Mammary Arteries – ABC CARDIOL

ABCIC

Case Report

Spasm of the Internal Thoracic Artery. Value of Echocardiography and Doppler in Long-term Follow-up

José Sebastião de Abreu et al. Tereza Cristina Pinheiro Diogenes Ana Gardenia L. Ponte Farias Marilia Esther Benevides Abreu … Renan Abreu Freire José Erirtônio Façanha Barreto

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IJCS

Original Article

Prevalence of Atherosclerotic Lesions in the Left Internal Thoracic Artery, Evidenced by Selective Angiographic Findings

Hadrien Felipe Meira Balzan et al. Rafael Vinicius Lube Battilani Otávio Celeste Mangili Marcos Franchetti … Leonardo Celeste Mangili Julio de Paiva Maia Dorane Dias de Moura Bruna Felipe de Melo Lage

Abstract

Background:

By observing the high prevalence of failures in the surgical treatment of myocardial revascularization (MR), with the use of the Left Internal Thoracic Artery (LITA) as a graft, evidenced by the international literature, it was sought to demonstrate the prevalence of lesions that would not allow the use of LITA as a graft in myocardial revascularization surgery, with possible alteration in the surgical management performed by the cardiac surgeon, and reduction of the morbimortality of these patients.

Objectives:

To evaluate the prevalence of atherosclerotic lesions of the LITA, through selective preoperative angiography, in patients submitted to coronary angiography and indicated for myocardial revascularization. We also analyzed other lesions that made the use of LITA unfeasible as a main graft in cases of myocardial revascularization surgery (MRS).

Methods:

This was a cross-sectional, prevalence study that evaluated, through selective angiography, the LITA of 39 patients with a median age of 63 years, submitted to coronary angiography, with indication of Coronary Artery Bypass Graft (CABG). Categorical variables were compared by chi-square test and Fisher’s exact test. The single continuous variable, age, was tested for normality by the Kolmogorov-Smirnov test, described in median (P25; P75) and the groups compared with the Mann-Whitney test. The level of statistical significance adopted was p < 0.05. The analyzes were performed in SPSS^® software version 20.

Results:

It was identified the presence of 7.7% of disorders in the LITA that made it unfeasible to be used. In all of the patients there was no specific symptomatology evidencing the lesion. No variable was shown as a predictor for the occurrence of the outcomes.

Conclusion:

The prevalence of the lesions found in the study was significant, indicating that a preoperative evaluation of LITA could bring future benefits to the patients submitted to CABG.

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ABC

Letter to the Editor

Prophylactic Left Internal Mammary Artery Graft In Mildly-Stenosed Coronary Lesions. Still an Open Discussion

Levent Cerit

I have read the article entitled “Prophylactic Left Internal Mammary Artery Graft in Mildly-Stenosed Coronary Lesions. Still An Open Discussion” by Evora et al.1 with great interest, recently published in Arquivos Brasileiros de Cardiologia. The investigators reported that the idea of a prophylactic left internal mammary artery (LIMA) on left anterior descending in mild-stenosed vessels is not confirmed yet by clinical evidence.

Berger at al. reported that all moderate coronary lesions should be LIMA grafted during primary coronary bypass surgery.

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ABC

Image

Left Internal Mammary Artery Graft-to-Pulmonary Artery Fistula

Emmanouil Petrou et al. Ioannis Iakovou

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ABC

Case Report

Robotic dissection of the right internal thoracic artery through median sternotomy

Fabio Biscegli Jatene et al. Paulo Manuel Pêgo-Fernandes Ramez Anbar Fábio Antonio Gaiotto … Marcello S. Barduco Roberto Kalil Filho

The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma. The totally endoscopic myocardial revascularization, assisted by the DaVinci robot (Intuitive Surgical, Sunnyvale, California) is feasible and the learning process must be carried out in steps. The first step is the preparation of the left internal thoracic artery, through the totally endoscopic approach. The case presented here proposes the dissection of the right internal thoracic artery through complete sternotomy. It proposes a new step directed at the totally endoscopic procedure, aiming at decreasing the injuries caused by the learning curve.

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ABC

Case Report

Coronary artery bypass surgery in patients with anomalous circumflex artery

Walter J. Gomes et al. Rodrigo P. Paez Francisco A. Alves

The anomalous origin of the circumflex artery (Cx) is uncommon and presents course variations that might make the coronary artery bypass surgery (CABG) difficult. Two patients presenting unstable angina were submitted to coronary angiography that disclosed tri-vessel disease and presence of Cx with an anomalous origin and retroaortic course with severe stenosis. Both patients underwent CABG with use of bilateral internal thoracic artery (ITA) grafts. Therefore, CABG with bilateral ITA use is feasible in cases of an anomalous origin of the Cx artery. However, this finding may constitute an additional technical setback.

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Spasm of the Internal Thoracic Artery. Value of Echocardiography and Doppler in Long-term Follow-up

Prevalence of Atherosclerotic Lesions in the Left Internal Thoracic Artery, Evidenced by Selective Angiographic Findings

Abstract

Background:

Objectives:

Methods:

Results:

Conclusion:

Prophylactic Left Internal Mammary Artery Graft In Mildly-Stenosed Coronary Lesions. Still an Open Discussion

Left Internal Mammary Artery Graft-to-Pulmonary Artery Fistula

Robotic dissection of the right internal thoracic artery through median sternotomy

Coronary artery bypass surgery in patients with anomalous circumflex artery

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