Assessment of Left Ventricular Function and Coronary Artery Patency in Patients with Left Anterior Descending Coronary Artery Reconstruction by Internal Thoracic Artery

Elfiky, Abdallah; Serag, Amany; Soliman, Rafik Fekry Barsoom; Mina, Morad Bishay

doi:10.21608/ejhm.2025.418444.1829

Assessment of Left Ventricular Function and Coronary Artery Patency in Patients with Left Anterior Descending Coronary Artery Reconstruction by Internal Thoracic Artery

Document Type : Original Article

Authors

¹ Cardiology department - Faculty of Medicine Menoufia University

² Cardiology, Faculty of Medicine - Menoufia University - Shebin Elkom - Menoufia - Egypt

³ Cardiothoracic Surgery department, Faculty of medicine, Menoufia University

10.21608/ejhm.2025.418444.1829

Abstract

Background: Coronary artery bypass grafting (CABG) is a procedure that aims to revascularize coronary arteries, especially the left anterior descending (LAD) artery, improving survival and quality of life.
Aim: This study aimed to assess left ventricular function and coronary artery patency in cases undergoing reconstruction of the diffusely diseased LAD using 2D speckle tracking strain imaging echocardiography and CT Coronary angiography.
Patients and methods: This prospective observational research has been performed on 116 cases with coronary artery disease (CAD) at the Department of Cardiology, Menoufia University Hospital and the National Heart Institute between May 2023 and May 2025. The cases have been separated into 2 equal groups: Group I (n = 58), who underwent LAD artery reconstruction with a left internal thoracic artery (LITA) patch, and group II (n = 58), who underwent standard LITA–LAD bypass grafting.
Results: The study showed significant improvement in left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and longitudinal strain rate (LSr) at 6 and 12 months postoperatively compared to preoperative values in both groups, with greater improvement in left anterior descending artery (LAD) reconstruction patients. Operative, cross-clamp, and bypass times were shorter in the LAD reconstruction group, while postoperative complications, intensive care unit (ICU)/hospital stay, and LITA patency at follow-up were similar between groups.
Conclusion: LAD reconstruction with a LITA patch improved left ventricular function and reduced operative time versus standard CABG, without increasing complications or hospital stay.

Keywords

Main Subjects