Journal «Angiology and Vascular Surgery» • 

1999 • VOLUME 5 • №3

CAN MAMMARY-TO-CORONARY ARTERY BYPASS BE RECOMMENDED FOR PATIENTS WITH MULTIFOCAL ATHEROSCLEROSIS?

Yu.V. Belov, A.B. Stepanenko, E.B. Rosseilkin
Department of Aora and Aortic Branches Surgery,
Russian Scientific Center of Surgery Russian Academy of Medical Sciences,
Moscow, Russia

Along with superior long-term results of mammary-coronary bypass (MCB) compared with aortocoronary shunting, this procedure can achieve short-term functional amelioration when atherosclerotic progression takes place in proximal segments of subclavian artery. This statement is illustrated by a case report of patient who underwent MCB to anterior intraventricular artery (AIVA) and 4 years later suffered from recurrent angina pectoris and myocardial infarction in AIVA area. Angiography revealed occlusion of proximal segment of left subclavian artery; internal mammary artery (IMA) was not visualized. Endarterectomy of left IMA ostium and left subclavian-carotid grafting were performed. Postoperative course was uneventful. Control angiography demonstrated patency of left carotid artery, left IMA, reconstruction area, AIVA. Electrocardiography showed no sings of myocardial ischemia. Nine months postoperatively angina pectoris was not detected. Authors conclude that in cases of multifocal atherosclerotic lesions the use of IMA for MCB can be a potential threat for cardiac function because of progressive atherosclerosis of subclavian artery.

KEY WORDS: Mammary-to-coronary artery anastomosis, subclavian artery occlusion.

P. 107-111

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