CORONARY REVASCULARIZATION IN PATIENTS WITH DIFFUSE CORONARY ARTERY DISEASE

Abstract

One hundred and twenty patients suffering from angiographically determined severe diffuse multivessel coronary artery disease were included in this study. There were 98 males (81.7%) and the mean age was 63.65 ± 9.97 years. Sixty patients constituted (group!) and were subjected to conventional coronary artery bypass grafting (CABG). Thirty patients (group II) were subjected to coronary endarterectomy (CEA) as an adjunct to CABG. The decision to perfonn CEA was taken intraoperatively and thereafter, the patients were considered in group II seperately. Thirty patients (groupiii) were subjected to TMLR as an adjunct to CABG. The groups were not similar as regards the preoperative risk factors and co-morbidities, where the risk factors increased from group I to group II to group ill significantly. The average aortic cross-clamping time was 65.32 minutes being longest m group II. The average bypass time was 109.98 ± 42.18 being highest in group III. The patients received an average number of 3.89 ± 0.95 grafts per patient, being least in group III. In group II, one endmterectomy was done per patient. The left anterior descending coronm-y arte1-y (LAD) was endarterectornized in 18 patients (60%), the posterior descending coronary artery (PDA) in 4 (13.3%), and the right coronary artery (RCA) in 8 (26.7%). The left internal mammal)' artery (LIMA) on top of a saphenous vein (SV) patch was used to reconstruct the LAD in 3 pati ents (10%), while the LIMA was used directly in 10 (33.3%) and SV graft in th e rest. The degree of revasc ul arization was 98% ± 0.8%, 86% ± 0.7%, and 84% ±

0.8% for groups I, II, and III respecti vel y.