HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Martin Misfeld Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Misfeld, M. Search for Related Content PubMed PubMed Citation Articles by Misfeld, M. Related Collections Coronary disease Related Article

Ann Thorac Surg 2006;82:1451
© 2006 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Invited commentary

Clinic of Cardiac Surgery, University Clinic of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, Luebeck, 23538 Germany

(Email: martinmisfeld{at}yahoo.com).

Di Giammarco and colleagues [1] evaluate the safety and efficacy of off-pump left internal mammary artery to an occluded left anterior descending artery through a left anterior small thoracotomy. Overall survival, freedom from cardiac death, reintervention, and major adverse cardiac event are notably good at follow-up.

Although this surgical strategy has been described before, the authors address a topic that is still of immense importance in the era in which patients desire treatment by less invasive procedures. If a patient is asked what kind of procedure he prefers for his single vessel disease, he will favor catheter intervention. Re-stenoses after drug eluting stents is less compared with balloon angioplasty and bare metal stents. However, the mortality rate has not been improved and patients with chronically occluded coronary arteries represent a challenging patient population for angioplasty. In addition, published results so far do not reach the success rates of clinical outcomes after coronary artery bypass grafting. Alternative strategies featuring minimally invasive surgical access for revascularization, such as the one described here, may convince patients to choose the procedure with the best long-term results.

Although there are parts in the article worthy of discussion, the article is an important contribution to the discussion of therapeutic options available to patients with occluded single vessel disease in experienced centers.

	References

Top References

 

1. Di Giammarco G, Pano M, Giancane M, Di Francesco A, Di Mauro M. Off-pump revascularization of chronically occluded left anterior descending artery through left anterior small thoracotomy: early and late angiographic and clinical follow-up Ann Thorac Surg 2006;82:1446-1451.[Abstract/Free Full Text]

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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Martin Misfeld Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Misfeld, M. Search for Related Content PubMed PubMed Citation Articles by Misfeld, M. Related Collections Coronary disease Related Article