Surgical management of diffusely diseased coronary arteries

  • Gutti Ramasubrahmanyam
  • Karthik Panchanatheeswaran
  • Tej Kumar Varma Kalangi
  • Goli Nagasaina Rao
Original Article



To analyze the outcomes of long segment coronary anastomoses in patients with diffusely diseased coronary arteries and compare them with medically managed patients.


We retrospectively studied patients with diffusely diseased coronary arteries who underwent complete revascularization with long segment coronary reconstruction (> 2 cm in length) from February 2015 to November 2016. During the same time, patients who opted medical management for diffuse coronary artery disease were also studied.


Forty-one patients underwent long segment coronary anastomoses for diffuse coronary artery disease with either left internal thoracic artery (LITA) or saphenous vein conduits. In 15 (36.58%) patients, the anastomosis length was more than 4 cm. In 41 patients, left anterior descending (LAD) artery had long segment anastomosis and in four patients, posterior descending artery (PDA) had long segment anastomosis. Twenty-one patients were operated off-pump and the rest were operated on cardiopulmonary bypass. The post-operative recovery of all the patients was uneventful. There were no procedural complications. There was one mortality due to cerebrovascular accident (2.43%). During the study period, 50 patients with diffuse coronary artery disease were under medical management. In the medically managed group, there were seven death during the follow-up, with mortality rate of 14%.


Patients with diffuse disease coronary diseases, who are surgically managed, have a better outcome when compared to the medically managed patients with acceptable morbidity and mortality.


Coronary artery bypass grafting Diffuse coronary artery disease Surgical management 


Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Individual consent for the study was waived by the committee as it was a retrospective study. All the patients provided informed written consent for the surgery.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2019

Authors and Affiliations

  • Gutti Ramasubrahmanyam
    • 1
  • Karthik Panchanatheeswaran
    • 1
  • Tej Kumar Varma Kalangi
    • 1
  • Goli Nagasaina Rao
    • 1
  1. 1.Department of Cardiothoracic SurgeryCare HospitalsHyderabadIndia

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