Deep Intramuscular Left Anterior Descending (LAD) Artery: Implications for a Young Surgeon Performing Coronary Artery Bypass Surgery

Venkat R Machiraju and Dhaval M Trivedi

Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15237, USA

^*Correspondance to: Venkat R. Machiraju 

 PDF  Full Text DOI: 10.25107/2474-1647.1495

Abstract

Dissecting out a deep intramuscular Left anterior descending coronary artery (DIMLAD) is one of the most difficult aspects of coronary artery bypass surgery. About 17-20% of the patients presenting for surgical revascularization have a deep lying LAD in the interventricular septum. Coronary artery bypass surgery (CABG) is the most commonly performed operation by the adult cardiac surgeon and is also generally performed by the junior most cardiac surgeon as they start their surgical practice. It is of concern that surgeons who do not have the surgical skill to dissect out a DIMLAD will perform their anastomosis in the distal segment of the LAD where it comes to the surface. In this location it can be of small caliber, be affected by atherosclerotic disease and pose technical difficulties due to its small size to perform a durable anastomosis.

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Cite the article

Machiraju VR, Trivedi DM. Deep Intramuscular Left Anterior Descending (LAD) Artery: Implications for a Young Surgeon Performing Coronary Artery Bypass Surgery. Clin Surg. 2017; 2: 1495.