AI Article Synopsis
- The study reviews the literature on coronary artery bypass grafting (CABG) for adults with an anomalous origin of coronary arteries, analyzing 31 studies with 62 patients included.
- Most patients were middle-aged, with common anomalies being the right coronary artery arising from the left sinus and the left coronary artery from the pulmonary artery.
- The findings suggest CABG is effective with low mortality and that using arterial grafts and ligation of the native artery could enhance long-term success rates.
Article Abstract
Objective: To review the available literature on the use of coronary artery bypass grafting (CABG) as a treatment option for anomalous origin of coronary artery in adults.
Methods: A systematic literature search was performed in March 2023 (including Ovid MEDLINE, Ovid Embase, and the Cochrane Library databases) to identify studies reporting the use of CABG in adult patients with anomalous origin of coronary artery.
Results: A total of 31 studies and 62 patients were included, 32 patients (52%) were women, and the mean age was 45.1±16.1 years. The most common coronary anomaly was the right coronary artery arising from the left coronary sinus in 26 patients (42%), followed by an anomalous left coronary artery from the pulmonary artery in 23 patients (37%). A total of 65 conduits were used in 61 patients, and 1 case report did not report conduit type. Reported grafts included saphenous vein (23 of 65 [35.4%]), left internal thoracic artery (15 of 65 [23.1%]), right internal thoracic artery (23 of 65 [35.4%]), and radial artery (2 of 65 [3.1%]); right gastroepiploic artery and basilic vein were used once (1.5%) each. Ligation of the native coronary artery was performed in 42 (67.7%) patients. Patient follow-up was available in 19 studies with a mean of 31.2 months. Only 1 operative mortality was reported.
Conclusions: Based on the limited available data, CABG can be performed with good early results. Use of arterial conduits and ligation of the native coronary artery may improve long-term graft patency.
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| http://dx.doi.org/10.1016/j.hlc.2023.09.014 | DOI Listing |
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