Mid-term patency of the inverted left internal thoracic artery conduit.

In order to expand the revascularization of the left anterior descending coronary artery, we have applied the inverted left internal thoracic artery (left internal thoracic artery [LITA] transected near its origin, thus supplied by retrograde flow from superior epigastric and musculophrenic arteries) in carefully selected cases (four patients). The 64-slice multidetector row computed tomographic scans performed postoperatively (range, 6 to 40 days), as well as the scans performed in the follow-up period (range, 18 to 35 months) showed preserved inverted LITA conduits with thrombolysis in myocardial infarction (TIMI) 3 flow in all patients.

Repair of separated coronary segments resulting from a complicated coronary endarterectomy.

Cardiac surgeons are treating an increasing number of patients with diffuse coronary artery disease that requires the use of alternative surgical techniques. We present a patient who had a technically unsatisfactory endarterectomy of the left anterior descending coronary artery. We were left with only 3 segments of properly endarterectomized coronary bed areas, separated with totally disintegrated coronary bed portions.