الفهرس 
Historical BackgroundOnly 14 pages are availabe for public view
 |  | from | 34 |  |  |
| | | from | 34 | | |
Abstract
Revascularization of the diffusely diseased coronary artery is a big challenge for both interventional cardiologists and cardiac surgeons.
Long reconstruction with or wihout endarterectomy is one of the coronary artery bypass grafting methods for treating severely or diffusely diseased coronary arteries. The greatest advantage of this method is that the myocardium supplied by the side branches of the diffusely diseased coronary artery can be revascularized simultaneously.
This study was aiming at comparing the short term results between long segmental reconstruction of the diffusely atherosclerotic LAD using saphenous vein patch with or without endarterectomy and conventional grafting.
This study included 90 patients divided into 2 groups:
group I: LAD reconstruction with saphenous vein patch with or without endarterectomy (45 patients).
group II: conventional grafting of diffusely athersclerotic LAD (45 patients).
Cardiac enzymes were done preoperatively and postoperatively at day 0, day 1 and day 2 followed by dobutamine echocardiography after 3 months.
Preoperative data was analyzed with no marked difference between the study and other data collected from other similar studies.
Operative data was analyzed with statistically significant difference between the two groups as regard ischemic time, cardiopulmonary bypass time which were more in the group I and the need for inotropic cardiac support which was more evident in group II. There were 5 patients underwent endarterectomy in group I.
Postoperative data was analyzed with statistically highly significant difference between the two groups as regard postoperative Troponin I in D2, CK-MB in D2, postoperative EF and SWMA.
The postoperative cardiac enzymes levels were increased in both groups but in group I they started to decline at the day 2 while in group II they continued to increase.
Follow up of patients 3 months after discharge by dobutamine echocardiography showed improvement of SWMA in both groups but more evident in group I.
The results were compared to similar studies in literature, and data showed no great difference, concerning preoperative risk factors, intraoperative events and postoperative complications.