1. [Reimplantation of the right internal mammary artery into the left internal mammary artery. The Y anastomosis--25 cases].
- Author
-
Barra JA, Mondine P, Mahlab A, Bezon E, Rukbi I, Slimane AK, and Terky AK
- Subjects
- Adult, Aged, Anastomosis, Surgical adverse effects, Coronary Circulation physiology, Coronary Disease physiopathology, Coronary Disease surgery, Female, Follow-Up Studies, Humans, Male, Mammary Arteries physiopathology, Middle Aged, Myocardial Infarction physiopathology, Myocardial Infarction surgery, Myocardial Revascularization adverse effects, Vascular Patency physiology, Anastomosis, Surgical methods, Mammary Arteries surgery, Myocardial Revascularization methods
- Abstract
Distal latero-circumflex arteries (DLCA) and posterior descending artery (PDA) are anatomically too far and cannot be revascularized with internal mammary artery (IMA) by a conventional procedure. The reimplantation of the right IMA into the left IMA in situ increases (2 times) the length of right IMA graft available. Fifty-five patients underwent this technique. Their preoperative status was: 22 males, 3 females; mean age: 57 years, 38% myocardial infarction (MI). Coronary angiography showed: stenosis of the left main coronary artery: 3; stenosis of 3 vessels: 15; 2 vessels: 10; 2.3 anastomoses by patient were performed with Y right and left IMA procedure: 24 LDA, 8 diagonals, 25 DLCA and 1 PDA anastomosis. No deaths were observed in this short series. Morbidity was: 1 MI, 2 sternal sepsis, 1 bilateral phrenic paralysis (all were cured without sequelae). To date (March 90) 15 patients have been followed for 3 to 12 months, 12 are angina-free, 3 are significantly improved, 11 have a negative exercise test. Thallium test is normal in the revascularized area in 14 patients. Seven angiographies have been performed (6 months to 1 year) and all Y right IMA are patent.
- Published
- 1991