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Ann Thorac Surg 1999;67:1212
© 1999 The Society of Thoracic Surgeons

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Correspondence

Reply

^a Servicio de Cirugía Cardiaca, Hospital General Universitario de Alicante, C/Maestro Alonso 109, E-03010 Alicante, Spain

e-mail: jmeseguer{at}coma.es

To the Editor

There is no doubt that surgical angioplasty of the LMCA is a surgical challenge and is not free of morbidity and mortality risks, but it could be valuable in a few occasions. Complete arterial revascularization of all the left-side coronary vessels is the most appropriate surgical treatment for the LMCA stenosis but it is not strictly always achievable, due to anatomical variations or other reasons.

Some authors as Dion and coworkers [1] have obtained good immediate and midterm results with this technique. Moreover, recently, other authors have obtained encouraging midterm results using the coronary stem surgical plasty in children [2]. Fortunately we have no case of immediate operative technical failure in our 7 patients series [3], all of which were discharged without complications. In our experience we had two cases of restenosis when a pericardial patch was used to enlarge an LMCA stenosis that was not strictly ostial, which was similar to what occurred in the Dion series. We agree with Dr Dion that safenous vein patch angioplasty is applicable to disease which extends the ostium of the LMCA whenever the stenosis is not strongly calcified nor involves the distal stem bifurcation, even in the most common presence of ateromatous lesions.

References

1. Dion R., Elias B., El Khoury G., Noirhomme P., Verheist R., Hanet C. Surgical angioplasty of the left main coronary artery. Eur J Cardiothorac Surg 1997;11:857-864.[Abstract]
2. Bonnet D., Bonhoeffer P., Sidi D., et al. Surgical angioplasty of the main coronary arteries in children. J Thorac Cardiovasc Surg 1999;117:352-357.[Abstract/Free Full Text]
3. Meseguer J., Hurlé A., Fernández-Latorre F., Alonso S., Liamas P., Casillas J.A. Left main coronary artery patch angioplasty: midterm experience and follow-up with spiral computed tomography. Ann Thorac Surg 1998;65:1594-1598.[Abstract/Free Full Text]

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This Article Full Text (PDF) 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 Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Juan Meseguer Aquilino Hurlé Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Meseguer, J. Articles by Gomez-Plana, J. Search for Related Content PubMed Articles by Meseguer, J. Articles by Gomez-Plana, J. Related Collections Related Article