Follow-Up of Patients Operated on With Arterial Patch Angioplasty of the Left Main Coronary Artery Anders Jönsson, MD, Jens Jensen, MD, PhD, Arne Olsson,

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Follow-Up of Patients Operated on With Arterial Patch Angioplasty of the Left Main Coronary Artery Anders Jönsson, MD, Jens Jensen, MD, PhD, Arne Olsson, MD, Peter Holm, MD, PhD, Jan Liska, MD, PhD The Annals of Thoracic Surgery Volume 81, Issue 4, Pages 1249-1255 (April 2006) DOI: 10.1016/j.athoracsur.2005.11.043 Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative angiographic image of a circular left main coronary artery stenosis. The Annals of Thoracic Surgery 2006 81, 1249-1255DOI: (10.1016/j.athoracsur.2005.11.043) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Postoperative angiographic image of the circular left main coronary artery stenosis illustrated in Figure 1 with the arterial patch reaching just proximal of the bifurcation. The Annals of Thoracic Surgery 2006 81, 1249-1255DOI: (10.1016/j.athoracsur.2005.11.043) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Intravascular ultrasound image demonstrating a transversal cross-section of a left main coronary artery after arterial patch angioplasty, with the arrow indicating the patched side. The Annals of Thoracic Surgery 2006 81, 1249-1255DOI: (10.1016/j.athoracsur.2005.11.043) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Arterial patch angioplasty of the left main coronary artery (LMCA) with the aortic transsection technique. (A) Transsection of the ascending aorta and incision into the left coronary ostium. (B) The incision is further extended through the roof of the LMCA, when necessary, all the way to the bifurcation. (C) A trimmed arterial patch consisting of a proximal segment of the right internal mammary artery is sutured onto the lateral portion of the incised LMCA. (D) The medial part of the incision in the LMCA is closed after retracting the proximal part of the aorta in a caudal direction. The Annals of Thoracic Surgery 2006 81, 1249-1255DOI: (10.1016/j.athoracsur.2005.11.043) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions