Top

Published in:

Open Access 01-12-2008 | Case report

Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report

Authors: Thanos Athanasiou, Emmanouil I Kapetanakis, Christopher Rao, Loris Salvador, Ara Darzi

Published in: Journal of Cardiothoracic Surgery | Issue 1/2008

Abstract

With the proliferation of minimally invasive cardiac surgery a number of alternative inflow sites for coronary artery bypass grafting have been utilized, especially in higher risk patients. The use of axillary-coronary artery bypass is a safe and effective alternative especially in the case of patients requiring redo coronary revascularization. However, the length and convoluted course of the axillary-coronary vein graft makes is susceptible to twisting, trauma and neointimal hyperplasia. We therefore report a case of an axillary-coronary artery bypass in a high risk patient in which a Dacron conduit was used to externally support and protect the vein graft to the left anterior descending artery. Surgical technique and considerations are presented and discussed.

Available only for authorised users

Coulson AS, Bakhshay SA: Clinical Concepts: Subclavian Artery Origin for a Coronary Bypass Graft. Contemp Surg. 1997, 50: 65-66.

Knight WL, Baisden CE, Reiter CG: Minimally Invasive Axillary-coronaryArtery Bypass. Ann Thorac Surg. 1997, 63: 1776-1777. 10.1016/S0003-4975(97)00311-1.CrossRefPubMed

Coulson AS: Minimally Invasive Coronary Artery Surgery. J Thorac Cardiovasc Surg. 1998, 115: 486-487.PubMed

Shabb B, Khalil I: Minimally Invasive Axillary-Left Anterior Descending Saphenous Vein Bypass. Heart Surg Forum. 1999, 2: 254-255.PubMed

Bonatti J, Coulson AS, Bakhshay SA, Posch L, Sloan TJ: The Subclavian and Axillary Arteries as Inflow Vessels for CoronaryArtery Bypass Grafts: Combined Experience from Three Cardiac Surgery Centers. Heart Surg Forum. 2000, 3: 307-311.PubMed

Wolf RK, Miyaji K, Flege JB: Saphenous Vein Graft for Minmally Invasive Coronary Bypass Surgery. J Thorac Cardiovasc Surg. 1999, 117: 822-10.1016/S0022-5223(99)70305-3.CrossRefPubMed

Flege JB, Wolf RK: Minimally Invasive Axillary-coronary Artery Bypass. Heart Surg Forum. 2000, 3: 238-240.PubMed

Magovern JA, Hunter TJ, Yoon PD: Clinical Results with Left Axillary to Left Anterior Descending Coronary Artery Bypass. Ann Thorac Surg. 2001, 71: 561-564. 10.1016/S0003-4975(00)02460-7.CrossRefPubMed

Tarakji AM, Sinclair MC: Should Axillary Artery to Coronary Artery Bypass be Part of the Cardiac Surgeon's Armamentarium ?. Eur J Cardiothorac Surg. 2007, 32: 65-68. 10.1016/j.ejcts.2007.03.046.CrossRefPubMed

10.

Tovar EA, Blau N, Borsari A: Axillary Artery-coronary Artery Bypass Grafting. J Thorac Cardiovasc Surg. 1998, 115: 242-243. 10.1016/S0022-5223(98)70465-9.CrossRefPubMed

11.

Bonatti J, Ladurner R, Hangler H, Katzgraber F: Anatomical Studies Concerning Technical Feasibility of Minimally Invasive Axillo-coronary Bypass Grafting. Eur J Cardiothorac Surg. 1998, 14 (Suppl 1): S71-S75. 10.1016/S1010-7940(98)00109-2.CrossRefPubMed

12.

Bonatti J, Hangler H, Oturanlar D, Posch L, Sieb M, Salvador S, Krismer A, Voelckel W, Schwarz B, Lingnau W, Klima G, Mairinger T, Coulson AS: The Axillocoronary Bypass. Blood Flow and Short-term Graft Histology in a Porcine Model. Cardiovasc Surg (Torino). 2002, 43 (5): 625-631.

13.

Bonatti J, Hangler H, Oturanlar D, Posch L, Müller LC, Voelckel W, Schwarz B, Bodner G: Beating Heart Axillocoronary Bypass forManagement of the Untouchable Ascending Aorta in Coronary Artery Bypass Grafting. Eur J Cardiothorac Surg. 1999, 16 (Suppl 2): S18-S23. 10.1016/S1010-7940(99)00264-X.CrossRefPubMed

14.

Christenson JT, Schmuziger M, Simonet F: Re-operativeCoronary Artery Bypass Procedures: Risk Factors for Early Mortalityand Late Survival. Eur J Cardiothorac Surg. 1997, 11: 129-133. 10.1016/S1010-7940(96)01030-5.CrossRefPubMed

15.

Coulson AS, Glasgow EF, Bonatti J: Minimally Invasive Subclavian/Axillary Artery to Coronary Artery Bypass (SAXCAB): Reviewand Classification. Heart Surg Forum. 2001, 4: 13-25.PubMed

16.

Angelini GD, Bryan AJ, Williams HM, Soyombo AA, Williams A, Tovey J, Newby AC: Time-course of Medial and Intimal Thickening in PigVenous Arterial Grafts: Relationship to Endothelial Injury and Cholesterol Accumulation. J Thorac Cardiovasc Surg. 1992, 103: 1093-1103.PubMed

17.

Mehta D, George SJ, Jeremy JY, Izzat MB, Southgate KM, Bryan AJ, Newby AC, Angelini GD: External Stenting Reduces Long-termMedial and Neointimal Thickening and Platelet Derived Growth Factor Expression in a Pig Model of Arteriovenous Bypass Grafting. Nat Med. 1998, 4: 235-239. 10.1038/nm0298-235.CrossRefPubMed

18.

Violaris AG, Newby AC, Angelini GD: Effects of External Stenting on Wall Thickening in Arteriovenous Bypass Grafts. Ann Thorac Surg. 1993, 55: 667-671.CrossRefPubMed

Title: Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report
Authors: Thanos Athanasiou
Emmanouil I Kapetanakis
Christopher Rao
Loris Salvador
Ara Darzi
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2008
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/1749-8090-3-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2008

Large asymptomatic Left Atrial Myxoma with ossification: case report

Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate

Penetration of left and right atrial wall and aortic root by an Amplatzer atrial septal occluder in a nine year old boy with Marfan syndrome: Case report

Cardiac Valvular Inflammatory Pseudotumor

Intra-abdominal pectus bar migration – a rare clinical entity: case report

Successful surgical treatment of a giant coronary artery aneurysm presenting with recurrent profuse haemoptysis