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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 1, January/February 2019
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AFRICA
artery disease, there is no need for endarterectomy during the
LITA onlay patchplasty.
2
The risk of thrombosis is minimised
since the endothelial layer is not damaged in LITA onlay
patchplasty without performing endarterectomy. We routinely
treat our patients with dual antiplatelet therapy with clopidogrel
and acetylsalicylic acid and we have not encountered any
complications originating from the anastomotic line.
Our study has the limitations inherent in a retrospective study.
The absence of a control group and postoperative coronary
angiography are limitations. The number of patients was low
because it was a single-centre study. In our department we
perform priority surgery on the beating heart in all patients, even
those with diffuse coronary lesions. Therefore we did not have
sufficient patients operated on with cardiopulmonary bypass
to create a control group. Randomised, controlled studies are
needed to confirm the results of our study.
Conclusion
With consecutive LAD lesions, LITA onlay patchplasty can be
performed after long-segment arteriotomy for increased perfusion
of myocardial tissue. Application of this method without
endarterectomy limits the risk of early-stage graft thrombosis
as it reduces the risk of endothelial damage. Application of
LITA onlay patchplasty without endarterectomy on the beating
heart is a useful surgical approach that provides acceptable early
results in patients with consecutive LAD disease.
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