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Document Type

Original Article

Abstract

Background: The development of numerous atheromatous plaques often compromises the long-term patency of a LIMA to LAD in patients with diffuse LAD disease, making it difficult to attain full myocardial revascularization using traditional bypass procedures. Reconstructing such LAD, has been proposed as a surgical solution. aims: to assess and compare the early surgical results of left anterior descending coronary artery reconstructional patch-plasty using the left internal mammary artery onlay patch technique and the saphenous vein graft patch alongside LIMA anastomosed to the patch technique among individuals with diffusely diseased LAD coronary artery. Patients and methods: this prospective study involves sixty individuals who underwent coronary artery bypass graft surgery with reconstruction of the left anterior descending artery in the cardiothoracic surgery departments of Al-Azhar University and Nasser Institute hospitals from March 2021 to March 2023. Results: there were statistically significant variances among the groups being studied in terms of CK in the first 3 days postoperatively, echocardiography postoperatively (except for MV regurge), and complications such as post-operative AF, ventricular arrhythmia, and hemorrhage. There were no clinically noteworthy variations in demographics, ECG changes, postoperative low COP, or reopening among the groups. Problems with the kidneys, the brain, and the lungs.conclusion, left internal mammary patch reconstruction of the left anterior descending coronary artery appears to be an excellent option, superior to saphenous vein graft patch reconstruction without endarterectomy for patients with diffusely diseased left anterior descending coronary artery.

Keywords

Left Anterior Descending Coronary artery (LAD); reconstruction; poor target LAD; Bypass Grafting procedure

Subject Area

Thoracic and cardiovascular surgery

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