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Ann Thorac Surg 1997;64:883
© 1997 The Society of Thoracic Surgeons

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Correspondence

What to Do With Surgical Coronary Patients Who Have Minimal LAD Disease?

Department of Cardiac Surgery Po Box 1347 Al Hada Armed Forces Hospital Taif, Saudi Arabia

To the Editor:

Coronary surgeons are faced every now and then with patients who have significant and multiple coronary artery disease involving most or all coronary vessels except the left anterior descending coronary artery, which appears to have angiographically minimal disease or minor irregularity. We used not to bypass such left anterior descending artery lesions, but we have noticed a higher incidence of early postoperative irritability, arrhythmias, intraaortic ballon pump use, and myocardial infarction, which affected both morbidity and mortality.

To explore the problem, we have found intraoperatively that such patients have more than the expected angiographic left anterior descending artery disease and most of them have significant longitudinal, multiple atheromatous plaques extending all along the left anterior descending artery. We recommend revascularizing the left anterior descending artery with the internal mammary artery to avoid postoperative complications and to achieve the best short-term and long-term results [1–3].

References

1. Jones EL, Weintraub WS, Craver JM, et al. Coronary bypass surgery: is the operation different today? J Thorac Cardiovasc Surg 1991;101:108–15.[Abstract]
2. Lytle BW, Loop FD, Cosgrove DM, et al. Long term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts. J Thorac Cardiovasc Surg 1985;89:248–58.[Abstract]
3. Okies JE, Page US, Bigelow JC, et al. The left internal mammary artery: the graft of choice. Circulation 1984;70(Suppl 1):213–21.

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This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Khalid E. Al-Ebrahim Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Al-Ebrahim, K. E. Search for Related Content PubMed PubMed Citation Articles by Al-Ebrahim, K. E.