypass graft (CABG) surgery. Methods: The prospective observational study was conducted at Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, Pakistan, from December 2016 to August 2018. All patients undergoing isolated CABG surgery in which LIMA conduit was harvested after establishing cardiopulmonary bypass because of hemodynamic instability at induction of anaesthesia or during surgery were included in the study. Preoperative, operative and postoperative characteristics of the patients were recorded. Data was analyzed using SPSS 19. Results: In Forty nine patients including 39 male and 10 female, early CPB had to be established because of hemodynamic instability and afterwards LIMA was harvested. Out of 49, 30 patients presented with CCS class III angina. 37 (75.5%) patients were scheduled on elective coronary surgery waiting list. There were 39 (79.59%) patients who weaned off bypass on mild inotropic support and 4 (8.16%) patients needed IABP support. All patients had multi-vessel coronary artery disease. Mean number of grafts were 3.428±0.577, CPB time was 110.59±25.594 and hospital stay was 5.367±1.424. Conclusions: The study showed that LIMA can be safely harvested in unstable patients after establishing extracorporeal circulation and by using this operative strategy in patients who need urgent or emergent surgical coronary revascularization LIMA can be safely used as a conduit. doi: https://doi.org/10.12669/pjms.35.3.988 How to cite this:Sher-i-Murtaza M, Baig MAR. On pump harvesting of Left Internal Mammary Artery (LIMA) in unstable patients undergoing coronary artery bypass grafting (CABG) is a safe operative strategy: A pilot study. Pak J Med Sci. 2019;35(3):---------.  doi: https://doi.org/10.12669/pjms.35.3.988 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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