Successful Total Arterial Coronary Artery Bypass Grafting surgery in Elderly [ > 70 yrs age] with Severe Left Main Stem Block. [At Lilavati Hospital]

Dr. Pavan Kumar, Dr. S. Borkar, Dr. Amit Modi, Dr. N. Kothari, Dr. Asmita Hegde

Department Of Cardiac Surgery

A 72 yr old gentleman was admitted in Lilavati Hospital with coronary angiography done elsewere. Angiography showed severe LM 90%, RCA 90%, RAMUS 99%, block with preserved L. V. function.

He underwent CABG x 3 [ LAD – LIMA, RAMUS – RADIAL , RCA – RIMA] total arterial type CABG on 6th April,2004 by Dr. Pavan Kumar.

His operative and post operative period was smooth and uneventful .

Elderly patients beyond 70yrs have high incidence sternal nonunion and infection. Here
Skeletonized IMA were used with very small in thickness pedicle to minimize sternal devascularisation. Pre – operative Radial Doppler studies suggested healthy radial artery which could be used for C.A.B.G.

With this kind of techniques it is safe to do total arterial CABG which has proven better long term results.