Surgical revascularization strategies of CAD involving dual left anterior descending artery

AbstractDual left anterior descending artery (LAD) is not an uncommon coronary artery anomaly. Preoperative identification of this anomaly in patients with coronary artery disease is important to develop strategies to ensure complete revascularization of the LAD territory. From April 1996 through February 2022, more than 16,500 patients underwent isolated coronary artery bypass surgery (CABG) by our team. Retrospective review of the angiographic and operative records of these patients revealed 85 cases with stenosis of the dual LAD system. The incidence of dual LAD in patients undergoing CABG is 0.51%. Among the 85 patients, 59 (69.4%) had stenosis of both long and short LADs, whereas the remaining 26 (30.5%) had stenosis of either of the LADs. Among the 59 patients who had stenosis of both the LADs, 26 (44.1%) received a left internal thoracic artery (LITA) sequential graft to bypass both the LADs and two received a LITA-LITA baby-Y graft. And in 31 (52.5%) patients, the longer LAD was revascularized with LITA and the other LAD with saphenous vein graft.
Source: Indian Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research