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Ann Thorac Surg 1978;26:383-386
© 1978 The Society of Thoracic Surgeons

Articles

Saphenous Vein Bypass from the Aorta to the Anterior Interventricular Vein

Bernardo Treistman, M.D., Tulio A. Sulbaran, M.D., Denton A. Cooley, M.D.*

Divisions of Cardiology and Surgery of the Texas Heart Institute of St. Luke's Episcopal and Texas Children's Hospitals, Houston, TX.

Accepted for publication January 13, 1978.

* Address reprint requests to Dr. Cooley, Texas Heart Institute, P. O. Box 20345, Houston, TX 77025.

A patient is described who had myocardial revascularization with saphenous vein grafts. One of the grafts was inadvertently anastomosed to the anterior interventricular vein instead of the anterior descending coronary artery. He also underwent saphenous vein bypass to the right coronary artery and resection of a left ventricular aneurysm. The patient remained free of angina up to 3 1/2 years after operation, at which time he was seen with tachyarrhythmia and a continuous murmur. Coronary arteriography revealed patent bypass grafts to both the distal right coronary artery and the anterior interventricular vein.

Whether the patient benefited from the graft to the anterior interventricular vein remains indeterminable because of the successful bypass to the right coronary artery and the left ventricular aneurysmectomy. He did experience clinical improvement for 3 1/2 years, and the symptom when he was seen at our institution was tachyarrhythmia, not chest pain. Additionally, his exercise tolerance had improved markedly. We believe the potential advantages of bypass from the aorta to the coronary veins is still unexplored.




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