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Abstract
Background: Coronary Artery Bypass Grafting (CABG) is one of the most frequently performed operations worldwide. Its application is expected to increase particularly in the developing world, incidence of coronary heat disease continue to rise.
Objectives: The aim of this study is to compare early outcomes of double grafts to LAD versus long patch in cases of double lesions of LAD.
Patients and methods: This prospective randomized comparative study was carried out between August 2006 and August 2008, in the department of cardiothoracic surgery, Zagazig University and Frontier life line hospital (Cherian Foundation) Chennai, INDIA. Including 52 patients for whom CABG Surgery was performed with overall number of 47 men (90.4%)) and 5 women (9.6). We compared two groups 25 patients in group (A), 27 patients in group (B) to either of whom patients were selected according to surgeon’s preference. Group (A) included CABG patients submitted to long saphenons patch technique on the LAD; while Group (B) included GABG patients. Results were evaluated in the perioperative & early perioperative period of 6 monthes.
Results: The mean duration of Bypass time was 103±28 minutes for group (a) and 116±38 minutes for group (B) (P = 0.17, NS) , with mean aortic cross- clamp time of Group (A) 66 ± 21.6 minutes versns 75 minutes for group (DNS) mean number of omastanotic points were 3.68 0.1 for group (a) and 4 0.2 for group (B) intraoperative inotopes was used to weam off CPB in 8 patients (32%) group (A) versus 10 patients (37%) group B. The length of arteriotomy for group (A) rein patch was 3.62 1.3 (range 2-7 cm). Mean ICU stay was 43.1 20 hours for group (A) 45.3 19.3 hour for mean hospital stay was 8.5 2.2 days for group (a) versus 9.3 1.8 days for group (B) (P=0.6) ECG changes of new MI occurred in one patients died in group (A) while 2 patients died in group (B) (P =0.05 ). After the immediate and short term 6 months follow up , both techniques are very promising in this challenging patient population, our study revealed comparable results with those of patients with non-diffuse coronary artery disease, but long follow up is needed.
Conclusion: The ideal choice for surgical management of double lesions (diffuse LAD) of the LAD has not been settled upon.