Intraoperative Observations for the Patients with Angiographically Invisible Distal Portion of Occluded LAD Surgical Results and Operative Indications

Noyan Temuçin OĞUŞ, Erdeşir NASERİ, Sinan ARSAN, *Suat ALTINMAKAS, *Oral PEKTAŞ, **Muhsin TÜRKMEN

Maltepe Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı
^*Maltepe Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı
^**Koşuyolu Kalp ve Araştırma Hastanesi

Failure to visualize LAD angiographically is a debatable condition in coronary bypass surgery. In our clinic, 52 patients underwent CABG operation with no visualization of distal LAD. They were classified according to the intraoperative findings: Group I (44 patients 84.6 %) with suitable LAD luminal diameter, Group II (8 patients 15.4 %) with unsuitable luminal diameter which couldn't be revascularized using conventional bypass techniques. In group I; patients are younger, the percentage of male patients is higher (72.8 % versus 12.5 %) and left ventricular functions are better. advanced age, female gender, poor left ventricular functin, hypertension, Diabetes Mellitus and extracardiac atherosclerosis were found to be the risk factors for diffuse obliteration of distal LAD. Global operative mortality is 5.7 %. In a follow-up period of 11±3 months there was no recurrence of angina and left ventricular functions improved by this time.

This is the first review of coronary bypass operation in patients with invisible LAD on angiography. We believe that inability to visualize distal portion of occluded LAD shouldn't be a contraindication to coronary bypass operation.

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