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Acute Lower Limb Ischemia After Coronary Artery Bypass Grafting

2015; Elsevier BV; Volume: 29; Issue: 6 Linguagem: Inglês

10.1053/j.jvca.2014.10.014

1532-8422

Clémence Le Tanneur, Nicolas Mongardon, Hakim Haouache, Nizar Allouche, Pierre Andrivet, Lauriane Auvergne, Rabih Houballah, Costin Radu, Gilles Dhonneur,

Cardiac and Coronary Surgery Techniques

THE INTERNAL MAMMARY ARTERY (IMA) is used as the conduit of choice in coronary artery bypass grafting (CABG) due to its superior long-term outcomes compared to venous grafts. 1 Dimitrova K.R. Hoffman D.M. Geller C.M. et al. Arterial grafts protect the native coronary vessels from atherosclerotic disease progression. Ann Thorac Surg. 2012; 94: 475-481 Abstract Full Text Full Text PDF PubMed Scopus (129) Google Scholar , 2 Poston R. Gu J. Brown J. et al. Hypercoagulability affecting early vein graft patency does not exist after off-pump coronary artery bypass. J Cardiothorac Vasc Anesth. 2005; 19: 11-18 Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar The IMA collateralizes to the external iliac artery by anastomosis with the inferior epigastric artery. In patients with chronic aortoiliac occlusion, arterial perfusion of the lower limbs may be supplied mostly by this collateral pathway. 3 Arnold J.R. Greenberg J.D. Clements S. Internal mammary artery perfusing the Leriche׳s syndrome. Ann Thorac Surg. 2000; 69: 1244-1246 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar , 4 Kitamura S. Inoue K. Kawachi K. et al. Lower extremity ischemia secondary to internal thoracic-coronary artery bypass grafting. Ann Thorac Surg. 1993; 56: 157-159 Abstract Full Text PDF PubMed Scopus (33) Google Scholar In this case report, the authors describe the occurrence of acute bilateral lower limb ischemia following CABG using bilateral IMA grafts in a patient with severe aortoiliac occlusive disease.