BACKGROUND AND AIM OF THE STUDY: Coronary venous arterialization with a catheter-based system has renewed interest in this therapy for the revascularization of areas that cannot be treated by conventional coronary artery bypass graft or angioplasty. However, the durability of the venous system to supply arterial pulsatile blood is still a matter of debate. METHODS: We report the outcome of four patients that underwent elective coronary artery bypass grafting of the left coronary system and in addition had selective arterialization of the posterior vein due to ungraftable poor distal vessels of the right coronary artery. Complete revascularization of the left side was achieved using the left internal mammary artery and the left radial artery. One vein graft was anastomosed to the postero-inferior vein in three cases and to two postero-inferior veins in the fourth case. RESULTS: No perioperative complications were observed and after 24 months of follow-up; all patients were angina free and without any symptoms of heart failure. The 24 months follow-up also showed (i) normal exercise test in all patients, (ii) ischemic changes in dobutamine stress echocardiography in the areas corresponding with the venous arterialization in two cases, and (iii) occlusion of the graft supplying the coronary veins in the three patients that accepted to undergo selective angiogram. CONCLUSION: In conclusion, these results indicate that arterialization of the coronary veins is not durable and that it is unlikely that this strategy is a useful technique for the revascularization of the ischemic myocardium.
BACKGROUND AND AIM OF THE STUDY: Coronary venous arterialization with a catheter-based system has renewed interest in this therapy for the revascularization of areas that cannot be treated by conventional coronary artery bypass graft or angioplasty. However, the durability of the venous system to supply arterial pulsatile blood is still a matter of debate. METHODS: We report the outcome of four patients that underwent elective coronary artery bypass grafting of the left coronary system and in addition had selective arterialization of the posterior vein due to ungraftable poor distal vessels of the right coronary artery. Complete revascularization of the left side was achieved using the left internal mammary artery and the left radial artery. One vein graft was anastomosed to the postero-inferior vein in three cases and to two postero-inferior veins in the fourth case. RESULTS: No perioperative complications were observed and after 24 months of follow-up; all patients were angina free and without any symptoms of heart failure. The 24 months follow-up also showed (i) normal exercise test in all patients, (ii) ischemic changes in dobutamine stress echocardiography in the areas corresponding with the venous arterialization in two cases, and (iii) occlusion of the graft supplying the coronary veins in the three patients that accepted to undergo selective angiogram. CONCLUSION: In conclusion, these results indicate that arterialization of the coronary veins is not durable and that it is unlikely that this strategy is a useful technique for the revascularization of the ischemic myocardium.
Authors: Frank Harig; Joachim Schmidt; Evelyn Hoyer; Sebastian Eckl; Edytha Adamek; Dirk Ertel; Ehab Nooh; Kerstin Amann; Michael Weyand; Stephan M Ensminger Journal: Comp Med Date: 2011-04 Impact factor: 0.982
Authors: Frank Harig; Evelyn Hoyer; Dirk Labahn; Joachim Schmidt; Michael Weyand; Stephan M Ensminger Journal: Comp Med Date: 2010-02 Impact factor: 0.982
Authors: Maria Munz; Mário J Amorim; Miguel Faria; Corália Vicente; Ana Pinto; Joana Monteiro; Adelino F Leite-Moreira; Artur P Águas Journal: Interact Cardiovasc Thorac Surg Date: 2012-11-30